| 摘要 |
According to the present invention, improved apparatus and methods are provided for applying surgical clips to body tissue in inaccessible places and at various angles with particular usefulness in laparoscopic surgery. In one embodiment, the apparatus comprises a shaft having a distal end and a proximal end; means for advancing clips along the shaft toward the distal end with the legs of the clip oriented in a distal direction; means at the distal end of the shaft for rotating the clips relative to the shaft to orient the legs in a lateral direction and means for closing the legs of the clips after the rotation. The means for advancing usually comprises a movable belt disposed in the shaft having a plurality of retainers for holding clips; means for closing typically includes an anvil mounted at the distal end of the shaft and a hammer movable against the anvil. In another embodiment the apparatus further comprises means disposed at the proximal end of the shaft for actuating the hammer, which usually consists of a trigger pivotally mounted to a handle. In an exemplary embodiment, the trigger is ratcheted in stages, wherein one stage advances a clip, a second stage rotates a clip and a third stages closes a clip.
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