JP2006175225A - Highly visible cartridge having improved retainer - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To give a highly visible cartridge having an improved retainer. <P>SOLUTION: An almost translucent cartridge for holding a surgical clip such as used in surgical ligating treatment is given. This cartridge has a base part of a polymer compound and a separable clip retainer of the polymer compound supported by this base part. The polymer compound of these base part and retainer essentially gives a translucent optical effect and has optical diffusing particles which make the surgical clip in the cartridge visible. This polymer compound can further have a radiation impermeable additive for being capable of imaging the cartridge during radiation photography. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present subject matter generally relates to the storage and subsequent removal of clips, particularly surgical tie clips, in preparation for use of the clip in surgical procedures such as congestion. More particularly, the present invention relates to a highly visible cartridge suitable for holding clips in an improved manner.

  This application claims the benefit of US Provisional Patent Application No. 60 / 635,361, dated 10 December 2004, the disclosure of which is incorporated herein by reference in its entirety.

  In many surgical procedures, it is necessary to tie human blood vessels or other tissues during surgery. For example, many surgical procedures require the cutting of blood vessels (eg, veins or arteries) that may need to be tied together to reduce bleeding. In some cases, the surgeon may desire to tie a blood vessel during surgery to temporarily reduce blood flow to the surgical site. In other cases, the surgeon may desire to permanently tie the blood vessel. The ligation of a blood vessel or other tissue can be done by closing the blood vessel with a ligating clip or by suturing the blood vessel with a surgical suture. The use of surgical sutures for ligation requires complex handling of the suture as well as the suture member to form the nodules required to secure the blood vessel. Performing such complicated processing is time consuming and difficult, especially in endoscopic surgery characterized by a limited space and field of view. In contrast, the tied clip is relatively easy and fast to apply. Therefore, the use of tied clips in laparotomy and endoscopic surgery is greatly increasing.

  Various types of clips for congestion and arterial cancer are used in surgery to tie blood vessels or other tissues and stop blood flow. Such clips are also used to block or occlude vessels and blood vessels in special procedures such as sterilization procedures. Typically, the clip is a blood vessel or other tissue using a specialized medical instrument commonly described as a surgical clip removal instrument, a ligation clip removal instrument, or a congestive clip removal instrument. Applied to. Such a clip is permanently placed in place after it is applied to the tissue.

  Tie clips may be classified according to geometric structure (eg, symmetric or asymmetric clip) and the material being manufactured (eg, metal clip or polymer clip). it can. Symmetric clips are generally “C”, “U”, or “V” shaped, and are thus generally symmetric about a central major axis extending between the legs of the clip. Symmetric clips are typically formed from materials such as stainless steel, titanium, tantalum, or alloys thereof. An example of such a clip is disclosed in US Pat. With a dedicated clip device, the metal clip is permanently deformed to cover the blood vessel. The asymmetric clip is usually made of a polymer material.

  Because the types of clips described are small and various clips are often used in surgical procedures, the device that holds the clips can be used in the manufacture and / or combination of the clips and the ultimate in the surgical procedure. Used to house and hold multiple clips between different uses. Multiple clip cartridges have been developed, and some of these clip cartridges are designed to prevent the clips from being loosened or removed completely during shipping and processing. The clip cartridge is intended to be used with a “manual” clip device.

  As used in this specification, the term “automatic” is adjacent to the jaws of the clip device so that a new clip is automatically applied to the jaw after the previous clip has been crimped into place. A kind of clip device for holding a plurality of clips for hemostasis is shown. An example of a device for dispensing a plurality of clips for a series of applications is disclosed in US Pat.

  In contrast, the term “manual” refers to a type of clip device that receives one clip at a time between jaws and must be manually reloaded after the previous clip has been crimped. Such manual instruments typically have a forceps-type design, and the reloading action inserts the instrument jaws into a clip holder, i.e. cartridge, and engages or grips the contained clip. It is almost accomplished by that. Clip device jaws typically have elongated grooves to receive the legs of the clip and can have a stop plate at the end of each groove to limit movement of the clip in the distal direction. This clip is fixed to the jaw by the dam plate if there is a dam plate due to the natural elastic force of the leg of the clip. An example of a forceps-type instrument having a regular jaw that is used to grip and maintain the alignment of the clip is disclosed in US Pat.

