POLIMERO-COATED BARIATRIC CLAMP AND INSTALATION METHOD

Abstract

A bariatric clamp may include polymer overmolded substrate members forming elongated first and second portions, a loop portion having a flexible hinge, a clamping portion, and a coupling portion to retain the clamp in a closed position for dividing the stomach;One method for installation may include creating an opening in the patient's abdominal cavity to access the stomach, removing tissue attached to adjacent areas of the stomach where the clamp will be positioned, positioning the clamp in an open position where the first ends of the first and second elongated portions are open to each other, inserting the clamp into the abdominal cavity in the open position and the first and second elongated portions of the clamp pass separately through the opening into the abdominal cavity, positioning the first and second elongated portions adjacent to the first and second sides of the stomach, and closing the clamp to divide the stomach.

Description

Overmolded Polymer Bariatric Clamp and Installation Method CROSS REFERENCE TO RELATED APPLICATIONS Pursuant to 35 USC §119(e), this application claims priority from, and hereby incorporates by reference for all purposes, U.S. Provisional Patent Application Serial No. 61 / 681,601, entitled Polymer Overmolded Bariatric Clamp and Installation Tool, filed on August 9, 2012, and U.S. Provisional Patent Application Serial No. 61 / 798,128, entitled Polymer Overmolded Bariatric Clamp and Method of Installing, filed on March 15, 2013. FIELD OF INVENTION This description refers in general to surgical forceps and surgical forceps installation tools. BACKGROUND OF THE INVENTION The statements in this section only provide background information related to the present description and cannot constitute prior art. Recently, there has been increasing interest in the use of surgical forceps to divide sections of the stomach. An example of a bariatric surgical forceps can be found in Jacobs et al., U.S. Patent Application No. 11 / 984,452, Jacobs et al., U.S. Patent Application No. 11 / 797,537, and Jacobs et al., U.S. Patent Application No. 13 / 017,666. The aforementioned patent applications are incorporated herein by reference in their entirety for any purpose. BRIEF DESCRIPTION OF THE INVENTION In one embodiment, a method for installing a bariatric clamp having at least a first elongated portion, a second elongated portion, and a flexible hinge, the method comprises: creating an opening in a patient's abdominal cavity to access the patient's stomach; removing tissue attached to an external surface of the adjacent areas of the stomach where the bariatric clamp will be positioned; positioning the bariatric clamp in an open position such that a first end of the first elongated portion and a first end of QZAQnn / l 7P7 / E / YILI the second elongated portion are open to one another, and a second end of the first elongated portion and the second end of the second elongated portion are linked by one or more members including the flexible hinge; insert the bariatric clamp into the abdominal cavity through the opening while the clamp is positioned in the open position, and wherein the first elongated portion and the second elongated portion of the bariatric clamp pass separately through the opening into the abdominal cavity; position the second elongated portion of the bariatric clamp adjacent to a portion of the outer surface of a second side of the stomach; position the first elongated portion of the bariatric clamp adjacent to a portion of the outer surface of a first side of the stomach;and close the bariatric clamp to apply pressure to portions of the outer surfaces of the stomach to at least partially divide a cavity inside the stomach. In another embodiment, a bariatric clamp having a polymer overmolding comprises: a first elongated portion having a first substrate member disposed, at least partially, within the first elongated portion, the first elongated portion including a first adjustable portion; a second elongated portion having a second substrate member disposed, at least partially, within the second elongated portion, the second elongated portion including a second adjustable portion; a looping portion having a first looping substrate member, a second looping substrate member, and a flexible hinge formed from the polymer overmolding at a proximal end of the bariatric clamp, the looping portion joining the first and second elongated portions; a clamping portion disposed toward a distal end of the second elongated portion;and a coupling portion disposed towards a distal end of the first elongated portion, the coupling portion being operable to engage the clamping portion to retain the surgical clamp in a closed position. Another embodiment provides a bariatric clamp comprising: a first elongated member having a coupling portion disposed at a first end of the first elongated member and a first receiving portion disposed toward a second end of the first elongated member; a second elongated member having a clamping portion disposed at a first end of the second elongated member and a second receiving portion disposed toward a second end of the second elongated member; and a loop member having a first retaining feature operable for coupling the loop member to the first receiving portion of the first elongated member, and having a second retaining feature operable for coupling the loop member to the second receiving portion of the second elongated member;wherein the first elongated member and second elongated member comprise a division-forming section of the bariatric clamp, and the loop member comprises a passage-forming section of the bariatric clamp.; Ο7βαηη / ι 7Π7 / β / υιλι In yet another embodiment, the present description provides a bariatric clamp having a polymer overmolding, the bariatric clamp comprising: a first elongated portion having a first adjustable substrate member disposed, at least partially, within the first elongated portion; a second elongated portion having a second adjustable substrate member disposed, at least partially, within the second elongated portion; a looping portion having a flexible hinge formed from the polymer overmolding at a proximal end of the bariatric clamp, the looping portion joining the first and second elongated portions; a clamping portion disposed toward a distal end of the second elongated portion; and a coupling portion disposed toward a distal end of the first elongated portion, the coupling portion being operable to engage the clamping portion to retain the surgical clamp in a closed position. Additional modalities and devices, including other areas of applicability, will become apparent from the description provided herein. It should be understood that the description and specific examples are intended for illustrative purposes only and are not intended to limit the scope of this description in any way. BRIEF DESCRIPTION OF THE FIGURES For a more complete understanding of various embodiments of the present invention and its advantages, reference is now made to the following brief description, taken in conjunction with the accompanying Figures and detailed description, where similar reference numbers represent similar parts, and in which: Figure 1 is a view of a modality of a surgical clamp coupled with a modality of a surgical clamp installation tool having an articulating head; Figures 2A to 2K are a set of views illustrating the coupling of the surgical clamp to the articulating head of the surgical clamp installation tool in Figures 2A, 2B, and 2C, and the driving of the clamp in Figure 2D to a closed position in Figure 2E, and illustrating a six-sided view of the clamp, including a top view in Figure 2F, a left side view in Figure 2G, a bottom view in Figure 2H, a right side view in Figure 21, a view looking towards the distal end in Figure 2J, and a view looking towards the proximal end in Figure 2K; Figures 3A to 3F are a set of views illustrating the six-sided surgical clamp installation tool with the right side of the shown handle housing removed, including a left side view in Figure 3A, a top view in Figure 3B, a right side view in Figure 3C, a bottom view in Figure 3D, a view looking towards the distal end in Figure 3E, and a view looking towards the proximal end in Figure 3F; Figure 4A is a perspective view illustrating an exemplary surgical clamp installation tool with the right side of the shown handle housing removed; Figures 4B, 4C, 4D, and 4E provide side section views of various aspects of one modality of the surgical clamp installation tool; Figure 5 is a view of another modality of a surgical clamp coupled with another modality of a surgical clamp installation tool having an articulating head; Figure 6A is a top view of a rigid member having a male snap end of the clamp of Figure 5; Figure 6B is a side view of the rigid member of Figure 6A having the male snap end of the clamp of Figure 5; Figure 6C is a side view showing the male snap end of Figure 6B in greater detail; Figure 6D is a cross-sectional view showing a cross-section of the rigid member of Figure 6A; Figure 7A is a top view of a rigid member having a female snap end of the clamp of Figure 5; Figure 7B is a side view of the rigid member of Figure 7A having the female snap end of the clamp of Figure 5; Figure 7C is a side view showing the female snap end of Figure 7B in greater detail; Figure 7D is a cross-sectional view showing a cross-section of the rigid member of Figure 7A; Figure 8A is a top view of a spring member of the clamp of Figure 5; Figure 8B is a side view of the spring member of the clamp in Figure 5; Figure 8C is a close-up cross-sectional view showing a cross-section of the spring member of Figure 8B; Figure 8D is a view of the proximal end of the spring member of Figure 5; Figure 9A is a side view of the clamp in Figure 5; Figure 9B is a bottom view of the clamp in Figure 5; Q7AQAA / I 7A7 / B / YILI Figure 9C is a view of the proximal end of the clamp in Figure 5; Figure 9D is a perspective view of the clamp in Figure 5; Figure 10 is a view illustrating the surgical clamp installed in a substantially vertical position in a human stomach; Figure 11 is a flowchart illustrating one modality of a method for holding an internal organ; Figure 12 is a flowchart that illustrates another modality of a method for holding an internal organ; Figure 13 is a view of yet another modality of a surgical clamp coupled with yet another modality of a surgical clamp installation tool having an articulating head; Figure 14 is a perspective view of the surgical clamp in Figure 13; Figure 15A is a top view of the surgical clamp in Figure 14; Figure 15B is a left view of the surgical clamp in Figure 14; Figure 15C is an underside view of the surgical clamp in Figure 14; Figure 15D is a right-side view of the surgical clamp in Figure 14; Figure 15E is a proximal spring end in the surgical clamp view of Figure 14; Figure 15F is a distal hook end in the surgical clamp view of Figure 14; Figure 16 is a detailed view of a lower arm's hook end Q7RQnn / l 7Π7 / Β / ΥΙΛΙ of the surgical forceps in Figure 14; Figure 17A is a top view of the surgical clamp installation tool of Figure 13; Figure 17B is a left view of the surgical clamp installation tool of Figure 13; Figure 17C is a bottom view of the surgical clamp installation tool of Figure 13; Figure 17D is a right view of the surgical clamp installation tool of Figure 13; Figure 17E is a proximal handle end view of the tool. surgical clamp installation of Figure 13; Figure 17F is a distal head end in the surgical clamp installation tool view of Figure 13; Figure 18 is a detailed left side view of one handle end of the surgical clamp installation tool in Figure 13 in which the left side of the handle housing is shown removed; Figure 19 is a perspective view of the surgical clamp in Figure 14 having a silicone sleeve attached to it; Figure 20 is a perspective view of the silicone sleeve of Figure 19 in an uncoupled state; Figure 21 is a bottom view of the silicone case from Figure 20; Figure 22 is a proximal end view of the silicone sleeve of Figure 20; Figure 23 is a top view of the silicone case from Figure 20; Figure 24 is a left side view of the silicone sleeve in Figure 20; Figure 25 is a cross-sectional view of a distal end of the silicone sleeve of Figure 23; Figure 26 is a cross-sectional view of a proximal end of the silicone sleeve of Figure 24; Figure 27 is a cross-sectional view of a proximal end of Figure 23; Figure 28 is a flowchart illustrating a method for performing endoscopic surgery using the silicone sheath, clamp, and installation tool of Figures 13 to 27; Figure 29 is a perspective view of a one-piece surgical clamp modality comprising first and second substrate members overmolded in a polymeric material; Figures 30A and 30B illustrate respective side and perspective views of the one-piece surgical clamp of Figure 29, wherein the polymeric material is illustrated semi-transparently to show the first and second substrate members; Figures 31A and 31B illustrate the first and second substrate members respectively of the one-piece surgical clamp of Figure 29; Figure 32 illustrates another modality of the one-piece surgical clamp comprising first and second substrate members overmolded in a polymeric material; Figure 33 is a perspective view of one modality of an installation tool used to install a one-piece surgical clamp; Figures 34A, 34B and 34C illustrate various views of yet another modality of a one-piece surgical clamp comprising first and second substrate members overmolded in a polymeric material; Q7RQnn / l 7Π7 / Β / YILI Figure 35 is a perspective view of yet another modality of a one-piece surgical clamp comprising first and second substrate members overmolded in a polymeric material; Figure 36 is a flowchart illustrating one modality of a method for holding an internal organ; Figure 37 is a flowchart illustrating another modality of a method for holding an internal organ; Figure 38 is a perspective view of a modality of a two-piece surgical clamp comprising first and second substrate members, each overmolded in a polymeric material; Figures 39A, 39B, and 39C illustrate various views of the two-piece surgical clamp of Figure 38; Figure 40 is a perspective view of another modality of a two-piece surgical clamp comprising first and second substrate members, each overmolded in a polymeric material; Figures 41A to 41E illustrate various views of one type of bariatric clamp; Figures 42A and 42B illustrate a modality of an adjustable bariatric clamp in a retracted position and an extended position, respectively; Figures 43A and 43B illustrate a modality of an adjustable bariatric clamp in a retracted position and an extended position, respectively; Figures 44A and 44B illustrate a modality of an adjustable bariatric clamp having a ratchet feature, wherein the clamp is shown in a retracted position and an extended position, respectively; Figure 45 is a flowchart illustrating a method for installing a bariatric clamp; Figure 46 illustrates the bariatric clamp of Figures 41A to 41E in a substantially expanded position; Figure 47 is a flowchart illustrating a method for inserting a bariatric clamp into the patient's abdominal cavity; Figures 48A and 48B illustrate various views of a patient's stomach; Figures 49A and 49B illustrate various views of an exemplary modality of an alignment device; Figures 50A, 50B, 50C and 50D illustrate a modality of the bariatric clamp described in various closed and open positions; QZAQnn / l 7Π7 / Β / YΙΛΙ Figures 51A, 51B and 51C illustrate a modality of the bariatric clamp described in various contorted positions; Figure 52A illustrates one modality of the described clamp in a closed position, where the flexible hinge is in a compressed, or unexpanded, position; Figure 52B illustrates one modality of the described clamp in the closed position where the flexible hinge is stretched or expanded; Figures 53A to 53E illustrate various views of the coupling feature and clamping portion of one modality of the described bariatric clamp; Figure 54A illustrates a modality in which a modality of the described bariatric clamp is installed in a stomach and the first and second adjustable portions are articulated in such a way that the loop portion is angled in a first direction relative to the first and second elongated portions; Figure 54B illustrates another embodiment in which a modality of the described bariatric clamp is installed in a stomach and the first and second adjustable portions are articulated such that the loop portion is angled in a second direction with respect to the first and second elongated portions; and Figure 55 illustrates one modality of the described clamp that has suture needles embedded in the polymer overmolding. For Figures 5 through 9D, dimensions are given in inches. However, it should be understood that the various modalities are not limited to the dimensions shown. These dimensions are purely illustrative. For Figures 4B, 4C, 17A to 17D, 21, 23 and 24, the dashed lines indicate variability in the length of the dashed portions. DETAILED DESCRIPTION OF THE INVENTION The following description is merely illustrative and is not intended to limit the present description, application, or uses. It should be understood from the outset that although an exemplary implementation of the present invention is illustrated below, the present invention may be implemented using any number of techniques, whether currently known or existing. The present invention is in no way limited to the exemplary implementations, figures, and techniques illustrated below, including the exemplary design and implementations illustrated and described herein. Furthermore, the figures contained herein are not necessarily drawn to scale and may be provided in a variety of different dimensions, shapes, and configurations.The dimensions provided are provided only to illustrate a particular exemplary implementation, and shall in no way be construed to limit the present invention in the absence of an explicit citation of such dimensions and only with respect to the claim or claims that cite the dimension or dimensions. Referring to Figure 1, a embodiment of a surgical clamp 100 (also referred to herein as a bariatric clamp) is coupled with an embodiment of a surgical clamp installation tool 102. In these embodiments, the clamp 100 and the installation tool 102 are designed for performing bariatric surgery through a surgical trocar. The clamp 100, in a preferred embodiment, may be approximately 15 to 30 centimeters in length to accommodate the division of a human stomach. To accommodate insertion through a trocar, the closed clamp 100 will preferably have a diameter or circumference of less than 15 millimeters over its entire length or along most of its length. A non-handle section of the installation tool 102 intended for insertion through the trocar has a similar or smaller diameter.It is anticipated that other versions of the clamp and installation tool may be of different sizes. It is further anticipated that the clamp may be articulated in at least one plane to provide different angles and lengths of division for the stomach. It is also anticipated that other versions of the clamp and installation tool may be used to grasp other parts of the human body and / or to grasp other types of bodies or structures. Finally, it should be understood that installation tool 102 may be used to install surgical clamp versions other than those explicitly illustrated in the figures. Referring to Figure 2A, the surgical forceps 100 has two elongated limbs 104a and 104b. A loop portion 106 joins the two elongated limbs at a proximal end of the forceps 100 and deflects them into an open position at a distal end. As used herein, a loop is a bend, curve, hinge, corner angle, gap, fold, or similar structure. In some embodiments, the loop portion has one or more mating features, such as, for example, a slotted opening 108 as shown in Figure 2B. It should be understood that, in some embodiments, the mating features of the loop portion may be referred to as a joining feature.A snap mechanism, in one embodiment, has a male component 110 disposed on one of the two elongated members at the distal end, and a female component 112 disposed on the other of the two elongated members at the distal end. In particular, to partially divide a stomach during bariatric surgery, the space between the two elongated limbs 104a and 104b affects two or more sections of the clamp, as best shown in Figure 2E. At least one of these sections is a split-forming section 105a located closer to the distal end of the clamp 100 than to the proximal end. QZAQAÍVI 7Р7 / В / YΙЛΙ proximal of the clamp 100. At least one other of the sections is a passage-forming section 105b located closer to the proximal end of the clamp 100, such as