Device and Method for Through the Scope Endoscopic Hemostatic Clipping

Abstract

Medical device used to cause hemostasis of blood vessels using a clip arrangement delivered to a target region through an endoscope. Method for using the device to cause hemostasis of a blood vessel through an endoscope. Medical device including a reversibly closeable clip, a locking arrangement, a control wire, a sheath, and a handle with an actuating trigger. Through the endoscope, hemostatic clipping device that is fully reversible and lockable. Hemostatic clip that reversibly targets and clips bleeding ulcers.

1 - 45 . (canceled) 
     
     
         46 . A medical device, comprising:
 a clip having first and second clip legs, at least proximal portions of the first and second clip being received within the capsule;   a control wire operable coupled to the clip to separate distal ends of the first and second clip legs from one another into a tissue receiving configuration and to draw the distal ends of the first and second clip legs toward one another into a tissue gripping configuration;   a sheath enclosing the control wire and releasably coupled to the capsule;   an actuator coupled to the control wire to move the control wire proximally and distally within the sheath; and   a link coupling the control wire to the clip, the link including first and second opening members, each of the first and second opening members engaging a radially inner surface of a corresponding one of the first and second clip legs so that, movement of the control wire distally through the sheath urges the link distally moving the first and second opening members distally into an opening configuration in which each of the first and second opening members pushes radially outward against the respective one of the first and second clip legs to move the first and second clip legs into the tissue receiving configuration, movement of the control wire proximally relative to the sheath drawing the first and second clip legs together into the tissue gripping configuration until a tension above a predetermined threshold is placed on the control wire at which point the link releases the control wire from the clip and the capsule is released from the sheath.   
     
     
         47 . The medical device of  claim 46 , wherein the distal end of the control wire comprises an increased diameter portion. 
     
     
         48 . The medical device of  claim 47 , wherein the increased diameter portion has a substantially spherical cross section. 
     
     
         49 . The medical device of  claim 46 , wherein contact between the first and second clip legs with the capsule draws the first and second clip legs together as the control wire is withdrawn proximally relative to the sheath. 
     
     
         50 . The medical device of  claim 46 , wherein before the clip is separated from the control wire, moving the sheath proximally relative to the control wire moves the clip out of the capsule, moving the first and second clip legs into the tissue receiving configuration. 
     
     
         51 . The medical device of  claim 46 , further comprising a lock arrangement for locking the clip within the capsule in the closed configuration when the clip is separated from the control wire. 
     
     
         52 . The medical device of  claim 46 , wherein a proximal tensile force applied to the clip via the control wire is opposed by a distal compressive force on the sheath. 
     
     
         53 . The medical device of  claim 46 , wherein each of the first and second opening members slidingly engages the radially inner surface of the corresponding one of the first and second clip legs. 
     
     
         54 . The medical device of  claim 46 , wherein the sheath is constructed to communicate a first force opposing a second force applied to the clip via the control wire when the control wire is coupled to the link. 
     
     
         55 . The medical device of  claim 46 , wherein the control wire is reversibly operable to open and close the clip until the clip is separated from the control wire. 
     
     
         56 . The medical device of  claim 46 , wherein the first and second clip legs are configured to move radially inward when the clip is drawn proximally relative to the sheath due to a compressive force between the capsule and the first and second clip legs. 
     
     
         57 . The medical device of  claim 46 , wherein a distal portion of the sheath is comprised of a rigid portion. 
     
     
         58 . A medical device, comprising:
 a clip having first and second clip legs;   a control wire coupled to the clip, the control wire being movable relative to a sheath to open and close the clip legs, a distal end of the control wire received between arms of the clip; the sheath enclosing a distal portion of the control wire, wherein the control wire is configured to release from the clip as the arms spread laterally away from the control wire; and   an actuator coupled to the control wire to move the control wire relative to the sheath and to release the control wire from the clip.   
     
     
         59 . A method, comprising:
 inserting a medical device comprising a clip having first and second clip legs at least partially received within a capsule, a control wire, a sheath enclosing the control wire, a distal end of the sheath being releasably coupled to the capsule;   positioning the medical device at a desired deployment location;   moving the control wire distally relative to the sheath to move the first and second clip legs distally to extend out of the capsule, movement of the control wire distally operating a link coupled between the control wire and the clip so that first and second opening members of the link push radially outward against radially inner surfaces of the first and second clip legs, respectively, so that, the first and second opening members urge first and second clip legs radially outward into a tissue receiving configuration in which distal ends of the first and second clip legs are separated from one another;   moving the control wire proximally relative to the sheath to draw the first and second clip legs proximally into the capsule, contact between the capsule and the first and second clip legs forcing the first and second clip legs together into a tissue gripping configuration; and   further withdrawing the control wire proximally until a tension above a predetermined threshold is placed on the control wire at which point the link releases the control wire from the clip and the capsule is released from the sheath.