  Many types of clip cartridges currently available have a plurality of longitudinally spaced clip holding chambers. A single clip is held in each chamber by various means, inserted into the selected clip chamber, securely attached to the clip, such that it can be overcome whatever clip holding means is used. It is removed from the clip chamber by a forceps-type clip device. In this way, the clip can be removed from the clip chamber.

  Various mechanisms are known, by which the clip can be retained in the chamber of the clip cartridge. In all cases, the desired purpose of such a cartridge is to minimize the force required to load the clip into the instrument and then to remove the clip from the cartridge while maximizing safety. By safety, the clip is held in the cartridge and in the instrument jaws. For metal clips, the clip is usually well held by friction between the clip and the side wall of each chamber of the clip. Clip cartridges are typically molded from a molded plastic material so that the walls of each clip chamber are somewhat elastic and the clip instrument jaws are inserted into the chamber to remove the clip. Can be pushed away from each other. An example of a cartridge that holds a clip in each clip chamber by frictional engagement with the sidewall of each chamber is shown in US Pat.

  In some prior art clip cartridges designed for metal clips, each clip chamber is provided with a central post that approximately matches the shape of the open clip. Is slightly larger so that the frictional contact between the leg of the clip and the central post holds the clip in the clip chamber when the clip is pushed onto the central post. This type of cartridge is shown in US Pat. Nos. 5,6,7,8,9, all issued by Wood et al.

  The clip is partially retained by maintaining each clip in the clip chamber with tension by the interaction of the central post between the chamber and the central portion of the clip and the protrusions extending into each chamber from both ends to the central post. Conventional cartridges are also known which hold in a straight state. The clip is held by having a central hinge portion of the clip pushed upward by the central post and both ends of the clip pushed downward by the protruding portion. Such a cartridge is shown in U.S. Pat.

  U.S. Pat. No. 6,053,028 to Samuels describes another type of cartridge having a plurality of ribs extending inwardly from each side wall of each clip chamber toward the clip so as to hold the clip by frictional engagement with the rib. Is disclosed. U.S. Patent No. 6,053,009 by Samuels et al. Shows another embodiment for situations where the clip is intended to be kept loose in the cartridge without frictional engagement between the clip and the chamber. The clips in this situation are held in each cartridge by a covering tape that can be easily cut by the desired instrument.

These prior art cartridges for metal as well as polymer clips have been used to obtain proper results, but the structural design and construction of the cartridge to limit the function of the cartridge during use There are several drawbacks.
US Pat. No. 5,509,920 US Pat. No. 4,509,518 U.S. Pat. No. 3,326,216 U.S. Pat. No. 4,076,120 U.S. Pat. No. 3,270,745 U.S. Pat. No. 3,326,216 US Pat. No. 3,363,628 U.S. Pat. No. 3,439,522 U.S. Pat. No. 3,439,523 US Pat. No. 3,713,533 U.S. Pat. No. 4,146,130 U.S. Pat. No. 4,696,396

  First, because of the small size of the surgical clip housed within the cartridge and the prior art cartridge material impervious to visible light, surgeons are particularly lit in modern operating rooms. In the past, it was difficult to accurately determine how many clips were left in the cartridge. Accordingly, it is desirable to provide an improved clip cartridge that allows a surgeon to quickly determine how many clips remain in the cartridge by viewing the cartridge body.

  Second, like a small surgical instrument used in a surgical procedure, it may be accidentally dropped into the patient's body cavity during the procedure or left in place . Accordingly, it is desirable to provide an improved clip cartridge that can be imaged by radiographic techniques so that the presence of the remaining cartridge in the patient's body cavity can be easily detected.

  Finally, many cartridge retainer mechanism structures in the prior art are designed to simply function as a place holder for the clip during transport and preparation for use by the surgeon. These retainers do not function well when the cartridge is dropped or moved violently, resulting in early release of the clip from the cartridge. Thus, an improved design incorporating a novel structural design that not only functions to hold the clip statically but also acts as a shock absorber that dynamically holds the clip when the cartridge is moved violently. It is preferred to provide a clip cartridge.