near the loop portion 106, than the distal end of the clamp 100. In order to reduce injury to the divided organ, a filler material 116 may be connected to one or more of the two elongated limbs. For example, the filler material 116 may be connected to the elongated limb 104b at least at a location corresponding to at least part of the splitting section. In some embodiments, the filler material may be composed predominantly of silicone or entirely of silicone, or another polymeric material. It is also provided that the opposite limbs of the clamp may be equipped with handles to facilitate closure. In some embodiments, the coupling feature at the proximal end of the clamp 100 may be a slotted opening 108, as shown in Figure 2B, which is longer than it is wide. The length of the slotted opening may be oriented perpendicular or angled with reference to a longitudinal axis of the clamp 100. It is anticipated that other types of coupling features may be employed, such as a receptacle, loop, hook, clasp, chain, magnet, etc. In some embodiments, the male component 110 of the clasp at the distal end of the clamp may be an end of the elongated member 104a that flares out from a longitudinal axis of the clamp when the clamp is forced into a closed position. Accordingly, the female component 112 may be a loop attached to the end of the elongated member 104b and arranged to engage the male component 110 of the elongated member 104a when the clamp is forced into the closed position. This can be seen more clearly in relation to Figure 2E. It is anticipated that other types of clasp components may be employed, such as those found in a hinge, including a live hinge, hook and loop, spring ring, lobster or trigger, lever, tube, bolt and bolt hole, screw and threaded opening, or any other type of fastening arrangement. Returning to Figure 1 and referring generally to both Figure 1 and Figures 2A to 2K, the clamp 100, in use, engages with the installation tool by means of the slotted opening 108. For example, the installation tool 102 has an elongated member, such as a pull rod 138, having a proximal end and a distal end with a coupling feature. The distal end of the elongated member of the installation tool 102 engages with the proximal end of the clamp 100 through the slotted opening 108 of the loop portion 106. In some embodiments, the coupling feature takes the form of a T-bar 118. This T-bar 118 is dimensioned and shaped to allow its insertion through the slotted opening 108 to engage the clamp 100. QZAann / i znz / E / YiAi that other coupling features may have an X shape, and be sized for insertion through an X-shaped slot in the clamp. Other shapes are also possible. The installation tool 102 may include a lever radially coupled with the pull rod at its proximal end to a handle 122 that can be configured as a control wheel 120 extending out of the handle 122 of the installation tool 102 through an opening. While the T-bar 118 is inserted through the slotted opening 108, actuation of the control wheel 120 can cause the T-bar 118 to rotate ninety degrees, as illustrated, in one modality from a first position shown in Figure 2C and a second position as shown in Figure 2D. At this point, retraction of the traction rod, which can be achieved by squeezing a trigger 128 to retract the traction rod, forces the proximal end of the clamp 100 against and progressively further between the guide members of the surgical clamp installation tool 102, such as a pair of wedges 124a and 124b, formed in the articulating head 126 of the installation tool 102 (see Figure 2B). A curvature or inclination imparted to the articulating head of the installation tool 102 by the pair of wedges can be keyed to a curvature or inclination of the looping portion 106 of the clamp 100 such that the full or more full retraction of the traction rod forces the normally open clamp 100 into a closed position such as that shown in Figure 2E. Returning to Figures 2F to 2K, the various features of the clamp can be readily appreciated. These features include the loop portion 106, slotted opening 108, male component 110, female component 112, and filler material 116. It should be readily understood that the filler material 116 can be configured as a pair of sleeves as shown, but that other configurations are also possible. Furthermore, the nonlinear shapes can be used for various types of applications in clamping different types of organs, as required. Returning now to Figures 3A to 3F, and referring generally to Figures 1 and 3A to 3F, retraction of the traction rod of the installation tool 102 is accomplished by actuating or moving another lever or trigger that engages with the proximal end of the traction rod, such as via an axial coupling. This lever can be configured as the trigger 128, which extends outward from the handle 122 through an opening or slotted aperture. The shape of the handle and the arrangement of the trigger are preferably ergonomically configured to allow the surgeon to hold the installation tool parallel to the floor near waist level to grasp the handle 122 and trigger 128 in one hand. The control wheel 120 is positioned within easy reach of the thumb of that hand to facilitate the surgeon's grasping of the clamp 100 in the other hand while attaching the clamp to the head of the tool. QZAann / i znz / E / YiAi joint 126. The control wheel 120 can be conveniently adjusted to rotate the T-bar 118 to a desired position to lock the T-bar 118 to the clamp 100 in the loop portion 106 through the slotted opening 108. In one embodiment, the control wheel 120 can rotate the T-bar 118 ninety degrees. Once the surgeon has rotated and retracted the traction rod using the T-bar 118 and trigger 128 with one hand, the surgeon's other hand is free for other tasks, such as operating yet another lever that protrudes from the handle 122 and is configured, for example, as a selector 130. With the clamp 100 withdrawn, closed or partially closed against the pair of wedges, the head 126 can be articulated from side to side by rotating this selector 130. The movement of the articulating head 126 by rotating the selector 130 is illustrated in a top view of the installation tool 102 in Figure 3B, indicated by arrow 300, which shows a range of motion or articulation in one mode. Returning now to Figures 4A to 4E, in some embodiments, turning selector 130 allows a hub 132 or connector to be rotated within or adjacent to the handle 122, which connects to a pair of guide lines 134a and 134b. These guide lines 134a and 134b, together with the pull rod 138, can be extended through an elongated rigid sleeve, such as a cylindrical tube 136, for connection on each side of a swivel joint head assembly 126. It is provided that the guide lines can be flexible or rigid, that the cylindrical tube 136 can be rigid or semi-rigid, and that the pull rod 138 can be rigid or semi-rigid. By semi-rigid, it is understood that the pull rod 138 can be flexible or partially flexible, at least in the articulation plane along at least part of its length near the distal end of the installation tool 102, but still axially and rotationally rigid or semi-rigid along its length.Therefore, when the installation tool 102 and clamp 100 are held parallel to the ground, the pull rod 138 can be rotated and retracted by actuating the control wheel 120 and trigger 128, and the head 126 can be articulated in a plane orthogonal to the gravity vector by manipulating the selector 130. The articulation plane can be adjustable in certain modes, or it can be located in a desired plane that is not orthogonal to the gravity vector. Returning now to Figure 5, other embodiments of the clamp 200 and installation tool 202 may include a clamp 200 made of multiple pieces, a longer main tube 204, and a thumb lever 206 on the selector 130 to articulate the tool head 102 that is attached to the clamp 200. In some embodiments, the clamp 200 may be a three-piece clamp. A ratchet release 208 may also be provided on the installation tool 202 which, when pressed, allows the traction rod to extend, which in turn releases the clamp 200, allowing it to reopen. In other words, when the surgeon presses the trigger 210, causing the traction rod to retract and the clamp 200 to close, a ratchet mechanism locks the trigger 210 in the pressed position.Therefore, the traction rod will remain retracted and the clamp 200 will not reopen even if the surgeon releases the pressure on the trigger 210. Returning now to Figures 6A to 6D, and with general reference to Figures 6A to 6D, one part of a three-piece clamp may be a rigid member 212 having a male snap end 214. As will be further described below with reference to Figures 9A to 9D, this rigid member 212 serves as one of the elongated members of the clamp 200 to form the divider that splits the stomach. It may be made of plastic, metal, or any other rigid material. An exemplary material is hardened titanium. Figure 6C shows an exemplary outline of the male snap end 214, while Figure 6D shows an exemplary outline of the rigid member 212. It should be readily understood that the exemplary outline of the rigid member 212 makes it concave on an inner surface facing an outer surface of an organ to be grasped, and convex on an outer surface for coupling with a spring component.However, other forms can be used as desired. Returning to Figures 7A to 7D, and generally referring to them, another part of the three-piece clamp may be a rigid member 216 having a female clasp end 218 that includes a hinged loop 220. As will be further described below with reference to Figures 9A to 9D, this rigid member 216 serves as one of the elongated members of the clamp to form the divider that splits the stomach. It may be made of plastic, metal, or any other rigid material. An exemplary material is hardened titanium. Similarly, the loop 220 may be made of various materials, an example of which is titanium wire. Returning to Figures 8A to 8D, and generally referring to them, a third part of the three-piece clamp can be a spring member 222 having a slotted loop portion 224. As will be further described below with reference to Figures 9A to 9D, the spring member engages with the rigid members to form the clamp and provides the loop portion that enables the formation of a passage between the two divided regions of the grasped stomach. It can be made of plastic, metal, or any other elastic material. An exemplary material is tempered titanium spring. Returning now to Figures 9A to 9D, and with general reference to Figures 9A to 9D, the three-piece clamp can be assembled by coupling the rigid members 212 and 216 to the spring member 222. For example, the rigid members can be welded or coupled to the arms of the spring member at various locations 226. In one embodiment, the rigid members 212 and 216 can be attached to the inner surfaces of the arms of the spring member 222, with the loop 220 fixed to the hinge facing and coupling the male clasp end 214 of the distal end of the rigid member 212. Thus, the rigid members 212 and 216 are employed to form a partition, while the spring member 222 forms a passage between the divided regions of an organ or body as shown in Figure 10.These rigid members 212 and 216 can be of non-uniform thickness to accommodate the gradual closure of the clamp from the proximal to the distal end, allowing a non-uniform organ, such as the walls of a stomach, to be grasped without injury. Alternatively or additionally, sheaths of packing material can be slid over the clamp arms, and the packing material can be of non-uniform thickness as desired. It is anticipated that rigid members 212 and 216 and packing material of varying lengths, contours, and thicknesses can be provided to suit the needs of different patients as required. Returning now to Figure 10, some variations of the surgical clamp installation tool can be used to install the clamp 100 within an abdominal cavity for bariatric surgery. Specifically, the clamp can be positioned, closed, and hooked to divide the stomach into a small vertical portion or pouch 500 and an excluded section 502. The vertical pouch 500 receives food at 504, but food is unable to enter the excluded section 502. Using the installation tool 102 (or 202) to engage with the loop portion 106 of the clamp 100, the clamp 100 can be installed in a substantially vertical position within the stomach in one variation. That is, if the human patient with the clamp 100 installed remains upright, the longitudinal axis of the clamp 100 would be substantially parallel to the gravity vector.Therefore, a passage-forming section formed at the bottom of the stomach by the clamp allows gastric juices to flow in 506 from the excluded section 502 into the vertical pouch 500. Returning to Figure 11, one method for grasping an internal organ may include inserting a surgical clamp through an opening in the body of a living organism in block 150. Then, the two elongated limbs of the surgical clamp are positioned on opposite sides of an internal organ of the living organism in block 152. In block 154, closing and engaging the surgical clamp to divide a cavity inside the internal organ involves grasping the outside of the internal organ with the two elongated limbs. As mentioned previously, the internal organ can be a human stomach. In this case, clamp closure and engagement may involve installing the clamp in a substantially vertical or angled position with a passage-forming section of the clamp located toward a lower portion of the stomach. This positioning can create a small, vertical stomach pouch and thereby limit food intake to an excluded section or portion of the stomach, while still allowing gastric juices from the excluded portion to flow into the stomach. QZAQnn / l 7P7 / B / YILI vertical stomach pouch. This division can alter the production of hormones, enzymes, and chemicals that affect metabolism, energy levels, hunger, digestion, and nutrient absorption, which are affected by the exclusion of the gastric fundus and body of the stomach by the division. Wrapping the elongated limbs of the clamp in silicone padding material along most of their length is intended to reduce trauma and / or necrosis of the stomach or other internal organs and allow for successful reversal of the surgery. Therefore, the method may further include reversing the surgery by removing the clamp. The insertion of the surgical forceps may involve performing natural orifice transluminal endoscopic surgery (NOTES). Alternatively, or additionally, it may involve performing a combination of NOTES and an assistant trocar placed in an abdominal cavity. This combination may include two or more of a conventional, laparoscopic, and one-hole NOTES technique. The NOTES technique may include at least one transgastric, transvaginal, transrectal, transcolonic, or combination thereof. The one-hole technique is used for the introduction of various instruments and encompasses abdominal (including umbilical), perineal, retroperitoneal, or one-hole procedures. Returning to Figure 12, one method for grasping an internal organ may involve attaching a surgical clamp to the head of a surgical clamp-setting tool in block 160. In block 162, the surgical clamp-setting tool can be used to close the clamp and insert it through an opening into a body cavity of a living organism. The tool can then be used in block 164 to reopen the clamp and position the elongated clamp limbs on opposite sides of an internal organ within the body cavity. Finally, in block 166, the tool can be used to close the clamp around the internal organ, thereby dividing a cavity within the organ.The clamp's elongated limbs, arms, or prongs close in such a way as to gradually decrease the space between the two limbs as the opening of the space widens, corresponding to the varying thickness of the stomach. The clamp closes in a manner that exerts sufficient pressure to keep the opposing walls closed without causing damage, trauma, or ischemia to the stomach or other organ walls. Then, in block 168, the clamp can be engaged to lock it in position to divide the internal organ and its cavity. Furthermore, in block 170, the clamp can be detached from the surgical clamp attachment tool head, and the tool can be retracted from the body cavity in block 172. It is envisaged that the clamp can be configured to engage automatically when fully closed.Alternatively, the tool can first be detached and removed, and the clamp then engaged using an additional tool. Additional steps can then be employed for securing the clamp. Q7RQnn / l 7Π7 / Β / YILI the clamp in place, such as using sutures. As previously described, filler material can be used on the surfaces of the elongated limbs of the surgical clamp to reduce damage to the internal organ that would prevent reversal of the surgical procedure. In other embodiments, the thickness or contour of the surface of the elongated limbs or arms of the surgical clamp can be tailored to align with the particular organ or body being grasped in order to provide the desired pressure or force at each location of the organ or body being grasped. Furthermore, coupling the surgical clamp to the head of the surgical clamp installation tool may involve passing a T-bar adjacent to the end of a pull rod of the installation tool through a slotted opening formed in a loop portion of the clamp, and rotating the T-bar with a lever or selector.Additionally, using the surgical clamp installation tool to close and reopen the clamp may involve operating a lever or trigger on the tool's handle to pull and release the traction rod. Furthermore, using the surgical clamp installation tool to position the extended limbs of the surgical clamp may involve manipulating a selector on the tool's handle to articulate the head from side to side in a desired plane. Returning now to Figure 13, another configuration of a surgical clamp 600 and surgical installation tool 602 is similar in structure and function to the configurations described above. A notable difference from the previously described configurations is that the articulating head 604 of the surgical installation tool 602 is keyed with a curvature or radius configured to hold the clamp 600 firmly in place while allowing the clamp 600 to remain in an open position. This configuration allows a surgeon to hold the installation tool 602 in one hand to securely clamp the clamp 600 onto the articulating head 604 of the tool 602 while pressing the distal ends of the clamp 600 together with the other end for trocar entry.Once the distal ends of the clamp 600 have entered the trocar, the trocar then holds the ends closed, allowing the surgeon free use of the other hand. Upon entering the abdominal cavity, the clamp naturally twists open for coupling with a body organ, such as the stomach, and the surgeon can articulate the head from side to side while securely holding it in the open position (604). Once in position, the surgeon can close the clamp using sutures and / or by applying external or internal pressure using other surgical tools. Therefore, in this particular modality, the insertion tool 602 may not be used to close the clamp on an internal organ of the patient, but it can be used to hold, insert, and articulate the clamp in position. With reference now to Figure 14, the 600 clamp can have a three-part design Q7AQAA / I 7A7 / B / YILI parts similar to that described above. In other words, it may have a spring member 606 comprised predominantly of spring steel, which mates with the lower and upper rigid members 608 and 610. These rigid members 608 and 610 may be comprised primarily of titanium, and may have a concavity that increases their rigidity. In addition, suture holes 612a-612e may be provided in the upper rigid member 610, as well as in an upper portion of the spring member 606. A surgeon may use these suture holes 612 to secure the clamp 600 in place in a stomach or other body organ. It is anticipated that additional or alternative suture holes 612 may be provided, such as in the lower rigid member 608 and the lower portion of the spring member 606, and these positions of suture holes 612 may be different from those shown.However, as will be described more fully below with reference to Figures 19 to 27, the placement of suture holes in the upper rigid member 608 and the upper portion of the spring member 606 may allow the clamp suture 600 to be placed in position before the application of a silicone sleeve (see Figures 19 to 27) by sliding over the clamp through the sutureless lower rigid member 608 and the lower portion of the spring member 606. However, once the sleeve is installed, it should be understood that the additional suture holes 612 provided in the lower rigid member 608 and / or lower portion of the spring member 606 may prove useful in a subsequent request for additional sutures. Returning now to Figures 15A to 15F and referring to them in general, it should