Abstract:
Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, first and second links attached to both the jaws and the housing, and a driver. The housing, first and second jaws, and first and second links form a linkage mechanism that allows the jaws to engage tissue and be left in vivo.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a Continuation-In-Part of U.S. patent application Ser. No. 13/270,784 filed on Oct. 11, 2011, and also claims the benefit of U.S. Provisional Patent Application Ser. No. 61/423,420 filed on Dec. 15, 2010, entitled “MEDICAL DEVICES WITH DETACHABLE PIVOTABLE JAWS,” All of the foregoing applications are hereby incorporated by reference. 
    
    
     BACKGROUND 
     Conventionally, a clip may be introduced into a body cavity through an endoscope to grasp living tissue of a body cavity for hemostasis, marking, and/or ligating. Such clips are often known as surgical clips, endoscopic clips, hemostasis clips and vascular clips. In addition, clips are now being used in a number of applications related to gastrointestinal bleeding such as peptic ulcers, Mallory-Weiss tears, Dieulafoy&#39;s lesions, angiomas, post-papillotomy bleeding, and small varices with active bleeding. Clips have also been attempted for use in closing perforations in the stomach 
     Gastrointestinal bleeding is a somewhat common and serious condition that is often fatal if left untreated. This problem has prompted the development of a number of endoscopic therapeutic approaches to achieve hemostasis such as the injection of sclerosing agents and contact thermo-coagulation techniques. Although such approaches are often effective, bleeding continues for many patients and corrective surgery therefore becomes necessary. Because surgery is an invasive technique that is associated with a high morbidity rate and many other undesirable side effects, there exists a need for highly effective, less invasive procedures. 
     Mechanical hemostatic devices such as clips have been used in various parts of the body, including gastrointestinal applications. One of the problems associated with conventional hemostatic devices and clips, however, is that many devices are not strong enough to cause permanent hemostasis. Further, clips have also been attempted for use in closing perforations in the stomach or gastrointestinal structures, but unfortunately traditional clips suffer from difficult placement and the capability to grasp a limited amount of tissue, potentially resulting in incomplete closure. 
     SUMMARY 
     The invention may include any of the following aspects in various combinations and may also include any other aspect described below in the written description or in the attached drawings. 
     In a first aspect, a medical device is provided for engaging tissue, the medical device including a housing, first and second jaws, first and second links, and a driver. The housing defines an internal passageway and a longitudinal axis extending between proximal and distal ends of the housing. The housing also defines a jaw guide surface, a first link guide surface and a second link guide surface, each of the guide surfaces extending longitudinally between proximal and distal ends of the guide surfaces. The first jaw is slidably and pivotally connected to the housing, and has proximal and distal ends. The first jaw is slidably received within the internal passageway for longitudinal movement along the jaw guide surface. The second jaw is slidably and pivotally connected to the housing, and has proximal and distal ends. The second jaw is slidably received within the internal passageway for longitudinal movement along the jaw guide surface. The first link has first and second ends. The first end is fixedly attached to the first jaw, and the second end is slidably and pivotally attached to the housing for longitudinal movement along the first link guide surface. The second link has first and second ends. The first end is fixedly attached to the second jaw, and the second end is slidably and pivotally attached to the housing for longitudinal movement along the second link guide surface. The driver is operatively connected to the first and second jaws, whereby longitudinal movement of the driver moves the first and second jaws longitudinally along the jaw guide surface and moves the second ends of the first and second links along the first and second link guide surfaces. The distal portions of the first and second link guide surfaces are shaped such that longitudinal movement of the second ends of the first and second links therethrough rotates the first and second jaws relative to the housing. 
     According to more detailed aspects, the jaw guide surface is arranged parallel to a jaw plane extending through the longitudinal axis, and the first link guide surface extends along a first link path spaced away from the jaw plane, and the second link guide surface extends along a second link path spaced away from the jaw plane. Preferably, the first and second link paths are spaced on opposite sides of the jaw plane, and the first and second links are generally C-shaped and defined by a mid-section interconnecting a proximal-section and a distal-section. The first jaw is substantially positioned on a first side of the jaw plane, and the second jaw is substantially positioned on a second side of the jaw plane, wherein the mid-section of the first link is positioned on the second side of the jaw plane, and the mid-section of the second link is positioned on the first side of the jaw plane. The first and second jaw guide surfaces each have a proximal portion extending parallel to the longitudinal axis, and a distal portion extending transversely relative to the proximal portion. The distal portions of the first and second jaw guide surfaces extend towards the jaw plane. 