  In one embodiment of the present subject matter, a substantially translucent cartridge holds a plurality of biocompatible surgical clips formed of a suitable material including metals as well as polymeric compounds, each clip being generally symmetrical. It has a pair of legs that extend from the hinge point to form a shape and is removed from the cartridge by a clip removal device. The cartridge has a polymer base and a separable polymer retainer supported by the base. These base and retainer polymeric compounds have light diffusing particles to provide a substantially translucent optical effect and to make the surgical clip visible within the cartridge. The polymeric compound can optionally include a radiopaque additive to allow the cartridge to be imaged during radiography. The base has a base shaft extending in the major axis direction. The base portion has a plurality of walls that extend along the base portion, are arranged so as to extend in the lateral direction with respect to the base shaft, and are spaced apart in the axial direction. These walls define a plurality of clip compartments spaced apart in the axial direction, each clip compartment having a first side opening and a second side opening. The base further includes a plurality of clip hinge support members. Each hinge support member is disposed in each compartment and is adapted to prevent downward movement of the surgical clip by supporting the clip near its hinge point. The clip retainer has a first elastic tab and a second elastic tab facing each other. Each tab extends from a proximal end attached to the clip retainer through a corresponding side opening to a free end that extends into the corresponding clip compartment. Further, each tab terminates at a tip having a diverging side surface with the groove extending outward.

  In other embodiments of the present subject matter, the cartridge holds a plurality of surgical clips, each clip having a pair of legs extending from a hinge point to form a generally symmetrical shape, and the clip The device is adapted to be removed from the cartridge. The cartridge has a polymer compound base and a separable polymer compound clip retainer. The polymeric compound may optionally include a radiopaque additive to make the cartridge imageable during radiography and to make the surgical clip in the cartridge visible. The light diffusing particles may be selectively contained. The base has a base shaft extending in the major axis direction. The base portion also has a plurality of walls that extend along the base portion, are disposed so as to extend laterally with respect to the base shaft, and are spaced apart in the axial direction. The walls define a plurality of clip compartments spaced apart in the axial direction, each clip compartment having a first side opening and a second side opening. The base further includes a plurality of clip hinge support members, each clip hinge support member being disposed in each compartment, and below the surgical clip by supporting the clip near its hinge point. Is designed to prevent the movement of. The clip retainer has a plurality of pairs of first elastic tabs and second elastic tabs facing each other, and each tab has a corresponding side opening from a base end portion attached to the clip retainer. And extends to a free end that extends into the corresponding clip compartment. In addition, each tab terminates at a distal end where the groove has a diverging side extending outwardly, and is positioned between the diverging sides and inwardly toward the proximal end of the tab. And further has a slit extending to the surface.

  In a further aspect of the present subject matter, a method is provided for loading a selected surgical clip into a surgical clip instrument. Preferably, the clip is of the type having a first leg, a second leg, and a hinge point connecting the first leg and the second leg. The clip device is of the type having a pair of first and second jaws opposed to each other adapted to be engaged with a first leg and a second leg of the clip. It is preferable. In this method, a substantially translucent clip cartridge is provided. This clip cartridge has a polymer compound base and a separable polymer compound clip retainer. These base and retainer polymeric compounds have light diffusing particles to provide a substantially translucent optical effect and to make the surgical clip visible within the cartridge. Also, the polymeric compound of these bases and retainers can optionally include a radiopaque additive for making the cartridge imageable during radiography. The method further includes viewing the clip cartridge so as to verify the position of the clip within the clip cartridge. The clip device is then inserted into one of the plurality of compartments to engage the selected clip. At this point, the selected clip is removed from the cartridge.

  Accordingly, the object of the present subject matter is to hold a clip having a pair of legs extending from a hinge point in a generally symmetrical shape and being removed from the cartridge by a clip device in an improved manner. It is to provide a highly visible cartridge that is adapted to.

  The purpose of the present subject matter has been described above, and this purpose has been addressed in whole or in part by the present subject matter. Other objects will become apparent as the description proceeds, when taken in conjunction with the accompanying drawings as best described below.