be appreciated that a double row of suture holes 612a-612h can be provided in spring member 606 and upper rigid member 610, a distal portion of which can exhibit a male snap feature 614 positioned to engage a female snap feature, such as a wire loop 616, of the lower rigid member 608. Suture holes 612d and 612e can be positioned in spring member 606 at a location between a position where the upper rigid member 610 engages spring member 606, and a position where a groove 618 is formed in a loop portion of spring member 606.In the event that the distal end of the upper rigid member 610 exhibits a male clasp feature 614, such as a planular curvature away from a plane in which the upper rigid member 610 is predominantly located, a complementary female clasp feature may be exhibited by a distal end of the lower rigid member 608, such as the aforementioned rectangular wire loop 616 coupled by a hinge formation 620 provided at the distal end of the lower rigid member 608. It should be readily understood that the same functionality can be achieved if the upper rigid member 610 exhibits the female clasp feature, and the lower rigid member 608 exhibits the male clasp feature 614. Therefore, the positions of the clasp features may be reversed in other modalities. Returning now to Figure 16, another additional feature of the clamp 600 may be a retainer 622 formed in the hinge formation 620, which engages the wire loop 616 of the female snap feature. This retainer 622 may be positioned in the hinge formation 620 at a location that is more distal when the clamp 600 is held in a closed position, and may be sized and shaped to hold the wire loop 616 in a lowered position in which the loop 616 lies in a plane parallel to a plane in which the lower rigid member 608 lies predominantly. A similar or identical retainer (not shown) may be provided on an opposite side of the hinge formation 620, and may be similarly positioned distally to help maintain the wire loop 616 in the aforementioned lowered position.This lowered position allows the clamp 600 to be inserted through a trocar and guided to enclose a body organ, such as a stomach. At this point, the aforementioned silicone sleeve (see Figures 19 to 27) can be partially applied. Then, before the silicone sleeve is fully engaged with the clamp 600, the wire loop 616 can be forced out of the retainer 622 in a raised position, where it engages the male snap feature 614 of the clamp 600. Before elevating wire loop 616, clamp 600 can be pressed into a closed position using two or more grasping forceps inserted into the abdominal cavity through additional trocars (i.e., the multi-hole technique). A pre-applied suture mark on wire loop 616 can then be used to force the wire loop 616 out of the retainer 622 in the elevated position, resulting in the wire loop 616 engaging the male snap feature 614 and holding clamp 600 in the closed position without the aid of the two or more grasping forceps. Alternatively or additionally, closure and engagement of clamp 600 can be achieved using any of the appropriate endoscopic surgical techniques and tools, as will be readily apparent to a person skilled in the art from the present description. Returning now to Figures 17A to 17F and referring to them in general, an endoscopic surgical setup tool for attaching and manipulating the clamp may be similar to those described above. For example, the setup tool may have a handle 650, trigger 652, pull rod, T-bar 654, cylindrical tube 656, selector 658 (e.g., with thumb lever), hub, guide lines, and articulating head 604 that are identical or similar to those described above. However, as described above, a curvature or tilt imparted to the head 604 by the head wedges 604 may be keyed to a loop portion of the clamp described above in order to maintain the clamp in a fully open or predominantly open position when the T-bar Q7RQnn / l 7Π7 / Β / YILI 654 has been fully retracted by actuating the trigger 652. In addition, a latch release 660 can be provided which can be extended from both sides of the handle 650 for ergonomic ambidextrous operation. Returning now to Figure 18, the hook release 660 may have a hinged plate with a retaining spring that forces the hook release 660 upward to engage a hook 662 provided on a proximal end of the traction rod 664. In use, a surgeon can attach the T-bar to the clamp 600 by rotating the clamp 600 and / or installation tool on a common longitudinal axis until the T-bar fits through the notch in the loop portion of the clamp 600, and then rotating the clamp 600 and / or installation tool an integer multiple of ninety degrees until a length direction of the T-bar is perpendicular to a length direction of the notch.Then, triggering 652 can retract the draw rod to the opposite engagement surfaces (e.g., edges, extensions, faces, projections, gouges, hooks, slopes, flanges, lips, notches, overhangs, projections, protrusions, ribs, ridges, skirts, grooves, slits, slots, teeth, wedges, and combinations thereof) of the engagement 662, and release 660 can grasp and hold the draw rod 664 in a fully retracted or predominantly retracted position. Once the coupling 662 is engaged, the clamp 600 is ready to be inserted into an inflated abdominal cavity through a trocar as described above, and a seal provided between the cylindrical tube 656 and the fork 668 can prevent gassing of the abdominal cavity through the head 604 and / or cylindrical tube 656. Alternatively, the seal can be provided anywhere within the cylindrical tube 656. In some embodiments, the seal is achieved using a circular silicone die having a groove and a hole in the middle, with the pull rod 664 threaded through the hole. Once the clamp 600 is in position within the abdominal cavity to enclose and divide the stomach or other organ, pressure on the latch release 660 can enable the automatic extension of the pull rod 664 by the action of a provided torsion spring to activate the screw 666, forcing the release of the trigger 652. The T-bar can then be disengaged from the clamp by rotating the installation tool along its longitudinal axis an integer multiple of ninety degrees and removing it from the trocar. It should therefore be evident that, in some embodiments, the pull rod may not be configured to rotate as in the alternative embodiments described above, but only to retract and extend. Returning now to Figure 19, a 700 silicone sleeve can be configured to attach the 600 clamp. In some embodiments, the 700 silicone sleeve can be shaped to cover primarily an upper arm and both ends of the 600 clamp. This silicone sleeve ozAonη / i znz / E / YiAi 700 can be used as a filler to protect surrounding organs from irritation or damage. The thickness of the silicone can be varied for different applications, such as the division of an organ, stomach, or blood vessel. Returning now to Figures 20 to 27, and generally referring to them, the silicone sheath 700 may have a tubular section 702 at a proximal end that slides over the lower arm of the clamp and can be manipulated into position to encapsulate the loop portion of the clamp described above. The clamp can then be closed and engaged as described above. Assuming the upper arm of the clamp has already been sutured to the organ, stomach, or vessel, a distal end of the sheath 700 can then be attached to encapsulate the distal end of the clamp. For this purpose, the distal end of the sheath 700 can be configured as an engagement cap 704, which is the shape suited to the closed engagement characteristics (see Fig. 25).A filler strip 706 located between the tubular section 702 and the engagement cap 704 can be sized to a length suitable for the clamp to be stretched through the upper arm of the clamp once the sleeve 700 is installed. A groove coupling feature 708 formed inside the tubular section 702 can be provided to engage with the groove described above in the loop portion of the clamp, thereby connecting the groove and retaining the tubular section of the sleeve 700 in place within the loop portion of the clamp. Returning now to Figure 28, one method for performing the surgery can begin in step 750 by attaching the clamp described above to the surgical setup tool described above in one or more of the ways described above. The clamp can then be inserted through a trocar in step 752 and positioned to enclose an organ (e.g., stomach, vessel, etc.) in step 754. Next, in step 756, an upper arm of the clamp can be sutured to the organ through the suture holes provided in the clamp as described above, and the setup tool can be uncoupled and removed from the trocar in step 758. The silicone sheath described above can then be slid over a lower arm of the clamp in step 760 as described above, and the clamp can be closed and engaged in step 762.Finally, in step 764, a silicone sleeve hook cover can be attached over the clamp hook, and additional sutures can be applied if desired. It should be understood that the sequence of the steps mentioned above may vary in additional or alternative modalities, and that these additional or alternative steps may be employed, as will be readily apparent to someone skilled in the technique. Figures 29 to 40 and the accompanying description illustrate various forms of a surgical forceps overmolded in a polymeric material. The surgical forceps is, in a QZAQnn / l 7P7 / B / YILI implementation, a device implanted laparoscopically that, when closed and hooked or secured, divides a patient's stomach into two sections, such as two vertical sections or other divisions. The clamp can be installed using standard surgical tools (e.g., forceps, scissors, etc.) and / or, in some modalities, an installation tool, such as one of the installation tools discussed herein. When the clamp is installed, in one implementation, the lesser curvature segment of the stomach forms the Magenstrasse, and the greater curvature segment, including the fundus, is generally excluded from nutritional contact. In one implementation, the clamp includes, at one proximal end, an opening with an elongated radius (generally referred to hereafter as the loop portion or passage-forming section), through which gastric juices created by the fundus and body can flow into the atrum.By excluding the fundus, the clamp can alter or reduce hormones such as ghrelin, leading to a loss of appetite in the patient. Furthermore, the clamp acts as a restrictive procedure, reducing the size of the Magenstrasse and creating a small lumen for the vertical conduit of nutrients along the lesser curvature. Figure 29 illustrates one modality, in which the totally or partially overmolded surgical clamp is of a one-piece design. The one-piece clamp 2900 includes first and second substrate members (shown in Figures 30A, 30B, 31A, and 31B) overmolded in a polymeric or elastomeric material to form a first elongated portion 2902, a second elongated portion 2904, a loop portion 2906, a clamping portion 2908, and a coupling portion 2914. As mentioned above, the first and second elongated portions 2902 and 2904 serve as a splitting section of the clamp 2900. Referring briefly to both Figures 29 and 10, when the clamp 2900 is installed within an abdominal cavity, the first and second elongated portions 2902 and 2904 couple to split the stomach into a small vertical pouch 500 and an excluded section 502.The loop portion 2906 comprises a passage-forming section located toward the proximal end of the clamp 2900. The passage-forming section allows gastric juices to flow 506 from the excluded section 502 into the vertical pouch 500. According to the present description, the term overmolding is intended to describe a product in which the underlying substrate materials are substantially or partially encapsulated, covered, or coated with one or more layers of one or more underlying materials. For example, according to the embodiment illustrated in Figure 29, the first and second substrate members comprise the underlying substrate materials, and the underlying polymeric or elastomeric material comprises the overmolded material, or overmolding. In some embodiments, the overmolding may be of non-uniform thickness or durometer, or positioned in certain areas, to produce various portions or features (such as a QZAQnn / l 7P7 / B / YILI clamping portion, flexible hinge, etc.) and / or to adapt to the gradual closure of the clamp from the proximal end to the distal end in such a way that a non-uniform thickness of an organ, such as the walls of a stomach, can be adequately grasped without injury. In some embodiments, the overmolded polymeric material may comprise silicone, such as, for example, an unrestricted implant-grade silicone. In some embodiments, the substrate material may comprise the same material as the overmolding. Furthermore, in some embodiments, the substrate materials and the overmolding materials may comprise different or varied materials and / or durometers. As shown in Figure 29, the first and second elongated portions 2902 and 2904 are joined by the loop portion 2906 at the proximal end of the clamp 2900. The loop portion 2906 includes a flexible hinge 2918 formed, in one implementation, from the polymer overmold, wherein the flexible hinge 2918 allows expansion and movement of the loop portion 2906 to accommodate any irregularities in the stomach wall or fluctuations in the passage-forming section when the clamp 2900 is installed. The flexible hinge 2918 also allows the clamp 2900 to adapt to variations in stomach thickness without compromising the pressure applied by the clamp 2900, particularly in the cleavage-forming section. In some embodiments, the flexible hinge 2918 includes one or more joining features such as, for example, a slotted opening 2920.The joining feature allows the 2900 clamp to be coupled with an installation tool (e.g., such as the installation tool shown in Figure 33) according to the above description. In still other embodiments, the flexible hinge 2918 can be provided with a desired durometer or elasticity, which may be the same as or different from that of the overmolded silicone or polymer portions provided in other areas of the 2900 clamp, such as the first and second elongated portions 2902 and 2904. When the surgical clamp 2900 is installed, the clamp 2900 is placed in position as explained in more detail below, and the clamping portion 2908 and coupling portion 2914 are used to retain the clamp 2900 in a substantially closed position. In the embodiment illustrated in Figure 29, the fastening portion 2908 comprises a strap formed from the overmolded polymer or other material and located toward the distal end of the second elongated portion 2904. The strap may include one or more primary openings 2910 for receiving the coupling portion 2914, and a secondary opening 2912 used to adjust or manipulate the fastening portion 2908 and / or the second elongated portion 2904. For example, a surgeon may use a tool (not shown) to engage the secondary opening 2912 to position the strap so that the coupling portion 2914 engages one of the primary openings 2910.In the modality illustrated in Figure 29, the coupling portion 2914 comprises a protrusion, such. QZAQnn / l 7Π7 / Β / YILI as a hook or tab, to attach the openings of the fastening portion 2908. In some embodiments, the clamp 2900 can be adjusted by uncoupling the coupling portion 2914 from one of the primary openings 2910 and coupling the coupling portion 2914 with another of the primary openings 2910 to increase or decrease the space between the first and second elongated portions 2902 and 2904. In some embodiments, the clamping portion 2908 can be sutured to the first elongated portion 2902 using suture passing through holes 2916, such as those located along an outer surface of the first elongated portion 2902. Additionally, in some embodiments, once positioned in the stomach, suture passing through holes 2916 can be used to suture the clamp 2900 to the stomach walls to prevent displacement. It should be understood that, in some modalities, sutures can be placed through overmolding, as described in more detail below. With reference now to Figures 30A and 30B, the surgical clamp 2900 of Figure 29 is shown from the respective side and perspective views, where the polymeric material is illustrated semitransparently to show the underlying first substrate member 3001 and second substrate member 3002. As shown in Figures 30A and 30B, the first and second substrate members 3001 and 3002 may, in some embodiments, comprise the respective first and second elongated portions 2902 and 2904, as well as at least a portion of the loop portion 2906. Furthermore, in some embodiments, the first substrate member 3001 may also comprise at least a portion of the coupling feature 2914. Figures 31A and 31B illustrate the respective first and second substrate members 3001 and 3002 comprising the one-piece clamp 2900 illustrated in Figures 29, 30A and 30B. In some embodiments, the first and second substrate members 3001 and 3002 each comprise a titanium substrate 3 mm thick. As shown in Figure 31A, the first substrate member 3001 may include a tongue or hook 3102 comprising at least a portion of the coupling feature 2914, a first section 3104 comprising a portion of the first elongated portion 2902, and a second section 3106 comprising a portion of the loop portion 2906. As shown in Figure 31B, the second substrate member 3002 may include a first section 3108 comprising a portion of the second elongated portion 2904 and a second section 3110 comprising a portion of the loop portion 2906.It should be understood that the dimensions and materials comprising the substrate members provided herein are merely examples. It is anticipated that the substrate members may be of various thicknesses and lengths, and may be comprised of various biocompatible materials, such as titanium or biocompatible polymer resins such as polyether ketone (PEKK) or polyether ketone (PEEK). οζΑοηη / ι znz / E / YiAi According to the embodiment illustrated in Figures 29, 30A, 30B, 31A, and 31B, the overmolded polymer portion of the clamp 2900 is a 1.5 mm thick layer of polymeric material (e.g., silicone) encapsulating the first and second substrate members 3001 and 3002. The flexible hinge 2918 and gripping portion 2908 are formed from the polymeric material and are approximately 6 mm thick to provide a substantially constant thickness along the length of the surgical clamp 2900. However, as discussed above, in some embodiments, the polymeric material comprising or overmolding one or more portions of the clamp 2900 may have a non-uniform thickness or application. It should be appreciated that the above dimensions are merely examples and are not intended to limit or define any aspect of the clamp or portions thereof. Figure 32 illustrates another embodiment of a one-piece surgical forceps 3200 comprising first and second substrate members overmolded in a polymeric material. The forceps 3200 includes a first elongated portion 3202, a second elongated portion 3204, a loop portion 3206 with a flexible hinge 3208 and joining feature 3210, a clamping portion 3212, and a coupling feature 3214. The forceps 3200 illustrated in Figure 32 is similar to the forceps 2900 illustrated in Figure 29, except, for example, that the clamping portion 3212 of the forceps 3200 omits the secondary opening 2912. With reference now to Figure 33, another exemplary embodiment of a 3300 installation tool is illustrated. The 3300 installation tool is similar to those described above and can be used in a similar manner to attach and install certain embodiments of the surgical forceps illustrated in Figures 29 to 32. Using the 3300 installation tool, the forceps can be attached (via the joining feature of the loop portion), placed in the abdominal cavity (e.g., via a trocar), and positioned with the first and second elongated portions on opposite sides of the stomach, where the forceps engages, closes, grasps, secures, or is otherwise at least partially installed to divide a cavity within the stomach as described above. Figures 34A, 34B, and 34C illustrate various views of yet another embodiment of a one-piece surgical forceps 3400 comprising first and second substrate members 3401 and 3402 overmolded in a polymeric material 3403. The forceps 3400 includes a first elongated portion 3404, a second elongated portion 3406, a loop portion 3408 with a flexible hinge 3410, a gripping portion 3412, and coupling features 3414 and 3416. The forceps 3400 illustrated in Figures 34A, 34B, and 34C is similar to the forceps 3200 illustrated in Figure 32. The gripping portion 3412 of the forceps 3400 includes, for example, rounded primary openings 3418, and the loop portion 3412 omits a coupling feature. In addition, the 3400 clamp incorporates first and second coupling features 3414 and 3416, where the first and second QZAann / i znz / E / YiAi coupling features 3414 and 3416 include a raised member