Importance

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Abstract

An applier for applying a bulldog clamp endoscopically, and the combination of such an applier with a bulldog clamp, is disclosed. The applier has an endoscopic portion and a handle portion. The handle portion can be manipulated to open and close gripping arms of the applier at the distal end of the endoscopic portion to correspondingly open and close the clamping jaws of the bulldog clamp. The principle feature of the invention is the ability to pivot the clamp while it is gripped within the gripping arms of the applier without the necessity of using another instrument or adjacent bodily tissue. Furthermore, it is possible to perform this pivoting movement from the proximal end of the applier, therefore enabling a surgeon to pivot the clamp from outside the body during endoscopic surgery. The preferred means for achieving pivoting movement includes the combination of a cantilevered spring mounted on one of the arms of the applier which biases the clamp off center from the longitudinal axis of the applier, and a guiding tube fitted over the endoscopic portion for steering the off-centered clamp. This steering function can be performed when the steering tube is moved distally to contact the clamp. The surgeon can then control the degree of pivoting movement by controlling the degree to which he advances the steering tube against the clamp.

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First Claim