  FIG. 1 shows an example of a generally symmetrical surgical clip, generally designated 100. This clip is suitable for use with the cartridge described below. This clip 100 and other clips of similar design can be latched around the blood vessel or other tissue to tie the blood vessel and thus stop or reduce fluid flow through the blood vessel. It is particularly effective as a clip for blood congestion. The clip 100 can be constructed of a suitable biocompatible material that includes a metal and a polymer compound. The clip 100 is substantially symmetric and generally has a “C”, “U”, “V” shape. The main body of the clip 100 has a first leg portion 102 and a second leg portion 104. The first leg 102 and the second leg 104 are joined at their proximal end by an integral hinge section 106.

  In FIG. 2, a preferred embodiment of a combination clip cartridge, indicated generally at 200, is provided in accordance with the present subject matter. The clip cartridge 200 is designed to have a plurality of substantially identical clip chambers, each of which is suitable for housing one clip 100. The clip preferably has a generally symmetrical design as described above and shown in FIG. Although FIG. 2 illustrates a clip cartridge 200 of this embodiment suitable for housing six clips 100, other embodiments that accommodate more or less clips 100 can be provided. If desired, an adhesive backing (not shown) of the clip cartridge 200 may be used to facilitate attachment of the clip cartridge 200 to a tray or other support component during use. Can be applied to the bottom surface.

  As will be described in greater detail below with reference to FIGS. 2 and 3, the clip cartridge 200 includes a base generally designated 210 and a detachable clip generally designated 250. And a retainer member. Preferably, the base 210 and the retainer 250 are formed of a polymer compound. This polymeric compound can be polypropylene, nylon, polyethylene terephthalate (PET), polybutylene terephthalate (PBT), polyoxymethylene, acrylonitrile butadiene styrene (ABS), or other types of compositions known to those skilled in the art. May be included.

  In order to provide an improved clip cartridge that allows a surgeon to quickly determine the number of clips remaining in the cartridge by visually evaluating the cartridge body, an implementation of the subject cartridge 200. The form is designed to be substantially translucent. The substantially translucent optical effect imparted to the cartridge 200 according to the present subject matter results in a very small amount of light diffusing particles having an average maximum particle size of about 0.1 to about 200 microns in the thermoplastic polymer. It is obtained by mixing. Such mixing is performed before molding or extrusion. The particulate light diffusing material may be present from 0.01% to 15% by weight of the composition mixture. Such light diffusing particles may be in the form of powders, fibers, whiskers, platelets, flakes, aggregates, aggregates, or mixtures thereof. Suitable particles include calcium carbonate for reagent, natural calcium carbonate, including powdered chalk, powdered limestone, powdered marble, and powdered dolomite, and powdered or fibrous calcium sulfate. Glass fiber, glass piece, solid glass sphere, hollow glass sphere, aluminum silicate, synthetic calcium silicate, and silicates such as zirconium silicate, talc and kaolin , Mica flakes, mica platelets, mica pearls and natural silicic acids such as sand, quartz, wollastonite, pearlite, tripoli, and diatomaceous earth, and fumed silicas And titanates such as barium titanate, sulfates such as barium sulfate, sulfates such as zinc sulfide and molybdenum sulfide, aluminum oxide, zinc oxide, and beryllium oxide. Metal oxides such as magnesium oxide, zirconium oxide, antimony oxide, titanium dioxide, and aluminum hydroxide, aluminum diboride flakes, wollastonite, basalt, boron, boron nitride, and ceramic Inorganic fibers such as, monocrystalline fibers such as alumina trihydrate fibers (eg whiskers), aluminum silicates containing aluminum oxide and magnesium oxide, and calcium sulfate hemihydrate (calcium sulfate) hemihydrate) fibers, and organic matting agents such as wood dust and starch, and mixtures of any of the foregoing, but are not limited to these.