and a retaining loop, respectively, formed from the polymer overmolding 3403. In some embodiments, the raised member may also be formed, at least partially, from the first substrate member. According to the embodiment illustrated in Figures 34A, 34B, and 34C, the clamp 3400 can be inserted into an abdominal cavity through a trocar, positioned with the first and second elongated portions 3404 and 3406 on opposite sides of the stomach, and closed and secured by coupling one of the primary openings 3418 with the raised member of the first coupling feature 3414, and securing the grasping portion 3412 under the retaining loop of the second coupling feature 3416. According to the present embodiment, the insertion, positioning, closure, and securing steps can be performed using surgical tools (e.g., clamps, forceps, scissors, etc.).However, it should be appreciated that the loop portion 3408 of the 3400 clamp can be modified to include a joining feature, such as that provided on the 2900 or 3200 clamp, to allow the 3400 clamp to be coupled and installed using a surgical clamp installation tool, such as that provided in Figure 33. Figure 35 illustrates another embodiment of a one-piece surgical forceps 3500 comprising first and second substrate members overmolded in a polymeric material. The forceps 3500 includes a first elongated portion 3502, a second elongated portion 3504, a loop portion 3506 with a flexible hinge 3508, a gripping portion 3510, and coupling features 3512, 3514, and 3516. The forceps 3500 is similar to the forceps 3400 illustrated in Figures 34A, 34B, and 34C. The 3500 clamp incorporates an additional coupling member 3516 comprising a retaining loop formed from the polymer overmolding to receive the clamping portion 3510. The 3500 clamp is installed in a manner similar to the 3400 clamp and may be modified to include a joining feature, such as that provided on the 2900 or 3200 clamp, to allow the 3500 clamp to be coupled and installed using a surgical clamp installation tool, such as that provided in Figure 33.It should be noted that the various embodiments described herein may be modified to include different numbers and combinations of coupling features and clamping portion openings without departing from the scope of this description as described in the claims below. With reference now to Figure 36, one method for grasping an internal organ may include inserting a surgical clamp through an opening (e.g., using a trocar) into the body of a living organism in block 3610. The first and second elongated portions of the surgical clamp are then positioned on opposite sides of an internal organ of the living organism in block 3620. In block 3630, the clamp is closed and secured. QZAann / i znz / E / YiAi surgical to divide a cavity inside the internal organ includes the clamping of the outside of the internal organ with the two elongated portions. As mentioned previously, the internal organ may be a human stomach. In this case, the clamp closure and securing may involve installing the clamp in a substantially vertical or angled position with a passage-forming section of the clamp located toward the lower part of the stomach. This positioning can create a small, vertical stomach pouch and thus limit food intake in an excluded section or portion of the stomach, while still allowing certain gastric juices from the excluded portion to flow into the vertical stomach pouch. This division can alter the production of hormones, enzymes, and chemicals that affect metabolism, energy levels, hunger, digestion, and nutrient absorption, which are affected by the exclusion of the gastric fundus and body of the stomach by the division.The polymer overmolding of the clamp reduces trauma and / or necrosis of the stomach or other internal organs, thus allowing for successful reversal of the surgery. Therefore, the above method may also include reversing the surgery by removing the clamp. The insertion of the surgical forceps may involve performing natural orifice transluminal endoscopic surgery (NOTES). Alternatively, or additionally, it may involve performing a combination of NOTES and an assistant trocar placed in an abdominal cavity. This combination may include two or more conventional laparoscopic NOTES and one-hole techniques. The NOTES technique may include at least one transgastric, transvaginal, transrectal, transcolonic, or combination thereof. The one-hole technique is used for the introduction of various instruments and encompasses abdominal (including umbilical), perineal, retroperitoneal, or one-hole procedures. With reference to Figure 37, one method for grasping an internal organ may include attaching a surgical clamp, such as a bariatric clamp, to the head of a surgical clamp-setting tool in block 3710. In block 3720, the surgical clamp-setting tool can be used to close the clamp and insert it through an opening into a body cavity of a living organism. The tool can then be used in block 3730 to reopen the clamp and position the first and second elongated portions of the clamp on opposite sides of an internal organ within the body cavity. Next, in block 3740, the tool can be used to close the clamp around the internal organ, thereby dividing a cavity within the organ. The limbs, arms, or elongated portions of the clamp close in such a way as to cause a gradual decrease in the space between the two elongated portions as the opening of the space extends proximally, representing the different thicknesses of the stomach. The clamp closes QZAQAÍVI 7Ω7 / E / YILI is a method that exerts sufficient pressure to keep opposing walls closed against each other without causing undue damage, trauma, or ischemia to the stomach or other organ walls. Then, in block 3750, the clamp can be engaged or otherwise secured to fix it in position to divide the internal organ and the internal organ cavity. Furthermore, in block 3760, the clamp can be detached from the surgical clamp installation tool head, and the tool can be withdrawn from the body cavity in block 3770. In some modalities, the clamp can be engaged or secured before or after detachment and removal of the surgical clamp installation tool. In such modalities, clamp securing can be performed using surgical tools alone or in combination with the installation tool.Alternatively, the tool can first be detached and removed, and the clamp then attached using additional surgical tools. Furthermore, additional steps, either before or after the clamp is secured, can be employed to further secure and position it in place, such as using sutures. As previously described, polymer overmolding of the surgical clamp reduces damage to the internal organ, which would prevent or significantly decrease the likelihood of surgical procedure reversal. In some designs, the thickness or surface contour of the elongated portions of the surgical clamp can be tailored to align with the specific organ or body being grasped, providing the desired pressure or force at each location. Furthermore, attaching the surgical clamp to the clamp-installing tool head may involve passing a T-bar adjacent to the end of a pull rod of the installation tool through a slotted opening formed in a loop portion of the clamp, and rotating the T-bar using a lever or selector.Additionally, using the surgical clamp installation tool to close and reopen the clamp may involve operating a lever or trigger on the tool's handle to extend and release the pull rod. Furthermore, using the surgical clamp installation tool to position the elongated portions of the surgical clamp may involve manipulating a selector on the tool's handle to articulate the head from side to side in a desired plane. Figures 38, 39A, 39B, and 39C illustrate one embodiment of the present description, wherein the polymer overmolded surgical forceps is of a two-piece design. Figure 38 illustrates a perspective view of the two-piece forceps 3800, and Figures 39A, 39B, and 39C illustrate various views of the forceps 3800, wherein the polymer overmolding is shown semitransparently to reveal the underlying first substrate member 3901 and second substrate member 3902. Figure 39A illustrates a profile view of the forceps 3800; Figure 39B illustrates a top-down view of the forceps 3800; and Figure 39C illustrates a cross-sectional view of the forceps. 3800 taken along line AA of Figure 39B. The two-piece clamp 3800 includes first and second substrate members 3901 and 3902 (shown in Figures 39A, 39B, and 39C) overmolded in a polymeric material to form a first elongated member 3802 and a separate second elongated member 3804. The first elongated member 3802 includes a first loop portion 3806 located toward a proximal end of the clamp 3800, and a first elongated portion 3808 located toward a distal end of the clamp 3800. The second elongated member 3804 includes a second loop portion 3810 located toward the proximal end of the clamp 3800 and a second elongated portion 3812 located toward the distal end of the clamp 3800. When the clamp is installed, the first and second loop portions 3806 and 3810 comprise a forming section passage at the proximal end of the clamp 3800, and the first and second elongated portions 3808 and 3812 comprise a split-forming section at the distal end of the clamp 3800.Referring briefly to both Figures 38 and 10, when the clamp 3800 is installed within an abdominal cavity, the first and second elongated portions 3808 and 3812 are coupled to divide the stomach into a small vertical pouch 500 and excluded section 502, and the first and second loop portions 3806 and 3810 are coupled to form a passage allowing gastric juices to flow 506 from the excluded section 502 into the vertical pouch 500. As shown in Figures 38, 39A, 39B, and 39C, the first elongated member 3802 includes first and second clamping portions 3814 and 3816 formed at least partially from the polymer overmold at opposite ends of the first elongated member 3802. The second elongated member 3804 includes first and second receiving portions 3818 and 3820 formed from the polymer overmold at opposite ends of the second elongated member 3804, and retention features 3822, 3824, 3826, and 3828 formed on an outer surface of the second elongated member 3804. It should be understood that, in some embodiments, the first and second receiving portions 3818 and 3820 may be formed from the polymer overmold, or a combination of the second substrate material and polymer overmold.Similarly, in some embodiments, retention features 3822, 3824, 3826, and 3828 can be formed from the polymer overmold, or a combination of the second substrate material and polymer overmold, as shown in Figure 39C. When the clamp 3800 is installed, the first and second elongated members 3802 and 3804 are inserted into the abdominal cavity (for example, using a trocar) and positioned on opposite sides of the stomach. The first and second grasping portions 3814 and 3816 are then each fed through the respective first and second receiving portions 3818 and 3820. A gap between the looping portions 3806 and 3810 defines the passage formed in the lower part of the stomach and affects the pressure applied to the internal organ, while a gap between The elongated portions 3808 and 3812 affect the pressure applied to the stomach by the split-forming section of the clamp 3800. The gap between the first and second looping portions 3806 and 3810 can be controlled independently, primarily by adjusting the length of the first clamping portion 3814, which feeds through the first receiving portion 3818. Similarly, the gap between the first and second elongated portions 3808 and 3812 can be controlled independently, primarily by adjusting the length of the second clamping portion 3816, which feeds through the second receiving portion 3820. Once the desired gap is reached, the clamp 3800 is closed, engaged, or otherwise secured by mating the first and second clamping portions 3814 and 3816 with the outer surface of the second elongated member. 3804 using retention features 3822, 3824, 3826, and 3828.The 3800 clamp can be adjusted or removed by reversing the installation procedure. Additionally, in some models, the installation, removal, and / or adjustment of the 3800 clamp can be performed using standard surgical tools (e.g., forceps, tweezers, scissors, etc.). In the form illustrated in Figures 38, 39A, 39B and 39C, retention features 3822 and 3828 comprise retention loops, and retention features 3824 and 3826 comprise raised members. The first clamping portion 3814 is fed through the first receiving portion 3818 and under the retaining loop 3822. The first clamping portion 3814 includes one or more operable openings 3830 to receive the raised member 3824. Once the first clamping portion 3814 is fed through the retaining loop 3822, it is secured by a friction fit using the raised member 3824 and one of the openings 3830. Similarly, the second clamping portion 3816 is fed through the second receiving portion 3820 and under the retaining loop 3828. The second clamping portion 3816 includes one or more operable openings 3832 to receive the raised member 3826.Once the second clamping portion 3816 is fed through the retaining loop 3828, it is secured by a friction fit using the raised member 3826 and one of the openings 3832. In some embodiments, the first and second clamping portions 3814 and 3816 can be further secured by suturing the clamping portions 3814 and 3816 to the second elongated member 3804 using suture holes (not shown) formed within the second substrate member and polymer overmolding. As briefly discussed earlier, the gaps in the passage-forming and split-forming sections of the clamp can be adjusted independently of each other. Therefore, the 3800 two-piece surgical clamp allows for customized installation and adjustment by enabling one end of the clamp (i.e., the passage-forming or split-forming section) to be adjusted without having to adjust the other end. This allows a surgeon or other medical personnel to control the clamping pressure at each end of the device, regardless of differences in stomach thickness from one end of the clamp to the other. Figure 40 illustrates another exemplary embodiment of a two-piece surgical forceps 4000. The two-piece forceps 4000 includes first and second substrate members overmolded in a polymeric material to form a first elongated member 4002 and a separate second elongated member 4004. The first elongated member 4002 includes a first loop portion 4006 located toward a proximal end of the forceps 4000, and a first elongated portion 4008 located toward a distal end of the forceps 4000. The second elongated member 4004 includes a second loop portion 4010 located toward the proximal end of the forceps 4000 and a second elongated portion 4012 located toward the distal end of the forceps 4000.When the clamp is installed, the first and second loop portions 4006 and 4010 comprise a passage-forming section at the proximal end of the clamp 4000, and the first and second elongated portions 4008 and 4012 comprise a split-forming section at the distal end of the clamp 4000. The space between the loop portions 4006 and 4010 defines the passage formed in the lower part of the stomach and affects the pressure applied to the internal organ, while the space between the elongated portions 4008 and 4012 affects the pressure applied to the stomach by the split-forming section of the clamp 4000. The first elongated member 4002 includes first and second clamping portions 4014 and 4016 formed from the polymer overmolding at opposite ends of the first elongated member 4002. The second elongated member 4004 includes first and second receiving portions 4018 and 4020 formed from the polymer overmolding at opposite ends of the second elongated member 4004. The embodiment illustrated in Figure 40 is similar to that shown in Figures 38, 39A, 39B, and 39C, except that the retention feature of the embodiment illustrated in Figure 40 is included as a ratchet-type feature, wherein each of the first and second clamping portions 4014 and 4016 includes a plurality of teeth 4022 designed to engage the respective receiving portions 4018 and 4020 of the second elongated member. 4004. When the 4000 clamp is installed, the first and second elongated members 4002 and 4004 are inserted into the abdominal cavity (e.g., using a trocar) and positioned on opposite sides of the stomach. The first and second clamping portions 4014 and 4016 are then fed through the respective first and second receiving portions 4018 and 4020. The teeth 4022 on each of the clamping portions 4014 and 4016 are designed to flex to allow the feeding of the respective clamping portion 4014 or 4016 through the respective receiving portion 4018 or 4020, and to engage the respective receiving portion 4018 or 4020 to retain the second elongated member 4004, thereby securing the clamp 4000 in a closed position.In some embodiments, the first and second elongated limbs 4002 and 4004 can be further secured by suturing the first and second elongated limbs 4002 and 4004 to the stomach using suture holes (not shown) formed within the elongated limbs. The spacing between the first and second loop portions 4006 and 4010 can be independently controlled primarily by adjusting the length of the first clamping portion 4014 fed through the first receiving portion 4018. Similarly, the spacing between the first and second elongated portions 4008 and 4012 can be independently controlled primarily by adjusting the length of the second clamping portion 4016 fed through the second receiving portion 4020. The clamp 4000 can be readjusted or removed by disengaging the teeth 4022 of the clamping portions 4014 and 4016 from the respective receiving portions 4018 and 4020, and by adjusting or removing the clamping portions 4014 and 4016 from the receiving portions 4018 and 4020.In some embodiments, once the 4000 clamp is installed, the excess length of the first and second clamping portions 4014 and 4016 can be removed, for example, using scissors or other cutting instruments. In some embodiments, the installation, removal, and / or adjustment of the 4000 clamp can be performed using standard surgical tools (e.g., forceps, tweezers, scissors, etc.). Similar to the 3800 clamp in Figure 38, the two-piece 4000 clamp in Figure 40 allows independent adjustment of the gaps in the passage-forming and split-forming sections of the clamp. Therefore, the two-piece 4000 surgical clamp allows one end of the clamp (i.e., the passage-forming or split-forming section) to be adjusted without having to adjust the other end. This allows a surgeon or other medical personnel to control the clamping pressure at each end of the device regardless of differences in stomach thickness from one end of the 4000 clamp to the other. The two-piece polymer-overmolded surgical clamp designs can be installed as previously described with respect to the flow diagram illustrated in Figure 36. Furthermore, the polymer overmolding of the two-piece surgical clamp reduces or prevents damage to the internal organ, which would otherwise hinder or complicate the reversal of the surgical procedure. In some designs, the thickness or surface contour of the elongated portions of the surgical clamp can be tailored to align with the specific organ or body being grasped, thus providing the desired pressure or force at each location. It should be noted that, in some designs, the first and second elongated members can be formed entirely from the polymeric or elastomeric material, or they can be omitted and not include an underlying substrate member. It should be understood that one or more of the various fastening portions and Q7AQAA / I 7A7 / B / YILI Retention features of the two-piece overmolded surgical clamp, such as the ratchet-type feature of the 4000 clamp, the raised limbs and retention loops of the 3800 clamp, or various combinations thereof, may, in some embodiments, be incorporated into a one-piece overmolded surgical clamp. Furthermore, in some embodiments, one or more of the coupling features of the one-piece overmolded surgical clamp may be incorporated into the two-piece overmolded surgical clamp. It should also be noted that, in some embodiments, the one-piece surgical clamp may be a single integrated unit, or, in other embodiments, it may be a modular unit formed from multiple pieces or parts combined to form the one-piece (bariatric) surgical clamp.It should also be noted that, in some modalities, each of the pieces comprising the two-piece surgical clamp may include a single integrated piece or, in other modalities, may be a modular piece formed from multiple parts combined to form one piece of the two-piece surgical (bariatric) clamp. Figures 41A to 48B and the accompanying description depict various modalities of a bariatric clamp (or surgical clamp) overmolded in a polymeric material or otherwise provided in support of such description. The bariatric clamp is, in one implementation, a