     According to further detailed aspects, a first link pivot pin pivotally connects the second end of the first link to the housing, and a second link pivot pin pivotally connects the second end of the second link to the housing. The driver includes a distal end having at least one slot receiving the first and second link pins, the at least one slot being elongated and slidably receiving the first and second link pins. Preferably, the distal end of the driver includes a first flange laterally spaced apart from a second flange, the at least one slot including a first slot formed in the first flange and receiving the first link pin, and a second slot formed in the second flange and receiving the second link pin. The first link guide surface is defined by a first link slot formed in the housing, and the second link guide surface is defined by a second link slot formed in the housing, wherein the first link slot is positioned on an opposite side of the housing as the second link slot. 
     According to still further detailed aspects, the distal end of the driver includes driver end surface located distal to the at least one slot, the end surface abutting the proximal ends of the jaws. The driver is engaged with the second ends of the first and second links when the driver is moved distally, and preferably both distally and proximally. The proximal ends of the first and second jaws are slidably and pivotally attached to the housing, and preferably the proximal ends are pivotally attached to the housing about a shared jaw pivot axis. The first ends of the first and second links are non-rotatably attached to the mid-sections of the first and second jaws, respectively. The second ends of the first and second links are slidably and pivotally connected to the housing. Further, the distal portions of the first and second link guide surfaces extend vertically towards each other, and the distal portions of the first and second link guide surface may cross over the jaw guide surface. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present invention, and together with the description serve to explain the principles of the invention. In the drawings: 
         FIG. 1  is a perspective view of a medical system and device constructed in accordance with the teachings of the present invention; 
         FIG. 2  is a side view of the medical system and device of  FIG. 1 , having the housing drawn in dashed lines to show the interior components; 
         FIG. 3  is a perspective view of a driver forming a portion of the medical system and device of  FIG. 1 ; 
         FIG. 4  is a side view of a link forming a portion of the medical system and device of  FIG. 1 ; 
         FIG. 5  is a front view of the link shown in  FIG. 3 ; 
         FIG. 6  is a side view of the medical system and device of  FIG. 1 , having the housing removed to show the interior components; 
         FIG. 7  is a side view of a housing forming a portion of the medical system and device of  FIG. 1 ; 
         FIGS. 8-10  are side views showing operation of the medical system and device of  FIG. 1 ; 
         FIGS. 11 and 12  are top views, partially in cross-section, depicting operation of the medical system and device depicted in  FIG. 1 ; and 
         FIGS. 13 and 14  are cross-sectional views showing operation of the medical system depicted in  FIG. 1 . 
     
    
    
     DETAILED DESCRIPTION 
     The terms “proximal” and “distal” as used herein are intended to have a reference point relative to the user. Specifically, throughout the specification, the terms “distal” and “distally” shall denote a position, direction, or orientation that is generally away from the user, and the terms “proximal” and “proximally” shall denote a position, direction, or orientation that is generally towards the user. 
     An exemplary medical system  20  having a medical device  40  for engaging tissue T ( FIG. 9 ) is shown in  FIGS. 1 and 2 . The medical system  20  and device  40  are generally sized and structured for operation through the working channel of an endoscope (not shown) or other scope, although the system  20  and device  40  may also be used alone or in conjunction with other elongate devices such as catheters, fiber-optic visualization systems, needles and the like. Generally, the medical system  20  includes a drive wire  22  slidably housed within the distal end  23  of a catheter  24  for selective connection to, and operation of, the medical device  40 . As will be described in further detail herein, the medical device  40  generally includes a housing  42  having a first jaw  44  and a second jaw  46  pivotally connected thereto for engaging the tissue T. Generally, the jaws  44 ,  46  have been shown as forming grasping forceps, although the jaws are intended to be used to clip tissue, e.g. to close an opening or for hemostasis. Accordingly, it will be recognized that the shape and structure of the jaws may take many forms and serve many purposes and functions, all in accordance with the teachings of the present invention. 