  The subject cartridge 200 includes a radiopaque additive so that the cartridge 200 can be imaged by radiographic techniques, so that the unexpected presence of the cartridge 200 within a patient's body cavity is facilitated. It is envisioned that it can be detected. The radiopaque additive is preferably present in about 1.0% to about 5.0% of the polymeric compound. This additive may also be a ceramic material such as tungsten carbide or tungsten boride, or a metal (eg, platinum, tantalum, iridium, tungsten, rhenium, gold, stainless steel), conductive ink, or barium sulfate. Although it may be made of a metallurgical material such as a heavy metal salt, or a combination thereof, other materials may be used. Most preferably, the radiopaque additive is 2.0% barium sulfate by weight.

  With reference to FIG. 3, the structure of the clip cartridge 200 will be described. The clip cartridge 200 has a base 210. The base may have a base recess 212 formed in the base 210 along the base long axis BA while manufacturing the clip cartridge 200 to reduce the required structural material. . The first axial end wall 214 and the second axial end wall 215, the first side wall 216, and the second side wall 217 extend upward from the base 218 of the base 210. A post 219 extends upward from the base 218 to facilitate mounting of a clip retainer member 250, described in detail below. As will be apparent from the following description, the clip cartridge 200 is configured so that the symmetrical clips 100 can be loaded in only one direction while all the clips 100 are loaded in the same direction. . Therefore, as shown in FIG. 3, the first leg portion 102 and the second leg portion 104 of each clip 100 are always downward in the clip cartridge 200 when the clip 100 is accommodated. It extends.

  Further, in FIG. 3, a plurality of laterally and axially spaced compartment walls 222 extend upward from the base 218 and are spaced apart from each other along the base axis BA of the clip cartridge 200. The two lateral walls closest to the axial end of the clip cartridge 200 (eg, the first and seventh lateral walls in the particular example shown) are the outermost lateral walls 222A, Each is designed as 222B. Each adjacent pair of lateral walls 222 (including the outermost lateral walls 222A, 222B) define a corresponding clip compartment 226 therebetween. As shown in FIG. 3, each lateral wall 222 is generally symmetrical about the base axis BA, and each lateral wall 222 reduces the cartridge and improves the accessibility of the clip 100. Thus, it can be tapered outward from the base axis BA.

  Further, in FIG. 3, each lateral wall 222 has a pair of opposing lateral walls that define the boundaries of each compartment 226. For simplicity, the wall facing rearward in FIG. 3 is labeled 223A and the wall facing front is shown as 223B. To form a predetermined clip compartment 226, the wall surface 223A of one lateral wall 222 faces the rear of the base 210, and the wall surface 223B of the rear lateral wall 222 adjacent thereto is the base. Facing the front of 210. The mutually facing lateral wall surfaces 223A, 223B associated with each clip compartment 226 define a pair of side openings, generally designated 228A, 228B, in the clip compartment 226, each opening Is defined on each side of the base axis BA of the clip cartridge 200. As will be described later, portions of the clip retainer member 250 extend into the respective clip compartments 226 through the side openings 228A, 228B.

  Still referring to FIG. 3, each clip compartment 226 of the clip cartridge 200 supports a clip 100 in the form of a saddle or post to prevent downward movement of the clip 100 by supporting the clip 100 near the hinge point 106 of the clip. A member 232 is provided. Each clip support member 232 is preferably formed along a base axis BA between intermediate portions of adjacent lateral walls 222 that correspond to each other. The clip support member 232 preferably extends from the base 218. Alternatively, the clip support member 232 may be coupled between adjacent lateral walls 222 without being supported by the base 218, and the clip support member 232 may be coupled to the adjacent lateral wall 222. Instead, it may be supported by the base 218.

  3 and 4, the clip cartridge 200 further includes a detachable clip retainer member 250. The clip retainer member 250 generally has an outer frame structure such as a box having a retainer bottom wall 252, end walls 253A, 253B, and side walls 254A, 254B. An aperture 255 is preferably formed at each corner of the bottom wall 252 so that it receives the corresponding post 219 of the cartridge base 210 and is attached to the clip cartridge base 210.