laparoscopically implanted device that, when closed and hooked or secured, divides a patient's stomach into two sections, such as two vertical sections or other divisions. The clamp can be installed using standard surgical tools (e.g., forceps, scissors, etc.) as described later. When the clamp is installed, in one implementation, the lesser curvature segment of the stomach forms the Magenstrasse, and the greater curvature segment, including the fundus, is generally excluded from nutritional contact.In one implementation, the clamp includes, at its proximal end, an opening with an elongated radius (generally referred to as the loop portion or passage-forming section), through which gastric juices produced by the fundus and body can flow into the atrum. By excluding the fundus, the clamp can alter or reduce hormones such as ghrelin, leading to a loss of appetite in the patient. Furthermore, the clamp acts as a restrictive device by reducing the size of the Magenstrasse, creating a small lumen for a vertical nutrient conduit along the lesser curvature. Figures 41A to 41E illustrate various views of one embodiment of an overmolded bariatric clamp 4100. The clamp 4100 includes first and second substrate members 4101 and 4103 (shown dotted in Figures 41A and 41E and similar to those shown in Figures 30A, 30B, 31A, and 31B) overmolded in a polymeric or elastomeric material to form a first elongated portion 4102, a second elongated portion 4104, a loop portion 4106, a clamping portion 4108, and a coupling portion 4114. As discussed above, QZAQnn / l 7P7 / B / YILI The first and second elongated portions 4102 and 4104 serve as a division-forming section of the bariatric clamp 4100. Referring briefly to both Figures 41A and 10, when the clamp 4100 is installed within an abdominal cavity, the first and second elongated portions 4102 and 4104 are coupled together to divide the stomach into a small vertical pouch 500 and an excluded section 502. The looping portion 4106 comprises a passage-forming section located toward the proximal end of the clamp 4100. The passage-forming section allows gastric juices to flow 506 from the excluded section 502 into the vertical pouch 500. As shown in Figures 41A to 41E, the first and second elongated portions 4102 and 4104 are joined by the loop portion 4106, which is generally disposed at the proximal end of the forceps 4100. The loop portion 4106 includes a flexible hinge 4118 formed, in one implementation, from the polymer overmold. The flexible hinge 4118 allows the forceps 4100 to be positioned in a variety of positions ranging from a substantially closed position illustrated in Figures 41B and 41C, to a substantially expanded (or fully open) position as shown in Figure 41E. It should be appreciated that the flexible hinge 4118 allows the forceps 4100 to be flexed, rotated, contorted, expanded, stretched, or bent to virtually any desired angle or position.For example, referring briefly to Figures 50A to 50D, the 4100 clamp is shown in a closed position in Figure 50A, open so that an angle α to the loop portion is less than 90° in Figure 50B, open so that the angle α at the loop portion is approximately 180° in Figure 50C, and open so that the angle α at the loop portion is greater than 180° in Figure 50D. Referring briefly to Figures 51A through 51C, the clamp 4100 is shown in various contorted positions. As shown in Figures 51A through 51C, the flexible hinge 4118 allows the clamp 4100 to rotate, bend, and flex virtually at any desired angle or direction so that the first and second elongated portions 4102 and 4104 can be offset relative to each other at an angle (e.g., angle α) when the clamp 4100 is viewed from an overview position, such as that provided in Figure 51A. In some embodiments, the flexible hinge 4118 is stretchable and can rotate to provide the first elongated member in a desired position in any of the three orthogonal planes relative to the second elongated member. In some embodiments, the flexibility provided by the hinge 4118 can be advantageous when positioning the first and second elongated portions in the stomach during installation.For example, the flexible hinge 4118 allows the clamp 4100 to be installed, in one mode, in a smaller opening, such as a trocar opening, one limb at a time, and then properly install and position the bariatric clamp 4100 in the stomach within the limited space of the abdominal cavity. When the 4100 clamp is installed, the flexible 4118 hinge allows for expansion and Q7RQnn / l 7P7 / B / YILI movement of the loop portion 4106 to accommodate any irregularities in the stomach wall or fluctuations in the passage-forming section. For example, Figure 52A illustrates the clamp 4100 in a closed position, where the flexible hinge 4118 is in a compressed, unexpanded, or rest state, and Figure 52B illustrates the clamp 4100 in the closed position where the flexible hinge 4118 is stretched or expanded into a state of tension. As mentioned above, such stretching or expansion can accommodate irregularities in the stomach wall or fluctuations in the passage-forming section. The stretching or expansion of the flexible hinge 4118 also allows the clamp 4100 to accommodate variations in stomach thickness without compromising the pressure applied by the clamp 4100, particularly in the division-forming section.In some embodiments, the flexible hinge 4118 can be provided to a desired durometer or elasticity that may be the same as or different from that of the overmolded polymer or silicone portions provided in other areas of the clamp 4100, such as the first and second elongated portions 4102 and 4104. When the bariatric clamp 4100 is installed, the clamp 4100 is positioned as explained in more detail below, and the clamping portion 4108 and coupling portion 4114 are used to retain the clamp 4100 in a substantially closed position. Figures 41B and 41C illustrate the clamp 4100 in the substantially closed position. In the embodiment illustrated in Figures 41A to 41E, the clamping portion 4108 comprises a strap formed from the overmolded polymer, or other material, and is located toward the distal end of the second elongated portion 4104. Because the clamping portion 4108 is formed from the overmolded polymer in some embodiments, it is stretchable and capable of providing appropriate tension for dividing the stomach when installed. Also, as shown in Figures 53A to 53E, the clamping portion 4108 is able to stretch so that one of the primary openings 4110 can receive the coupling portion 4114.The clamping portion 4108 may also include a secondary opening 4112 used to adjust or manipulate the clamping portion 4108, the second elongated portion 4104, and / or the clamp 4100. For example, a surgeon may use a tool (not shown) to engage the secondary opening 4112 to position the strap so that the coupling portion 4114 engages one of the primary openings 4110. In the embodiment illustrated in Figures 41A to 41E and 53A to 53E, the coupling portion 4114 comprises a protrusion, such as a hook or tab, for engaging the openings of the clamping portion 4108. In some embodiments, the clamp 4100 can be adjusted by uncoupling the coupling portion 4114 from one of the primary openings 4110, and coupling the coupling portion 4114 with another of the primary openings 4110 to increase or decrease the space between the first and second elongated portions 4102 and 4104. In some embodiments, the clamping portion 4108 can be secured to the first elongated portion 4102 by suturing the clamping portion 4108 to the polymer overmolding of the first elongated portion 4102. Figures 42A, 42B, 43A, and 43B illustrate variations of an overmolded bariatric clamp similar to that shown in Figures 41A through 41E and described above, except that the variations illustrated in Figures 42A, 42B, 43A, and 43B have adjustable lengths. The adjustable length of the bariatric clamp allows it to be further customized for fixation to the patient's stomach during or even after the clamp has been installed. For example, when the bariatric clamp is being installed, a surgeon can adjust it as needed during the procedure to ensure a proper fit to the patient's stomach. Furthermore, if a bariatric clamp with an adjustable length is installed in a patient, and the clamp length is subsequently determined to be inadequate, the surgeon can adjust the clamp length for a better fit to the patient's stomach without having to remove the existing clamp or install a new one.Therefore, a bariatric clamp that has an adjustable length can prevent unnecessary surgical operations and / or reduce the amount of time needed to install or adjust the bariatric clamp. A variant of a 4200 bariatric clamp that has an adjustable length is illustrated in Figures 42A and 42B. The clamp 4200 includes first and second adjustable substrate members 4201 and 4203 (shown dotted) overmolded in a polymeric or elastomeric material to form a first elongated portion 4202, a second elongated portion 4204, a loop portion 4206, a clamping portion 4208, and a coupling portion 4214. The first and second elongated portions 4202 and 4204 serve as a splitting section of the bariatric clamp 4200. Referring briefly to Figures 42A, 42B, and 10, when the clamp 4200 is installed within an abdominal cavity, the first and second elongated portions 4202 and 4204 couple to split the stomach into a small vertical pouch 500 and an excluded section 502. The loop portion 4206 comprises a passage formation section located towards the proximal end of the 4200 clamp.The passage-forming section allows gastric juices to flow 506 from the excluded section 502 into the vertical pouch 500. Figure 42A illustrates the adjustable bariatric clamp 4200 in a retracted position, where the length of the first elongated portion 4202 and the length of the second elongated portion 4204 are decreased to shorten the overall length of the clamp 4200. Figure 42B illustrates the adjustable bariatric clamp 4200 in an extended position, where the first elongated portion 4202 and the second elongated portion 4204 are extended to increase the overall length of the clamp 4200. In the embodiment illustrated in Figures 42A and 42B, the adjustable length is provided, at least in part, by the first and second adjustable substrate members 4201 and 4203, which comprise the first and second elongated portions 4202 and 4204, respectively, as well as portions of the loop portion 4206. As discussed in the present, the adjustable substrate members 4201 and Q7AQnn / l 7A7 / B / YILI 4203 are each referred to as a single member, but it should be appreciated that each may be comprised of two or more pieces as shown, for example, in Figures 42A and 42B. It should also be appreciated that, in the embodiments described herein, the overmolded material is capable of stretching, expanding, and / or contracting to accommodate the extended and retracted lengths of the first and second elongated portions 4202 and 4204. In some embodiments, the first adjustable substrate member 4201 may comprise an outer member 4201a and an inner member 4201b, wherein the first adjustable substrate member 4201 is capable of at least partially removing, or accommodating, the inner member 4201b within the outer member 4201a. For example, the outer member 4201a may be formed so as to have an opening 4205, or hollow portion, operable to receive the inner member 4201b. In this embodiment, the length of the first elongated portion 4202 may be adjusted by extending or retracting the inner member 4201b from or within the outer member 4201a. Thus, a user may extend the inner member 4201b from the outer member 4201a as shown in Figure 42B to increase the length of the first elongated portion 4202.Conversely, the user may retract, or insert, the inner member 4201b into the outer member 4201a as shown in Figure 42A to decrease the length of the first elongated portion 4202. In some embodiments, the outer member 4201a, inner member 4201b, or both may include one or more retainers (not shown) or other means for retaining a particular length of the first elongated portion 4202. Additionally (or alternatively), the length of the first elongated portion 4202 may be retained by suturing the first elongated portion 4202 to a portion of the stomach, or to another device or tissue, to prevent inadvertently adjusting the length of the first elongated portion 4202. In some embodiments, the length of the first elongated portion 4202 may be further increased by extending or completely removing the inner member 4201b from the outer member 4201a.In other embodiments, the first adjustable substrate member may comprise one or more telescopic substrate members capable of expanding or retracting telescopically to adjust a length of the first elongated portion 4202 in a manner similar to that described above. Similarly, in some embodiments, the second adjustable substrate member 4203 may comprise an outer member 4203a and an inner member 4203b, wherein the second adjustable substrate member 4203 is capable of at least partially removing, or accommodating, the inner member 4203b within the outer member 4203a. For example, the outer member 4203a may be formed to have an opening 4207, or hollow portion, operable to receive the inner member 4203b. In this embodiment, the length of the second elongated portion 4204 may be adjusted by extending or retracting the inner member 4203b from or within the outer member 4203a. Thus, a user may extend the inner member 4203b from QZAQnn / l 7P7 / B / YILI external member 4203a as shown in Figure 42B to increase the length of the second elongated portion 4204. Conversely, the user can retract, or insert, the internal member 4203b into the external member 4203a as shown in Figure 42A to decrease the length of the second elongated portion 4204. In some embodiments, the external member 4203a, internal member 4203b, or both may include one or more retainers (not shown) or other means for retaining a particular length of the second elongated portion 4204. Additionally (or alternatively), the length of the second elongated portion 4204 may be retained by suturing the second elongated portion 4204 to a portion of the stomach, or to another device or tissue, to prevent inadvertent adjustment of the length of the second elongated portion 4204.In some embodiments, the length of the second elongated portion 4204 can be further increased by extending or completely removing the inner member 4203b from the outer member 4203a. In other embodiments, the second adjustable substrate member may comprise one or more telescopic substrate members capable of telescopically expanding or retracting to adjust the length of the second elongated portion 4204 in a manner similar to that described above. As shown in Figures 42A and 42B, the first and second elongated portions 4202 and 4204 are joined by the loop portion 4206 at the proximal end of the clamp 4200. The loop portion 4206 includes a flexible hinge 4218 formed, in one implementation, from the polymer overmold. The flexible hinge 4218 allows the clamp 4200 to be positioned in a variety of positions ranging from a substantially closed position (similar to that illustrated in Figures 41B and 41C) to a substantially expanded (or fully open) position (similar to that shown in Figure 41E). When the clamp 4200 is installed, the flexible hinge 4218 allows expansion and movement of the loop portion 4206 to accommodate any irregularities in the stomach wall or fluctuations in the passage-forming section.The flexible hinge 4218 also allows the clamp 4200 to adapt to variations in stomach thickness without compromising the pressure applied by the clamp 4200, particularly in the splitting section. In some embodiments, the flexible hinge 4218 can be provided with a desired durometry or elasticity that may be the same as or different from that of the overmolded polymer or silicone portions provided in other areas of the clamp 4200, such as the first and second elongated portions 4202 and 4204. When the bariatric clamp 4200 is installed, the clamp 4200 is positioned as explained in more detail below, and the clamping portion 4208 and coupling portion 4214 are used to retain the clamp 4200 in a substantially closed position. In the embodiment illustrated in Figures 42A and 42B, the clamping portion 4208 comprises a strap formed from the overmolded polymer, or other material, and located toward the distal end of the second portion. QZAQnn / l 7P7 / B / YILI elongated 4204. The strap may include one or more primary openings 4210 for receiving the coupling portion 4214, and a secondary opening 4212 used to adjust or manipulate the clamping portion 4208, the second elongated portion 4204, and / or the clamp 4200. For example, a surgeon may use a tool (not shown) to engage the secondary opening 4212 to position the strap such that the coupling portion 4214 engages one of the primary openings 4210. In the embodiment illustrated in Figures 42A and 42B, the coupling portion 4214 comprises a protrusion, such as a hook or tongue, for engaging the openings of the clamping portion 4208. In some embodiments, the clamp 4200 can be adjusted by uncoupling the coupling portion 4214 from one of the primary openings 4210 and coupling the coupling portion 4214 with another of the primary openings 4210 to increase or decrease the space between the first and second elongated portions 4202 and 4204. In some embodiments, this adjustment of the clamp 4200 can also include adjusting the length of the clamp 4200 as described above. In some embodiments, the clamping portion 4208 can be secured to the first elongated portion 4202 by suturing the clamping portion 4208 to the polymer overmolding of the first elongated portion 4202. Another variant of a 4300 bariatric clamp that has an adjustable length is illustrated in Figures 43A and 43B. The clamp 4300 includes first and second substrate members 4301 and 4303 (shown dotted) and first and second loop substrate members 4305 and 4307 (shown dotted) overmolded in a polymeric or elastomeric material to form a first elongated portion 4302, a second elongated portion 4304, a loop portion 4306, a clamping portion 4308, and a coupling portion 4314. The first and second elongated portions 4302 and 4304 serve as a splitting section of the bariatric clamp 4300. Referring briefly to Figures 43A, 43B, and 10, when the clamp 4300 is installed within an abdominal cavity, the first and second elongated portions 4302 and 4304 couple to split the stomach into a vertical pouch. small 500 and an excluded section 502.The loop portion 4306 comprises a passage-forming section located toward the proximal end of the clamp 4300. The passage-forming section allows gastric juices to flow 506 from the excluded section 502 into the vertical pouch 500. Figure 43A illustrates the adjustable bariatric clamp 4300 in a retracted position where the length of the first elongated portion 4302 and the length of the second elongated portion 4304 are decreased to shorten the overall length of the clamp 4300. Figure 43B illustrates the adjustable bariatric clamp 4300 in an extended position where the first elongated portion 4302 and the second elongated portion 4304 are extended to increase the overall length of the clamp 4300. In the embodiment illustrated in Figures 43A and 43B, the adjustable length is provided, at least in part, by a first adjustable portion 4302a formed from the polymer overmold comprising the first elongated portion 4302 and a second adjustable portion 4304a formed from the overmold. of polymer comprising the second elongated portion 4304.The first and second adjustable portions 4302a and 4304a are shown in a retracted position in Figure 43A, and in an extended position in Figure 43B. It should be noted that, in some embodiments, the first and second adjustable portions 4302a and 4304a may be comprised of a material other than the polymer overmolding. In some embodiments, the first adjustable portion 4302a is capable of extending (e.g., stretching, expanding, etc.) to increase the length of the first elongated portion 4302 and retracting (e.g., contracting) to decrease the length of the first elongated portion 4302. Therefore, a user can adjust the length of the first elongated portion 4302 by adjusting the position or placement of the first elongated portion 4302, while the first adjustable portion 4302a extends or retracts accordingly to account for the corresponding adjustments to the length of the first elongated portion 4302. Similarly, in some embodiments, the second adjustable portion 4304a is capable of extending (e.g., stretching, expanding, etc.) to increase the length of the second elongated portion 4304 and retracting (e.g., contracting) to decrease the length of the second elongated portion. 