     In the medical system  20 , the drive wire  22  slidably extends through the catheter  24 . Although the term “wire” is used to refer to the drive wire  22 , it will be recognized that any elongate control member capable of transmitting longitudinal force over a distance (such as is required in typical endoscopic, laparoscopic and similar procedures) may be used, and this includes plastic rods or tubes, single filament or multi-filament wires and the like. A connection block  26  is slidably fitted within the distal end  23  of the catheter  24  and defines a bore  28  therethrough which slidably receives the drive wire  22 . The exterior of the connection block  26  includes a recessed portion  27 , and two pins  30  (e.g., formed from stainless steel wire) are connected to the catheter  24  and positioned within the recessed portion  27  (i.e. between proximal and distal flanges defining the recessed portion  27 ) to limit the longitudinal movement of the connection block  26 . 
     A distal end of the drive wire  22  defines a distal head  32  that is sized larger than the drive wire  22 , and likewise larger than the bore  28  in the connection block  26 . As will be described later herein, the distal head  32  is used to slide the connection block  26  within the catheter  24  to disconnect the medical device  40  from the medical system  20 . As also seen in  FIGS. 1-4 , the housing  42  of the medical device  40  is a tubular member defining an interior space  43 . A proximal end of the housing  42  frictionally receives a distal end of the connection block  26  within the interior space  43  for selective connection therewith. 
     The internal passageway  43  of the housing  42  also receives the first and second jaws  44 ,  46  and a driver  48  which is used to interconnect the drive wire  22  to the jaws  44 ,  46 . As best seen in  FIG. 2 , the first and second jaws  44 ,  46  include distal ends  60 ,  62  that are structured to grasp and engage tissue, which have a talon shape as disclosed in 61/141,934 filed Dec. 31, 2008, the disclosure of which is incorporated herein by reference in its entirety. Generally, distal translation of the driver  48  causes the first and second jaws  44 ,  46  to rotate outwardly away from each other, while proximal retraction of the driver  48  causes the first and second jaws  44 ,  46  to rotate inwardly toward one another. 
     As best seen in  FIG. 3 , the driver  48  has a proximal portion which defines a socket  50  sized to receive the enlarged distal head  32  of the drive wire  22 . At the proximal entrance of the socket  50 , two deflectable locking tabs  52  are formed which rotate relative to the remainder of the driver  48  to increase or decrease the size of the socket  50 . The locking tabs  52  may be separately formed and pivotally attached to the driver  48 , or may be integrally formed with the driver  48  and formed of a resilient material which flexes or bends to permit rotation of the locking tabs  52  radially inwardly and radially outwardly. Here, a proximal portion of the locking tabs define slanted shoulders  54  which slope laterally outwardly for engagement with the housing  42  as will be discussed in further detail herein. The locking tabs  52  also include inner projections  53  which project laterally inwardly and separate the socket  50  into a distal portion  50   d  and a proximal portion  50   p.    
     As best seen in  FIGS. 3 and 4 , a distal portion of the driver  48  defines two flanges  56 ,  58  for engaging and operating the jaws  44 ,  46 . The distal end surface  58   d  of flange  58  engages a proximal end  64  of jaw  44 , while the distal end surface  56   d  of flange  56  engages a proximal end  66  of jaw  46 . The flanges  56 ,  58  also include elongated slots  57 ,  59 , respectively, for slidable and pivotal connection to two links  68 ,  70 , as will also be further discussed herein. The flanges  56 ,  58  are shaped to permit and promote rotation of the proximal ends  64 ,  66  of the jaws  44 ,  46  relative to the flanges  56 ,  58  while engaged therewith, and may be flat, curved, or a combination thereof as shown in  FIGS. 3 and 4 . 