  A pair of continuous elastic fingers, i.e., tabs 262A, 262B, opposed to each other, are attached to the side walls 254A, 254B at base ends 262A ', 262B', respectively, and the distal ends 262A ", 262B" are attached to each other. Each extends inward. Each pair of tabs 262A, 262B is spaced from the adjacent pair of tabs 262A, 262B along the longitudinal direction of the clip retainer member 250. Preferably, each of the tab tips 262A ", 262B" has a groove (see FIG. 4) generally designated G. The groove has diverging sides G1, G2 extending outwardly toward the outermost ends of the tab ends 262A ", 262B". In another embodiment of the present subject matter, the tab tips 262A ", 262B" are indicated generally by S and extend inwardly toward the tab proximal ends 262A ', 262B'. It has further. The slot S plays a role as a shock absorber. The diverging side surfaces G1 and G2 of the groove G statically hold the clip 100 in a predetermined position during normal use and conveyance, and the slot S is used in a situation where the clip 100 is moved violently. Allows energy absorption. This slot S holds the clip 100 more dynamically in the cartridge in situations where the early release of the clip 100 is caused by the fall of the cartridge 200 or other violent movement (as seen in prior art cartridges). can do.

  As shown in FIGS. 2 and 3, prior to sealing and assembling the clip cartridge 200, when the clip 100 is loaded into the respective clip compartment 226, the clip retainer member 250 can be attached to the clip cartridge. Mounted on and engaged with the base 210. In order to attach the clip retainer member 250 to the base 210 of the clip cartridge, each aperture 255 is fitted with a corresponding post 219 that projects upwardly from the base 218 of the clip cartridge. In the mounting position of clip retainer member 250, each pair of tabs 262A, 262B extends into corresponding clip compartments 226 from correspondingly opposed side openings 228A, 228B. The diverging side surfaces G1 and G2 of the tab groove portion G of each tab 262A and 262B are in contact with the first leg portion 102 or the second leg portion 104 of the clip 100, respectively. In this way, the clip 100 is prevented from moving excessively in the clip compartment 226 (provided by the slot S as further shock absorbers discussed above).

  With reference to FIGS. 5 and 6, the manner in which the clip 100 can be viewed and removed from the clip cartridge 200 will be described. When a substantially translucent cartridge, as described in detail above, is initially provided, the surgeon looks at the cartridge from virtually any angle to ascertain the number and location of the clips 100 within the cartridge 200. can do. An exemplary manual forceps-type clip applier generally designated 300 is shown in place to engage the clip 100 within the selected clip compartment 226. The instrument 300 has a pair of jaws 302 and 304 at the tip. These jaws have groove portions 306 and 308 and retaining plates 310 and 312 on the inner surfaces facing each other. It should be understood that if a clip removal device is operable with a particular clip loaded into the cartridge, then the clip removal device is suitable for use with the cartridge 200. Accordingly, the described subject matter provides clip cartridges that can be used with instruments having and without a stop plate.

  As the instrument jaws 302, 304 are initially introduced into the compartment 226, the tips 262 A ″, 262 B ″ of the tabs 262 A, 262 B help to center the instrument over the clip 100. . When fully seated in the compartment 226, the stop plates 310, 312 of the jaws 302, 304 pass through the ends of the clip legs 102, 104 and the clips (legs 102, 104) Due to the inherent elastic force, it will expand slightly in the grooves 306,308. Finally, when the jaws 302, 304 are successfully engaged with the clip legs 102, 104, the jaws 302, 304 are withdrawn from the clip compartment 226 along with the fully engaged clip 100. In this way, the clip 100 can be removed from the clip cartridge 200 for use in a desired surgical procedure.

  It will be understood that various details of the present subject matter may be changed without departing from the spirit of the present subject matter. Moreover, the foregoing description is for illustration purposes only and is not intended to be limiting as the subject matter is defined in the appended claims.

FIG. 3 is a perspective view of an example of a plurality of generally symmetrically shaped clips suitable for use in connection with the subject clip cartridge. 1 is a perspective view of a combination clip cartridge provided with a plurality of loaded clips and provided in accordance with the present subject matter. FIG. FIG. 3 is an exploded perspective view of the clip cartridge shown in FIG. 2. FIG. 3 is an exploded perspective view of a tab of a clip retainer provided to the clip cartridge shown in FIG. 2. 1 is a perspective view of a clip cartridge provided in accordance with the present subject matter with a clip device inserted into the compartment and engaged with a clip loaded in one of the clip cartridge compartments. FIG. FIG. 6 is another perspective view of the clip cartridge shown in FIG. 5 with the clip removed from the clip cartridge.