4304.Therefore, a user can adjust the length of the second elongated portion 4304 by adjusting the position or placement of the second elongated portion 4304, while the second adjustable portion 4304a extends or retracts accordingly to account for the corresponding adjustments to the length of the second elongated portion 4304. As discussed herein, the first and second adjustable portions 4302a and 4304a are capable of stretching, expanding, and / or contracting to accommodate the extended and retracted lengths of the first and second elongated portions 4302 and 4304. In some embodiments, the length of the first and / or second elongated portions 4302 and 4304 can be retained by suturing them to a portion of the stomach, or to another device or tissue, to prevent inadvertent length adjustment. Although Figures 43A and 43B illustrate the first adjustable portion 4302a disposed in a location adjacent to the first loop substrate member 4305 and the first substrate member 4301, the first adjustable portion 4302a It may be arranged in other locations along the length of the first elongated portion 4302.Similarly, although Figures 43A and 43B illustrate the second adjustable portion 4304a arranged in a location adjacent to the second loop substrate member 4307 and the second substrate member 4303, the second adjustable portion 4304a may be arranged in other locations along the length of the second elongated portion 4304. QZAQnn / l 7Π7 / Β / YΙΛΙ In some embodiments, the first and second adjustable portions 4302a and 4304a are capable of bending, flexing, or articulating such that the loop portion 4306 can be positioned at a desired angle with respect to the length of the first and second elongated portions 4302 and 4304. For example, Figure 54A illustrates an embodiment in which the clamp 4300 is installed in a stomach 5400 and the first and second adjustable portions 4302a and 4304a are articulated such that the loop portion 4306 is angled in a first direction with respect to the first and second elongated portions 4302 and 4304. In another exemplary embodiment, Figure 54B illustrates the clamp 4300 installed in the stomach 5400 and the first and second adjustable portions 4302a and 4304a They are articulated in such a way that the loop portion 4306 is angled in a second direction with respect to the first and second elongated portions 4302 and 4304.In some embodiments, the articulation portion of the 4300 clamp as described herein may be provided by hinges or other features incorporated in the 4300 clamp at locations where the first and second elongated portions 4302 and 4304 join the loop portion 4306. In some embodiments, the first and second adjustable portions 4302a and 4304a may hold the loop portion 4306 at a fixed angle. It should be noted that, in some models, the clamp can be positioned at various locations along the stomach as desired. For example, as shown in Figure 54A, the upper portion of the clamp can be positioned in the upper part of the stomach adjacent to the esophagus, and the lower portion can be positioned in the lower part of the stomach horizontally off-center with respect to the position of the upper portion. This can be achieved by providing a clamp that can be bent, flexed, adjusted, articulated, or curved to achieve the desired positioning (as in Figure 54A), or it can be achieved by positioning the clamp so that it is angled with respect to a vertical axis extending from the lower to the upper part of the stomach.In some modalities, such positioning can be useful to ensure that the vertical food pouch or portion of the stomach below the esophagus is substantially uniform in size from the upper part of the stomach to the lower portion of the stomach. As shown in Figures 43A and 43B, the first and second elongated portions 4302 and 4304 are joined by the loop portion 4306 at the proximal end of the clamp 4300. The loop portion 4306 includes a first loop substrate member 4305, a second loop substrate member 4307, and a flexible hinge 4318 formed, in one implementation, from the polymer overmold. The first and second loop substrate members 4305 and 4307 are similar (in both function and composition) to the first and second substrate members 4301 and 4303 (and other substrate members described herein). Q7RQnn / l 7Π7 / Β / YILI and can be formed from various biocompatible materials such as titanium or biocompatible polymer resins such as polyether ketone (PEKK) or polyether ketone (PEEK). The flexible hinge 4318 allows the clamp 4300 to be positioned in a variety of positions, ranging from a substantially closed position (similar to that illustrated in Figures 41B and 41C) to a substantially expanded (or fully open) position (similar to that shown in Figure 41E). When the clamp 4300 is installed, the first and second loop substrate members 4305 and 4307 provide structural support to the passage-forming section of the clamp 4300. In addition, the flexible hinge 4318 allows expansion and movement of the loop portion 4306 to accommodate irregularities in the stomach wall or fluctuations in the passage-forming section.The flexible hinge 4318 also allows the clamp 4300 to adapt to variations in stomach thickness without compromising the pressure applied by the clamp 4300, particularly in the splitting section. In some embodiments, the flexible hinge 4318 can be provided with a desired durometry or elasticity that may be the same as or different from that of the overmolded polymer or silicone portions provided in other areas of the clamp 4300, such as the first and second elongated portions 4302 and 4304. When the surgical clamp 4300 is installed, the clamp 4300 is placed in position as explained in more detail below, and the clamping portion 4308 and coupling portion 4314 are used to retain the clamp 4300 in a substantially closed position. In the embodiment illustrated in Figures 43A and 43B, the clamping portion 4308 comprises a strap formed from the overmolded polymer, or other material, and is located toward the distal end of the second elongated portion 4304. The strap may include one or more primary openings 4310 for receiving the coupling portion 4314, and a secondary opening 4312 used to adjust or manipulate the clamping portion 4308, the second elongated portion 4304, and / or the clamp 4300. For example, a surgeon may use a tool (not shown) to engage the secondary opening 4312 to position the strap such that the coupling portion 4314 engages one of the primary openings 4310.In the embodiment illustrated in Figures 43A and 43B, the coupling portion 4314 comprises a protrusion, such as a hook or tongue, for coupling the openings of the clamping portion 4308. In some embodiments, the clamp 4300 can be adjusted by uncoupling the coupling portion 4314 from one of the primary openings 4310, and coupling the coupling portion 4314 with another of the primary openings 4310 to increase or decrease the space between the first and second elongated portions 4302 and 4304. In some embodiments, this adjustment of the clamp 4300 can also include adjusting the length of the clamp 4300 according to the above description. In some embodiments, the clamping portion 4308 can be secured to the first elongated portion 4302 by suturing the clamping portion 4308 to the polymer overmolding of the first elongated portion 4302. Figures 44A and 44B illustrate yet another variant of the 4400 bariatric clamp, which has an adjustable length. The 4400 bariatric clamp differs from the bariatric clamps discussed earlier in Figures 41A through 41E, 42A, 42B, 43A, and 43B because the 4400 clamp in Figures 44A and 44B comprises multiple members, rather than a continuous design. However, it should be noted that the 4400 clamp functions in a similar manner to those described above. The bariatric clamp 4400 includes a first substrate member 4401, a second substrate member 4403, a first loop substrate member 4405, and a second loop substrate member 4407 (each shown dotted). The first substrate member 4401 is overmolded in a polymeric material to form a first elongated member 4402 having a coupling portion 4414 at a distal end and a first receiving portion 4416 toward a proximal end of the first elongated member 4402. The second substrate member 4403 is overmolded in a polymeric material to form a second elongated member 4404 having a clamping portion 4408 at a distal end and a second receiving portion 4417 at a proximal end of the second elongated member 4404.The first and second loop substrate members 4405 and 4407 are overmolded in a polymeric material to form a loop member 4406 having a flexible hinge 4418, a first retaining feature 4420, and a second retaining feature 4422. When the gripper 4400 is assembled, the first retaining feature 4420 is received by the first receiving portion 4416 to couple the loop member 4406 to the first elongated member 4402, and the second retaining feature 4422 is received by the second receiving portion 4417 to couple the loop member 4406 to the second elongated member 4404. The loop member 4406 comprises a passage-forming section disposed toward a proximal end of the gripper 4400, and the first and second elongated members 4402 and 4404 comprise a split-forming section disposed toward an end distal of the 4400 clamp. Referring briefly to Figures 44A, 44B and 10, when the clamp 4400 is installed within an abdominal cavity, the first and second elongated members 4402 and 4404 are coupled to divide the stomach into a small vertical pouch 500 and excluded section 502. The looping member 4406 comprises the passage-forming section located toward the proximal end of the clamp 4400 and allows gastric juices to flow 506 from the excluded section 502 into the vertical pouch 500. In the embodiment illustrated in Figures 44A and 44B, the adjustable length is provided, at least in part, by the positions of the first and second retaining features 4420 and 4422 with respect to the receiving portions 4416 and 4417 of the first and second extended members, respectively. For example, Figure 44A illustrates the adjustable bariatric clamp 4400 in a retracted position where the first and second retaining features 4420 and 4422 are positioned so that the overall length of the clamp 4400 is reduced. Figure 44B illustrates the adjustable bariatric clamp 4400 in an extended position where the first and second retaining features 4420 and 4422 are positioned so that the overall length of the clamp 4400 is increased. In some embodiments, such as, for example, those illustrated in Figures 44A and 44B, the first retaining feature 4420 and the second retaining feature 4422 each comprise a ratchet feature having a plurality of teeth 4424 formed from the polymer overmolding material, and the receiving portions 4416 and 4417 each comprise a loop-like shape formed from the polymer overmolding material. The teeth 4424 are capable of flexing to lock within the opening of the loop when the retaining feature 4420 / 4422 is inserted into the receiving portion 4416 / 4417. This allows the retaining feature 4420 / 4422 to slide through the opening of the receiving portion 4416 / 4417 to couple the lacing member 4406 to the respective first or second elongated member 4402 or 4404.Once a tooth 4424 of the retaining feature 4422 / 4424 has passed through the receiving portion 4416 / 4417, tooth 4424 is able to engage the receiving portion 4416 / 4417 to prevent the retaining feature 4422 / 4424 from unintentionally disengaging from the receiving portion 4416 / 4417. However, if a user wishes to remove at least a portion of the retention feature 4420 / 4422 from the receiving portion 4416 / 4417 (for example, to lengthen or disassemble the clamp 4400), the user may flex, or stretch, the receiving portion 4416 / 4417 and / or compress tooth 4424 to remove the retention feature 4420 / 4422 from the respective receiving portion 4416 / 4417. As mentioned previously, the adjustable length of the clamp 4400 is provided, at least in part, by the positions of the first and second retaining features 4420 and 4422 with respect to the receiving portions 4416 and 4417 of the first and second extended members, respectively. To decrease the length of the clamp 4400, the user can insert the first and / or second retaining features 4420 and 4422 into the respective receiving portions 4416 and 4417 as discussed above. If a user wishes to further decrease the length of the 4400 clamp, the user may further insert the first and / or second retaining features 4420 and 4422 into the respective receiving portions 4416 and 4417 so that the additional teeth 4424 have passed through the receiving portions 4416 and 4417. For example, Figure 44A shows the 4400 clamp in its most retracted, or shortest, position.In this configuration, all teeth 4424 of the first and second retention features 4420 and 4422 have passed through their respective receiving portions 4416 and 4417. To increase the. QZAann / i znz / E / YiAi For a longer length of the 4400 clamp, the user can remove a portion of the first and / or second retaining features 4420 and 4422 from their respective receiving portions 4416 and 4417 as discussed above. If the user wishes to further increase the length of the 4400 clamp, the user can further remove a portion of the first and / or second retaining features 4420 and 4422 from their respective receiving portions 4416 and 4417 so that the additional teeth 4424 have passed back through the receiving portions 4416 and 4417. For example, Figure 44B illustrates the 4400 clamp in its most extended, or longest, assembled position. In this embodiment, all teeth 4424 have been removed from the receiving portions 4416 and 4417, except for the last tooth 4424 of each retaining feature 4420 and 4422 that maintains the coupling between the lacing member 4406 and the first and second elongated members 4402 and 4404. As shown in Figures 44A and 44B, the first and second elongated members 4402 and 4404 are coupled to the lacing member 4406 toward the proximal end of the clamp 4400. As discussed above, the lacing member 4406 includes the first and second lacing substrate members 4405 and 4407, the first and second retention features 4420 and 4422, and a flexible hinge 4418 formed, in one implementation, from the polymer overmold. The first and second lacing substrate members 4405 and 4407 are similar (both in functionality and composition) to the first and second lacing substrate members 4401 and 4403 (and other lacing substrate members described herein), and can be formed from various biocompatible materials such as titanium or biocompatible polymer resins such as polyether ketone ketone (PEKK) or polyether ether ketone (PEEK).The flexible hinge 4418 allows the assembled clamp 4400 to be positioned in a variety of positions, ranging from a substantially closed position (similar to that illustrated in Figures 41B and 41C) to a substantially expanded (or fully open) position (similar to that shown in Figure 41E). When the clamp 4400 is installed, the first and second loop substrate members 4405 and 4407 provide structural support to the passage-forming section of the clamp 4400. In addition, the flexible hinge 4418 allows expansion and movement of the loop member 4406 to accommodate irregularities in the stomach wall or fluctuations in the passage-forming section. The flexible hinge 4418 also allows the clamp 4400 to accommodate variations in stomach thickness without compromising the pressure applied by the clamp 4400, particularly in the split-forming section.In some embodiments, the flexible hinge 4418 can be provided to a desired durometry or elasticity that may be the same as or different from that of the overmolded polymer or silicone portions provided in other areas of the clamp 4400, such as the first and second elongated members 4402 and 4404. When the assembled bariatric clamp 4400 is installed, the clamp 4400 is placed in QZAQnn / l 7Π7 / Β / YILI position as explained in more detail below, and the clamping portion 4408 and coupling portion 4414 are used to retain the clamp 4400 in a substantially closed position. In the embodiment illustrated in Figures 44A and 44B, the clamping portion 4408 comprises a strap formed of the overmolded polymer, or other material, and located toward the distal end of the second elongated member 4404. The strap may include one or more primary openings 4410 for receiving the coupling portion 4414, and a secondary opening 4412 used for adjusting or manipulating the clamping portion 4408, the second elongated member 4404, and / or the clamp 4400. For example, a surgeon may use a tool (not shown) to engage the secondary opening 4412 to position the strap such that the coupling portion 4414 engages one of the primary openings 4410.In the embodiment illustrated in Figures 44A and 44B, the coupling portion 4414 comprises a protrusion, such as a hook or tongue, for coupling the openings of the clamping portion 4408. In some embodiments, the assembled clamp 4400 can be adjusted by uncoupling the coupling portion 4414 from one of the primary openings 4410 and coupling the coupling portion 4414 with another of the primary openings 4410 to increase or decrease the spacing between the first and second elongated members 4402 and 4404. In some embodiments, this adjustment of the clamp 4400 may also include adjusting the length of the clamp 4400 as described above. In some embodiments, the clamping portion 4408 can be secured to the first elongated member 4402 by suturing the clamping portion 4408 to the polymer overmolding of the first elongated member 4402. Figure 45 illustrates a flowchart 4500 illustrating a method for installing a bariatric clamp. For clarity, the method illustrated in Figure 45 is generally discussed with reference to the bariatric clamp 4100 illustrated in Figures 41A through 41E and described above, unless otherwise specified. However, it should be appreciated that the described method for installing a bariatric clamp may be applicable to various bariatric clamp modalities, including, but not limited to, any of the modalities described above with respect to Figures 41A through 44A. Furthermore, when describing the method presented in Figure 45 (and the method presented in Figure 47), it should be understood that references to the first elongated portion and second elongated portion are not limited to the exact first elongated portion and second elongated portion modalities as illustrated in any of the figures described above.For example, as used in the context of the methods discussed with reference to Figures 45 and 47, the first elongated portion of Figures 41A to 41E may refer to a first half of the bariatric clamp 4100 including the first elongated portion 4102, the coupling portion 4114, and the section of the loop portion 4106 located on the same side of the bariatric clamp 4100. Similarly, the. QZAQAÍVI 7Ω7 / E / YILI second elongated portion may refer to a second half of the bariatric clamp 4100 including the second elongated portion 4104, the clamping portion 4108, and the section of the looping portion 4106 located on the same side of the bariatric clamp 4100. It should also be noted that, in some embodiments, the first elongated portion may include the clamping portion, while the second elongated portion includes the coupling portion. The method in Figure 45 first describes, in block 4502, creating an opening in a patient's abdominal cavity to allow access to the patient's stomach. In some modalities, this may include inserting one or more trocars into the patient's abdomen, where the trocars provide an opening through which a surgeon can insert various devices and equipment such as, for example, surgical tools, a camera, and the bariatric forceps 4100. The trocars may include various features known in the technique. For example, one or more of the trocars may, in some modalities, include a cutting portion to assist the surgeon (or other personnel) with penetration into the patient's abdominal cavity (or other tissue). In some modalities, other tools (e.g., scissors, needles, dilators, etc.) may also be included.Trocars can be used to create an opening in the abdominal cavity so that the trocar can be inserted. In some modalities, the abdominal cavity can be inflated by forcing air (e.g., CO2) into it. In such modalities, a hose or tube can be inserted or connected to one or more of the trocars, and the trocars may include a seal to prevent air from escaping the abdominal cavity through the trocars. In some modalities, a camera or endoscope can be placed in the abdominal cavity to allow a surgeon or other personnel to view the insertion, removal, or adjustment of the bariatric clamp. In such modalities, the endoscope can be inserted into the abdominal cavity through a trocar placed, for example, in the patient's umbilicus. In block 4504, the method describes the removal of tissue connected to the stomach, particularly in locations where the bariatric clamp 4100 will be positioned adjacent to the stomach. Tissue attached to or adhering to the outer surface of the stomach is removed to create a tunnel, pathway, or passageway in the