     Turning now to  FIGS. 5   a  and  5   b , one of the two links  68 ,  70  is shown from the side and front. Each link  68 ,  70  is C-shaped member that includes a mid-section  72  interconnecting a distal-section  74  defining a first end, and a proximal-section  76  defining a second end. Both the distal-section  74  and the proximal-section  76  are angled relative to the mid-section  72 , the proximal-section  76  being about perpendicular and the distal-section  74  being angled about 45 degrees (preferably within 20-70 degrees) relative to the mid-section. A bend  75  is formed along the mid-section  72  to provide lateral space between the links  68 ,  70  and the jaws  44 ,  46  (see, e.g.  FIG. 1 ). As best seen in  FIG. 2 , the distal-sections  74  of the first and second links  68 ,  70  are fixedly (non-rotatably) attached to the jaws  44 ,  46  at points  81 , while the proximal-sections are slidably and pivotally attached to the flanges  56 ,  58  of the driver  48  via pins  80  fitted through the slots  57 ,  59  therein. The connection points  81  are formed at a midpoint of the first and second jaws  44 ,  46 , i.e. anywhere between the proximal ends  66 ,  68  and the distal ends  60 ,  62  of the first and second jaws  44 ,  46 . 
     The housing  42  is shown in  FIG. 6 . The housing is a tubular member defining three pairs of opposing slots, namely first link slots  82 , second link slots  84 , and jaw slots  86 . The slots are for guiding the first and second links  68 ,  70  and the jaws  44 ,  46 . Relative to a longitudinal axis of the housing  42 , the jaw slots  86  are parallel to the axis and spaced laterally apart (i.e. parallel and co-existing in a lateral jaw plane) while the first and second links slots  82 ,  84  are spaced vertically apart from the jaw slots  86  (i.e. above and below). The first and second link slots  82 ,  84  include distal portions  83 ,  85  that are angled towards each other (vertically inwardly) and extend through the jaw slots  86 . 
     The internal passageway  43  of the housing  42  extends through the distal end of the housing  42 , and it is through this passageway  43  that the first and second jaws  44 ,  46  can extend. Additionally, as shown in  FIGS. 1-4 , the distal end of the housing  42  defines opposing slots  45  (vertically opposed) which are sized to permit the first and second jaws  44 ,  46  and the first and second links  68 ,  70  to pass therethrough when they rotate radially outwardly. Accordingly, it is also clear from  FIGS. 1 and 2  that the housing  42  serves to block rotation of the first and second links  68 ,  70  when they are entirely or partially contained within the internal passageway  43  of the housing  42 . Suitable plastics for forming the housing include, but are not limited to, polytetrafluorethylene (PTFE), expanded polytetrafluorethylene (EPTFE), polyethylene ether keytone (PEEK), polyvinylchloride (PVC), polycarbonate (PC), polyamide, polyimide, polyurethane, polyethylene (high, medium or low density), and suitable metals include stainless steel, nitinol and similar medical grade metals and alloys. 
     The proximal ends  64 ,  66  of jaws  44 ,  46  are pivotally attached to the housing  42  directly via a shared pin  87  that extends through both proximal ends  64 ,  66  and through opposing jaw slots  86  formed in the housing. By virtue of the jaw slots  86 , the jaws  44 ,  46  are both pivotally and slidably attached to the housing  42 . The opposing jaw slots  86  thus act and define a jaw guide surface of the housing  42  which guides longitudinal movement of the jaws  44 ,  46  relative to the housing. The distal ends of the jaw slots  86  also serve to restrict the longitudinal movement of the jaws  44 ,  46  relative to the housing  42 . It will be recognized that the jaw guide surface could also be formed by channels, recesses or other structures formed into the housing  42 , instead of, or in conjunction with, the jaw slots  86 . During assembly, the slots allow the pins of the device  40  to be inserted after the jaws, links and driver are positioned with the housing, and the slots may later be covered with a sleeve, strip, secondary housing or other material if desired. 
     The proximal ends of the first and second links  68 ,  70  are slidably and pivotally attached to the housing  42  via the two pins, each denoted by numeral  80 . The pins are fitted to the first and second link slots  82 ,  84  which thus define first and second link guide surfaces of the housing  42  which guide longitudinal movement of the first and second links  68 ,  70  relative to the housing  42 . By virtue of the pins  80  also being connected to the flanges  57 ,  59  of the driver  48 , movement of the drive wire  22  can be transferred to the links,  68 ,  70  and the jaws  44 ,  46 . As with the jaw guide surface, the first and second link guide surfaces could also be formed by channels, recesses or other structures formed into the housing  42 , instead of, or in conjunction with, the first and second link slots  82 ,  84 . 