Explanation of symbols

DESCRIPTION OF SYMBOLS 100 ... Clip, 200 ... Cartridge, 210 ... Base, 222 ... Wall, 232 ... Clip hinge support member, 250 ... Clip retainer member

Claims (28)

A substantially translucent cartridge for holding a plurality of surgical clips, each clip having a pair of legs extending from a hinge point to form a generally symmetrical shape, and the clip It is designed to be removed from this cartridge by an ejector, and this cartridge
(A) a base portion of a polymer compound having a base axis extending in the major axis direction;
(B) a polymer compound clip retainer supported by the base, wherein the base is
(I) It extends along this base part, is arrange | positioned so that it may extend in the horizontal direction with respect to the said base axis, and is spaced apart in the axial direction which each had the 1st opening part and the 2nd opening part which faced each side A plurality of clip compartments in between, a plurality of axially spaced walls,
(Ii) a plurality of clip hinge supports, each disposed in each clip compartment, adapted to prevent the surgical clip from moving downward by supporting said clip near its hinge point; And a member, and
The clip retainer is
A plurality of pairs of first elastic tabs and second elastic tabs opposed to each other, each tab corresponding from a proximal end attached to the clip retainer through a corresponding side opening Extending to a free end that extends into the clip compartment, and each tab terminates at a tip having diverging sides extending outwardly,
(C) The polymer compound of the base and the retainer has a light diffusing particle for providing a substantially translucent optical effect and making the surgical clip visible in the cartridge. ,cartridge.   The polymer compound of the base and the retainer is selected from the group consisting of polypropylene, nylon, polyethylene terephthalate (PET), polybutylene terephthalate (PBT), polyoxymethylene, acrylonitrile butadiene styrene (ABS) Item 1. The cartridge according to Item 1.   The cartridge of claim 1, wherein the light diffusing particles are present at about 0.01% to 15% by weight.   The cartridge of claim 3, wherein the light diffusing particles have an average maximum particle size of from about 0.1 microns to about 200 microns.   The light diffusing particles include calcium sulfate, talc, silicate, kaolin, silicic acid, mica flakes, mica platelet, mica pearl, titanate, metal sulfate, metal carbonate, sulfide, metal oxide, boron. 4. The cartridge of claim 3 selected from the group consisting of compounds, wollastonite, boron, ceramic, single crystal fiber, boron nitride, natural calcium carbonate, and mixtures thereof.   The base and retainer polymer compound further has a radiopaque additive present at about 0.1% to 5.0% by weight to enable imaging of the cartridge during radiography. The cartridge of claim 1.   The cartridge of claim 6 wherein said radiopaque additive is barium sulfate.   The cartridge of claim 6 wherein said radiopaque additive is present at 2.0% by weight.   2. The cartridge of claim 1, wherein the tip of each tab of the clip retainer further includes a slot disposed between the diverging side surfaces and extending inwardly to a proximal end of the tab.   The cartridge of claim 1, further comprising a surgical clip disposed in at least one of the clip compartments and supported by the corresponding clip hinge support member.   The cartridge of claim 10, wherein the surgical clip is a metal surgical clip.   Used with a forceps-type clip removal device having a pair of jaws for receiving the clips, each jaw having a groove for receiving a leg of the clip, the groove being received in the groove. The cartridge according to claim 10, wherein the cartridge is in contact with a leading end stop plate for restricting movement of one end portion of the leg portion of the clip to the leading end direction. A substantially translucent cartridge for holding a plurality of surgical clips, each clip having a pair of legs extending from a hinge point to form a generally symmetrical shape, and the clip It is designed to be removed from this cartridge by an ejector, and this cartridge
(A) a base portion of a polymer compound having a base axis extending in the major axis direction;
(B) a separable clip retainer made of a polymer compound supported by the base, and the base is
(I) Axial direction extending along the base and extending in a lateral direction with respect to the base axis, each having a first opening and a second opening facing each other laterally A plurality of clip compartments spaced in between, a plurality of axially spaced walls,
(Ii) a plurality of clip hinge supports, each disposed in each clip compartment, adapted to prevent downward movement of the surgical clip by supporting said clip near its hinge point; And a member, and