outer surface of the stomach for the first and second elongated portions 4102 and 4104 of the bariatric clamp 4100 to reside in the stomach, such as in a vertical, or primarily vertical, orientation on the anterior and posterior sides of the outer surfaces of the stomach, to divide the stomach, as described herein, and while providing a passage-forming section to allow some flow or exchange of gastric fluids between the first and second regions.When the 4100 bariatric clamp is in a closed position, it is considered likely that some gastric juices are exchanged through both the first and second regions, and mainly through the passage-forming section of the 4100 bariatric clamp. Q7RQnn / l 7Π7 / Β / YILI In some procedures, tissue removal can be performed by resecting the tissue using surgical equipment such as, for example, clamps, forceps, vacuum tubing, scalpels, an ultrasonic probe, or any combination thereof to create a passageway, tunnel, or pathway for the 4100 bariatric clamp or any other surgical tool (e.g., alignment device, guide member, etc.) used in the implantation process. Additionally, this step may include displacing tissue and / or organs (e.g., the liver) located to the superior, inferior, anterior, and / or posterior side of the stomach to expose the stomach and provide easier access. This may also include exposing one or more locations where the 4100 bariatric clamp, or other surgical equipment or tools, can be positioned in the stomach with little or no intervening tissue. In block 4506, the method describes positioning the bariatric clamp 4100 in a substantially expanded or open position. Referring briefly to Figures 46 and 50(a)-50(d), the bariatric clamp 4100 in Figures 41A to 41E is illustrated in various open positions (Figure 41E also illustrates the bariatric clamp 4100 in a substantially expanded or open position). As shown in Figure 46, the clamp 4100 is placed in an open position such that it is able to be fixed in the opening of the patient's abdominal cavity, with the first and second elongated portions 4102 and 4104 passing separately through the opening into the abdominal cavity. In some modalities, this may include fixing the open 4100 bariatric clamp through a trocar (e.g., a 12 mm trocar), while the 4100 bariatric clamp is in an open or substantially expanded position.It should be noted that the clamping portion 4108 is comprised of the polymer overmolding and is therefore able to flex, as shown in Figure 46, to lock into place within the abdominal cavity opening. Similarly, the flexible hinge 4118 is also comprised of the polymer overmolding and is also able to flex to allow the first and second elongated portions to twist or adjust as the bariatric clamp 4100 is inserted into the abdominal cavity opening. In some embodiments, positioning the bariatric clamp 4100 in the expanded position may involve aligning the first and second elongated portions such that a length h of the first elongated portion 4102 is substantially collinear with a length / 2 of the second elongated portion 4104.In some modalities, positioning the clamp in the expanded position may include assembling the clamp, for example, if the 4400 clamp modality provided in Figures 44A and 44B is implemented. However, in alternative modalities, the 4400 clamp in Figures 44A and 44B can be assembled after it is inserted into the abdominal cavity. In block 4508 of Figure 45, the bariatric clamp 4100 is inserted into the abdominal cavity in the substantially expanded or open position discussed herein. Figure 47 provides a flowchart 4700 illustrating one modality of a method for inserting the bariatric clamp 4100 into the abdominal cavity in the open position. The method illustrated in Figure 47 implements an alignment device (e.g., gold finger, clamp, forceps, etc.) to position a guide member (e.g., suture, string, thread, twist, wire, etc.), wherein the guide member is used to guide the bariatric clamp 4100 when it is inserted into the abdominal cavity and / or positioned adjacent to the stomach. In describing the method in Figure 47, reference is made to Figures 48A and 48B, which illustrate various views of the stomach of patient 4800.Figure 48A illustrates an overview perspective of a first side 4810, top 4815, and bottom 4817 of patient 4800's stomach. Figure 48B illustrates a profile view of stomach 4800 as seen along line AA in Figure 48A. The profile view shows the first side 4810, top 4815, and bottom 4817 of stomach 4800 and a second side 4820 of stomach 4800. In some modalities, the first side 4810 may be the posterior side of the stomach and the second side 4820 may be the anterior side of the stomach; however, in other modalities, the first side 4810 may be the anterior side of the stomach and the second side 4820 may be the posterior side of the stomach. With brief reference to Figures 49A and 49B, an exemplary embodiment of an alignment device, or tool 4900, is shown, having an end member 4910 disposed at a distal end of the tool 4900, and a handle 4920 disposed at a proximal end of the tool 4900. The end member 4910 is disposed at the end of a shaft portion 4915 of the tool 4900 and, in some embodiments, includes an opening 4912 for receiving and / or retaining a guide member (e.g., suture). As explained in more detail below, the tool 4900 can be used to assist in positioning the guide member through a tunnel or pathway created along one side of the stomach and around the upper part of the stomach.In some embodiments, the end member 4910 can be articulated in an upward direction with reference to the horizontal shaft portion 4915 as shown in Figure 49A, and it can also be articulated to be positioned in line with the shaft portion 4915 as shown in Figure 49B. The articulation of the end member 4910 can be controlled by actuating the handle 4920 as shown in Figures 49A and 49B. In the method of Figure 47, the alignment device is used to position the guide member so that it can be used to guide the bariatric clamp 4100 into the abdominal cavity, and into position as further described below. In block 4702, a first end of the guide member is attached to a distal end of the alignment device (or the first end of the guide member is grasped using the distal end of the alignment device), and the alignment device is inserted into the abdominal cavity (e.g., through QZAann / i ζηζ / Ε / γίΛΐ of a trocar). In block 4704, the alignment device is positioned along the first side 4810 of the stomach 4800 by passing the distal end of the alignment device along the first side 4810 of the stomach towards the top 4815 of the stomach 4800. Once positioned at the top 4815 of the stomach 4800 (for example, at location 4805), the distal end of the alignment device (for example, the end member 4910 of the tool 4900) is positioned (for example, hinged, extended, etc.) so that a portion of the guide member is accessible from the second side 4820 of the stomach 4800, while a portion of the alignment device (for example, the shaft portion 4915 of the tool 4900) remains positioned along the first side 4810 of the stomach 4800.In block 4706, the guide member is then positioned on the second side 4820 of the stomach 4800 (e.g., using a clamp or forceps), while the first end of the guide member remains attached to the distal end of the alignment device (e.g., the end member 4910 of the tool 4900). In block 4708, the alignment device is removed from the first side 4810 of the stomach 4800 (and preferably removed from the abdominal cavity) by passing through the first side 4810 of the stomach in a direction toward the lower 4817 portion of the stomach 4800 such that a first portion 4825a of the guide member is positioned or aligned along the first side 4810 of the stomach 4800, while a second portion 4825b of the guide member is retained (for example, using a clamp or forceps) on the second side 4820 of the stomach 4800. Figures 48A and 48B illustrate the first portion of the guide member 4825a and the second portion of the guide member 4825b, according to the present embodiment.In this mode, the first portion of the guide member is aligned in such a way that the position of the first portion of the guide member is relatively consistent with the location in which an elongated portion 4102 / 4104 of the clamp 4100 will be positioned adjacent to the first side 4810 of the stomach 4800. In block 4710, the first end of the guide member is then disconnected from the alignment device and attached to one of the first or second elongated portions 4102 or 4104 of the bariatric clamp 4100. In some embodiments, this can be achieved by attaching the guide member through the secondary opening 4112 and / or around the clamping portion 4108 of the second elongated portion 4104 of the clamp 4100. In other embodiments, this can be achieved by attaching the guide member to the coupling portion 4114 of the first elongated portion 4102. In block 4712, with the first end of the guide member attached to either the first elongated portion 4102 or the second elongated portion 4104, and the clamp 4100 positioned in the substantially expanded position, the second portion of the guide member 4825b is engaged to guide the clamp Bariatric surgery 4100 in the abdominal cavity. In some modalities, this can be achieved Q7AQnn / l 7P7 / E / YILI pulling the second portion of the guide member with surgical tools (e.g. forceps, clamps, etc.) to extract the first portion of the guide member 4825a from the first side 4810 of the stomach 4800 while feeding the bariatric clamp 4100 into a trocar while the clamp 4100 remains in the substantially expanded position. Referring again to Figure 45, the first or second elongated portion 4102 / 4104 of the clamp 4100, attached to the guide member in block 4710, is then positioned adjacent to the first side 4810 of the stomach 4800 in block 4510, while the clamp 4100 remains in an open position. In some embodiments, this can be achieved by continuing to attach the second portion of the guide member 4825b until the respective first or second elongated portion 4102 or 4104 is positioned adjacent to the first side 4810 of the stomach. At this point, the guide member can be disconnected from the first or second elongated portion 4102 or 4104 and removed from the abdominal cavity. In addition, other surgical tools (e.g., clamps, forceps, scissors, etc.) can be used to position the first or second elongated portion 4102 or 4104 adjacent to the first side 4810 of the stomach 4800.The remaining elongated portion is then positioned on the second side 4820 of the stomach 4800 in block 4512. The clamp 4100 should be positioned so that the loop portion 4106 of the clamp 4100 is adjacent to the lower part 4817 of the stomach 4800. In some modalities, surgical tools may be used to couple the remaining elongated portion and to correctly position the elongated portion adjacent to the second side 4820 of the stomach 4800. Although the method is described according to a preferred modality, it should be understood that, in some modalities, the clamp 4100 may be installed in a sequence where blocks 4510 and 4512 are performed in reverse order. In block 4514, the bariatric clamp 4100 is closed to divide the stomach according to the description provided above regarding the various bariatric (or surgical) clamp modalities. In some modalities, this may include stretching the stomach tissue along the length of the clamp 4100 to eliminate folds in the stomach tissue. In some modalities, closing the clamp 4100 may also include securing the clamp 4100 in the closed position. For example, closing and securing the bariatric clamp 4100 in Figure 41A may include using a tool to engage the clamping portion 4108 (for example, at the secondary opening 4112) to position the clamping portion 4108 so that the coupling portion 4114 engages one of the primary openings 4110. In some modalities, closure of the bariatric clamp 4100 may also include securing the first elongated portion 4102 to the side of the stomach adjacent to the first elongated portion 4102, and / or securing the second elongated portion 4104 to the side of the stomach adjacent to the second elongated portion 4104 to prevent unwanted migration or displacement of the portions of the QZAQnn / l 7P7 / B / YILI clamp 4100. In some embodiments, this can be achieved by suturing the first and second elongated portions 4102 and 4104 to their respective sides of the stomach. For example, the first elongated portion 4102 can be sutured to the first side of the stomach (assuming clamp 4100 is installed such that the first side of the stomach is adjacent to the first elongated portion 4102) by suturing through the overmolded portion of the first elongated portion 4102. Similarly, the second elongated portion 4104 can be sutured to the second side of the stomach (assuming clamp 4100 is installed such that the second side of the stomach is adjacent to the second elongated portion 4104) by suturing through the overmolded portion of the second elongated portion 4104. An example of one embodiment is illustrated in Figure 55, which shows a clamp 5500, similar to the clamp 4100 discussed herein, having curved suture needles 5502 embedded or encapsulated within the polymer overmolding of the bariatric clamp 5500 and used to anchor the first elongated portion 5508 and / or second elongated portion 5510 to the stomach once the clamp 5500 is installed and properly positioned. In some embodiments, the substrate members (e.g., first substrate member 5504) may be modified to accommodate the placement of the suture needles 5502. For example, as shown in Figure 55, the first substrate member 5504 and second substrate member 5512 include various recesses 5506 to accommodate the placement of the suture needles.In some embodiments, a modified clamp such as the one shown in Figure 55 can be inserted into the patient's abdominal cavity, having the curved suture needles 5502 embedded or encapsulated within the polymer overmolding of the bariatric clamp and having sutures 5514 attached to the curved suture needles 5502. In such an embodiment, once the first and / or second elongated portions 5508 and / or 5510 are correctly positioned, pressure can be applied to the needles 5502 or elongated portion of the clamp so that the needles 5502 protrude from the polymer overmolding and into the adjacent stomach walls to suture the respective first and / or second elongated portions 5508 and / or 5510 to the stomach. In some modalities, 5502 suture needles can be manipulated using 5514 sutures attached to the respective 5502 needle.In some embodiments, instead of applying pressure to the 5502 needles as discussed above, the 5502 needles can be extracted from the polymer overmolding by manipulating the 5502 needles with the attached 5514 sutures. Referring briefly to Figure 46, the clamp may, in some embodiments, include one or more visual indicators 4602 to define locations where sutures can be applied or embedded within the clamp. In some modalities, the bariatric clamp can be attached and positioned on the outer surface of the patient's stomach using one or more lever suture assemblies that are partially or fully positioned from the outside of the stomach to the stomach wall or Q7AQAA / I 7A7 / B / YILI from the outer wall of the stomach to the inside of the stomach, depending on a desired implementation of a lever suture. For example, the 5500 clamp modality illustrated in Figure 55 can be modified such that the curved needles 5502 in Figure 55 are replaced by a lever suture or lever suture assembly (such as a lever suture assembly known in the art). In some modalities, one or more lever suture assemblies can be temporarily inserted into the 5500 clamp at various locations (e.g., in the recesses 5506), or, in other modalities, they can be molded, machined, or installed at desired locations on the bariatric clamp to assist with the clamp's placement in the patient's stomach. In some configurations, lever suture assemblies can be retrofitted onto a pre-manufactured 5500 clamp.In one embodiment, various lever suture assemblies are provided adjacent to the first and second ends of the bariatric clamp, such as adjacent to the flexible hinge and / or the connection point where the bariatric clamp closes, and along the first and second elongated limbs and the loop portion, as desired. It should be noted that bariatric clamps and / or sutures can be implemented using known or available absorbable materials, such as bioabsorbable materials (e.g., gut suture), which provide desirable or adequate mechanical or structural properties and integrity for a desired or necessary period of time before being absorbed or disintegrating to an unacceptable level. Natural or synthetic absorbable materials may be used. Polyglycol, for example, may be used in certain implementations. In some configurations, the method illustrated in Figure 45 may also include adjusting the length of the bariatric clamp, as discussed previously with respect to the clamps illustrated in Figures 42A, 42B, 43A, 43B, 44A, and 44B. Depending on the particular clamp configuration, the length of the bariatric clamp can be adjusted in a variety of ways. For example, in the configurations described above with respect to Figures 42A, 42B, 43A, and 43B, the clamp length can be adjusted by adjusting the length of the first elongated portion and / or the second elongated portion. In the configurations described above with respect to Figures 44A and 44B, the clamp length can be adjusted by adjusting the positions of the first and second retaining features with respect to the receiving portions of the first and second elongated limbs.Regardless of the clamp used, the length can be adjusted at any time during clamp installation. However, it is preferable to adjust the clamp length before securing it to the patient's stomach. The clamp can also be removed by reversing any of the steps mentioned above (for example, by removing the sutures securing any portion of the clamp to the stomach), allowing it to be removed or adjusted, including adjusting its length. Q7RQnn / l 7Π7 / Β / YILI clamp as discussed herein, or adjust a clamp position on the stomach. In some procedures, the method for installing a bariatric clamp may also include ensuring the proper placement of the 4100 bariatric clamp. This may involve measuring the pressure applied to the stomach by the 4100 clamp. In some procedures, the pressure can be measured by placing one or more pressure transducers between the 4100 clamp and one side of the stomach. In some procedures, a pressure in the range of 0–2 or 0–3 inHg (0–50.8 or 0–76.2 mmHg) may be desirable. Furthermore, ensuring proper placement may, in some procedures, include injecting a radiopaque fluid, such as barium, into the stomach and observing the fluid, for example, using x-ray imaging, to determine the appropriate flow between the various regions of the stomach. Once the clamp is in place, the surgical team can be removed, and the internal organs are repositioned. Other precautions may be taken, including, for example, cleaning or cauterizing any bleeding tissue to prevent clotting. A number of additional and alternative surgical forceps, installation tools, and methods may have characteristics that differ from those described above. For example, a surgical forceps not intended for bariatric surgery might not have a passage-forming section, and such a forceps might be shorter or longer depending on its purpose. For instance, the forceps might be one-tenth of an inch long to divide a blood vessel, or twenty-two centimeters long to divide a stomach. Furthermore, the forceps may be configured to divide any internal organ and may vary in length accordingly between these two example lengths, or be longer or shorter as needed.Furthermore, the guide members may have one or more protrusions aligned with the coupling feature and configured for insertion into the groove formed in the loop portion of the clamp. Additionally, the installation tool is intended to be integrated with an endoscope and / or surgical robot, and appropriate robotic elements may be included instead of or in addition to those described above. These and other features may be included in various combinations without departing from the scope of the invention as defined in the following claims. 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I_____________________________________________._________________________________ 50§ POSITION A MINERO \ XV» <wer lado del eetó^ag FIG. 45 ozAonn / Lznz / E / γιΛι QZAonn / Lznz / E / γιΛι QZRQnn / Lznz / E / YILI QZRQnn / ΙΖΠΖ / Β / ΥΙΙΛΙ ozAonn / Lznz / E / γιΛι QZRQnn / ΙΖΠΖ / Β / ΥΙΙΛΙ QZRQnn / Lznz / E / YILI in QZRonn / Lznz / E / γιΛι QZAQnn / Lznz / E / YILI QZRQnn / ΙΖΠΖ / Β / ΥΙΙΛΙ ozAonn / Lznz / E / γιΛι ozbonn / Lznz / E / yliLi QZRQnn / Lznz / E / YIL QZAonn / Lznz / E / YiA QZRQnn / ΙΖΠΖ / Β / ΥΙΛ NOVELTY OF THE INVENTION< / wer>

Claims

1. A bariatric clamp, comprising: a first elongated portion having a distal end and a proximal end; a second elongated portion having a distal end and a proximal end; a looping portion having a flexible hinge and rotating in three orthogonal planes relative to the second elongated portion, the looping portion joining the first and second elongated portions at the proximal end of the first elongated portion of the bariatric clamp and the proximal end of the second elongated portion of the bariatric clamp; a clamping portion disposed toward the distal end of the second elongated portion; and a coupling portion disposed adjacent to the first elongated portion, the coupling portion being operable to engage the clamping portion to retain the bariatric clamp in a closed position.

2. The bariatric clamp according to claim 1, further characterized in that the first elongated portion has a first substrate member and a first polymer portion, wherein the second elongated portion has a second substrate member and a second polymer portion, and wherein at least one of the first substrate member or second substrate member is partially disposed within the loop portion.

3. The bariatric clamp according to claim 1, further characterized in that the first elongated portion has a first substrate member and a first polymer portion, wherein the second elongated portion has a second substrate member and a second polymer portion, and wherein at least one of the first and second substrate members is comprised of titanium.

4. The bariatric clamp according to claim 1, further characterized in that the clamping portion includes one or more operable openings to receive at least a portion of the coupling portion.

5. The bariatric clamp according to claim 1, further characterized in that the first elongated portion has a first substrate member and a first polymer portion, wherein the second elongated portion has a second substrate member and a second polymer portion, wherein the flexible hinge is formed at least partially from a third polymer portion, and the first polymer portion, second polymer portion, and third polymer portion comprise a polymer overmold of the bariatric clamp.

6. The bariatric clamp according to claim 1, further characterized in that the first and second elongated portions of the bariatric clamp form a split-forming section located towards the distal end of the bariatric clamp when the bariatric clamp is in the closed position, and the looping portion of the bariatric clamp forms a passage-forming section located towards the proximal end of the bariatric clamp when the bariatric clamp is in the closed position.

7. The bariatric clamp according to claim 6, further characterized in that the flexible hinge allows fluctuation of the passage formation section.

8. The bariatric clamp according to claim 1, further characterized in that a space between the inner surfaces of the first and second elongated portions can be adjusted by uncoupling the coupling portion from the clamping portion, and re-coupling the coupling portion with the clamping portion to retain the bariatric clamp in a second closed position.

9. The bariatric clamp according to claim 1, further characterized in that the coupling portion is integrated with the first elongated portion.

10. The bariatric clamp according to claim 1, further characterized in that the coupling portion includes a hook feature disposed towards the distal end of the first elongated portion.

11. The bariatric clamp according to claim 10, further characterized in that the first elongated portion has a second substrate member and the first substrate member comprises at least a portion of the hook feature.

12. The bariatric clamp according to claim 1, further characterized in that the coupling portion includes at least one raised member disposed on an outer surface of the first elongated portion.

13. The bariatric clamp according to claim 1, further characterized in that the coupling portion includes at least one retaining loop operable to retain at least a portion of the clamping portion.

14. The bariatric clamp according to claim 1, further characterized in that the first elongated portion has a first substrate member and a first polymer portion, wherein the second elongated portion has a second substrate member and a second polymer portion, and wherein at least one of the first polymer portion and the second polymer portion completely encloses the respective one of the first substrate member and second substrate member.

15. The bariatric clamp according to claim 1, further characterized in that the first elongated portion has a first substrate member and a first polymer portion, wherein the second elongated portion has a second substrate member and a second polymer portion, and at least one of the first polymer portion and the second polymer portion encloses at least partially the respective one of the first substrate member and second substrate member.

16. The bariatric clamp according to claim 1, further characterized in that the first elongated portion has a first substrate member and a first polymer portion, wherein the second elongated portion has a second substrate member and a second polymer portion, and wherein the looping portion further includes at least one portion of the first substrate member and at least one portion of the second substrate member.

17. A bariatric clamp comprising: a first elongated portion having a distal end and a proximal end, wherein at least a portion of the first elongated portion extends along a first longitudinal axis from a distal end to a proximal end when viewed from a first direction, wherein the first longitudinal axis of the first elongated portion lies in a first xy plane of an xyz coordinate system, the proximal end being a first outermost end in a positive x-direction and the distal end being a first outermost end in a negative x-direction;a second elongated portion having a distal end and a proximal end, wherein at least a portion of a second elongated portion extends along a second longitudinal axis from the distal end of the second elongated portion to the proximal end of the second elongated portion when viewed from a first direction, wherein the second elongated portion can be positioned such that the second longitudinal axis of the second elongated portion lies in a second xy plane of the xyz coordinate system, the proximal end of the second elongated portion being a second outermost end in the positive x-direction and the distal end of the second elongated portion being a second outermost end in the negative x-direction, the second xy plane being positioned parallel to the first xy axis but separated in a positive z-direction;a loop portion: a first bend section at the distal end of the first elongated portion and comprising a first bend member extending outwards from the first elongated portion at least partially in a direction composed of negative x and negative z vector components; a second bend section at the distal end of the second elongated portion and comprising a second bend member extending outwards from the second elongated portion at least partially in a direction composed of negative x and positive z vector components; a third member extending from the first bend section in a negative x direction and resting on a third xy plane separated from the xy plane in a negative z direction;a fourth member extends from the second bending section in a negative-x direction and rests on a fourth xy plane separated away from the second xy plane in a positive-z direction; and a flexible hinge joins the third and fourth members;wherein the first and second elongated portions of the bariatric clamp extend from a partition-forming section located toward a proximal end of the bariatric clamp when the bariatric clamp is in a closed position, wherein the partition-forming section is configured to apply pressure to a stomach, wherein the first bending section, the second bending section, the third member, and the fourth member of the bariatric clamp extend from at least a portion of the passage-forming section located toward a distal end of the bariatric clamp in the closed position, wherein the passage-forming section is configured to allow gastric juices to flow from an excluded section of the stomach into a stomach pouch, and wherein the passage-forming section comprises an opening at least partially defined by the looping portion.

18. The bariatric clamp according to claim 17, further characterized in that the opening is larger in the x-axis direction than in the z-axis direction.

19. The bariatric clamp according to claim 17, further characterized in that the first elongated portion has a first thickness measured perpendicular to the first longitudinal axis along a first lateral direction in a yz plane, the first lateral direction being orthogonal to the first longitudinal axis, and wherein the second elongated portion has a second thickness measured perpendicular to the second longitudinal axis along a second lateral direction in the yz plane, the second lateral direction being orthogonal to the second longitudinal axis.

20. The bariatric clamp according to claim 17, further characterized in that it additionally comprises: Q7RQnn / l 7Π7 / B / YILI a fastener portion disposed towards the proximal end of the second elongated portion, wherein the fastener portion includes one or more openings operable to receive at least a portion of the coupling portion.

21. The bariatric clamp according to claim 20, further characterized in that it additionally comprises: the fastening portion disposed towards the proximal end of the second elongated portion, wherein the fastening portion includes one or more openings operable to receive at least a portion of the coupling portion.

22. The bariatric clamp according to claim 21, further characterized in that a separation between the inner surfaces of the first and second elongated portions can be adjusted by uncoupling the coupling portion from the clamping portion, and re-coupling the coupling portion with the clamping portion to retain the bariatric clamp in a second closed position.

23. The bariatric clamp according to claim 20, further characterized in that the coupling portion is integrated with the first elongated portion.

24. The bariatric clamp according to claim 20, further characterized in that the coupling portion includes a hook feature disposed towards the proximal end of the first elongated portion.

25. The bariatric clamp according to claim 17, further characterized in that the first elongated portion further comprises at least one suture through-hole defined through the first elongated portion and configured to receive a suture for suturing the bariatric clamp to the stomach.

26. The bariatric clamp according to claim 17, further characterized in that it comprises a guide member comprising a cord attached to the second elongated portion of the bariatric clamp.

27. The bariatric clamp according to claim 17, further characterized in that the xyz coordinate system is a right-handed Cartesian xY-z coordinate system.

28. A bariatric clamp comprising: a first elongated member resting at least partially in a first xy plane of an xyz coordinate system and having a first distal end and a first proximal end providing opposite ends of the first elongated member along an x-axis of the xyz coordinate system; a first bending portion connected to the first distal end of the first elongated member and bending outwards at least partially along a z-axis of the xyz coordinate system;a second elongated member connected to the first bend portion and resting at least partially in a second xy plane of the xyz coordinate system and having a second distal end and a second proximal end providing opposite ends of the second elongated member along the x-axis of the xyz coordinate system, the second proximal end connecting to the first bend portion, wherein the second xy plane is separated from the first xy plane along the z-axis of the xyz coordinate system; a third elongated member resting at least partially in a third xy plane of the xyz coordinate system and having a third distal end and a third proximal end providing opposite ends of the third elongated member along the x-axis of the xyz coordinate system;a second bending portion connected to the third distal end of the third elongated member and bending outwards at least partially along a z-axis of the xyz coordinate system; a fourth elongated member connected to the second bending portion and resting at least partially in a fourth xy plane of the xyz coordinate system and having a fourth elongated member along the x-axis, the fourth proximal end connecting to the second bending portion, wherein the third xy plane is separated from the xy plane along the z-axis of the xyz coordinate system, wherein the fourth xy plane is separated from the third xy plane along the z-axis of the xyz coordinate system; and a loop member connecting the second distal end of the second elongated member to the fourth distal end of the fourth elongated member.

29. The bariatric clamp according to claim 28, further characterized in that the lacing member comprises a flexible hinge.

30. The bariatric clamp according to claim 28, further characterized in that the first xy plane and the second xy plane are parallel and wherein the third xy plane and the fourth xy plane are parallel.

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