The clip retainer is
A plurality of pairs of first elastic tabs and second elastic tabs opposed to each other, each tab corresponding from a proximal end attached to the clip retainer through a corresponding side opening Each tab has divergent sides extending outwardly, the tabs being positioned between the diverging sides and extending to the free end extending into the clip compartment A cartridge terminating at a distal end further having a slot extending inwardly into the portion.   The polymer compound of the base and the retainer is selected from the group consisting of polypropylene, nylon, polyethylene terephthalate (PET), polybutylene terephthalate (PBT), polyoxymethylene, acrylonitrile butadiene styrene (ABS). The cartridge of claim 13.   The polymeric compound of the base and the retainer further includes a radiopaque additive present at about 0.1% to 5.0% by weight to enable imaging of the cartridge during radiography. The cartridge according to claim 13.   The cartridge of claim 15, wherein the radiopaque additive is barium sulfate.   16. The cartridge of claim 15, wherein the radiopaque additive is present at 2.0% by weight.   16. The cartridge of claim 15, wherein the polymeric compound of the base and the retainer has light diffusing particles to provide a substantially translucent optical effect and to make the surgical clip visible in the cartridge visible. .   19. The cartridge of claim 18, wherein the light diffusing particles are present from about 0.01% to 15% by weight.   The cartridge of claim 18, wherein the light diffusing particles have an average maximum particle size of about 0.1 microns to about 200 microns.   The light diffusing particles include calcium sulfate, talc, silicate, kaolin, silicic acid, mica flakes, mica platelet, mica pearl, titanate, metal sulfate, metal carbonate, sulfide, metal oxide, boron. 19. The cartridge of claim 18 selected from the group consisting of compounds, wollastonite, boron, ceramic, single crystal fiber, boron nitride, natural calcium carbonate, and mixtures thereof.   14. The cartridge of claim 13, further comprising a surgical clip disposed in at least one of the clip compartments and supported by the corresponding clip hinge support member.   23. The cartridge of claim 22, wherein the surgical clip is a metal surgical clip.   Used with a forceps-type clip removal device having a pair of jaws for receiving the clips, each jaw having a groove for receiving a leg of the clip, the groove being received in the groove. 14. The cartridge according to claim 13, wherein the cartridge is in contact with a leading end stop plate for restricting movement of one end portion of the leg portion of the clip to the leading end direction. A method for loading a selected surgical clip into a surgical clip removal instrument comprising: a first leg; a second leg; and the first leg. And a hinge point joining the second leg and the clip removal device is adapted to be engaged with the first leg and the second leg of the clip. Having a pair of first and second jaws opposed to each other, the method comprising:
(A) providing a substantially translucent clip cartridge;
(B) viewing the clip cartridge so as to confirm the position of the clip in the clip cartridge;
(C) inserting a clip removal device into a selected one of the plurality of clip compartments to engage the selected clip;
(D) removing the selected clip from the cartridge, the cartridge comprising:
(I) a polymer base having a plurality of clip compartments and a plurality of clip hinge support members;
(Ii) a polymeric clip retainer supported by the base, each clip hinge support member being disposed in a corresponding clip compartment, and supporting the clip near the clip hinge point. The clip retainer has a plurality of pairs of first elastic tabs and second elastic tabs opposed to each other, and each tab includes the clip retainer. Extending from the proximal end attached to the distal end extending into the corresponding clip compartment, and each tab has a diverging side surface with the groove extending outwardly. It ends at the tip,
(Iii) The base and retainer polymer compound has light diffusing particles to provide a substantially translucent optical effect and to make the surgical clip visible in the cartridge visible.   26. The method of claim 25, comprising providing a slot disposed between the diverging sides of the tab groove of each elastic tab and extending inwardly to the proximal end of the tab.   26. The method of claim 25, further comprising providing a radiopaque additive to the base and retainer polymer so that the cartridge can be imaged during radiography.   26. The method of claim 25, comprising providing a metal surgical clip in the clip cartridge.

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