     Accordingly, it will be recognized that the jaw guide surface (formed by slots  86 ) is arranged parallel to the jaw plane extending through the longitudinal axis of the housing  42 , and the first link guide surface (formed by slots  82 ) extends along a first link path spaced away (vertically) from the jaw plane, and the second link guide surface (formed by slots  84 ) extends along a second link path spaced away (vertically) from the jaw plane. The distal portions  83 ,  85  of the first and second link slots  82 ,  84  are angled such that the distal portions of the first and second link paths extend vertically towards the jaw plane, thus guiding the opening/closing of the jaws  44 ,  46 , as will be discussed further herein. It will also be recognized that the first jaw  44  is substantially positioned on a first side of the jaw plane, and the second jaw  46  is substantially positioned on a second side of the jaw plane, while the mid-section  72  of the first link  68  is positioned on the second side of the jaw plane, and the mid-section  72  of the second link  70  is positioned on the first side of the jaw plane. 
     As shown in  FIGS. 1-4 , the flanges  56 ,  58  at the distal end of the driver  48  extend around the proximal-sections  76  of the first and second links  68 ,  70 , and abut the proximal ends  64 ,  66  of the first and second jaws  44 ,  46  to first expose and then open the jaws  44 ,  46 , as shown in  FIGS. 1 and 2 . By sizing the distance between the pins  80 ,  86  and the distal ends of the slots  82 ,  84 ,  86  in the housing  42 , relative to the guide surface formed by slots  82 ,  84 ,  86 , movement of the jaws  44 ,  46  is effectuated and controlled. Distal translation of the drive wire  22  and driver  48  causes distal translation of the jaws  44 ,  46  to an extended position outside of the housing  42  where at least a portion of the jaws  44 ,  46  are exposed. As the jaw pin  87  continues to be moved distally, it passes the point where slots  82 ,  84  cross over the jaw the slots  86 , whereupon the link pins  80  follow the angled distal portions  83 ,  85  of the first and second link slots  82 ,  84 . Thus, further distal translation of the drive wire  22  and driver  48  causes the pins  80  to move vertically and slide within the slots  57 ,  59  formed in the driver&#39;s flanges  56 ,  58 , and in turn rotate the jaws  44 ,  46  about their shared jaw pin  87 . 
     For example, with reference to  FIG. 7 , since the jaw pin  87  is vertically constrained by slots  86 , upward movement of the proximal-section  76  of second link  70  (i.e. along distal portion  85  of slots  84 ) causes downward movement of the distal-section  74  of the second link  70  since it is fixed to the second jaw  46  which is pivotally connected to the housing  42  via pin  87  and jaw slots  86 . Likewise, downward movement of the proximal-section  76  of first link  68  (i.e. along distal portion  83  of slots  82 ) causes upward movement of the distal-section  74  of the first link  68 , and in turn upward rotation of the first jaw  44 . In this manner, the jaws  44 ,  46  rotate outwardly to an open, tissue receiving, position shown in  FIGS. 1 and 2 . 
     Eventually, the link pins  80  reach the end of link slots  82 ,  84 , at which point the jaws  44 ,  46  are fully open. The jaws  44 ,  46  have been shown rotating about 75°, thus forming a 150° opening between them, however the housing  42  and its slots may be sized to permit rotation through a full 90° or more, thus forming at least a 180° between them. The slots in the housing  42  are sized to permit the rotation of the jaws  44 ,  46  and links  68 ,  70  out of the housing, and these slots  45  may also be used to limit the rotation thereof, in addition to or separately from the sizing of the slots  82 ,  84 ,  86 . It will therefore be seen that the distance and location of the pins  80  (at the ends of the first and second links  68 ,  70 ) relative the proximal ends  64 ,  66  of the jaws  44 ,  46  and pin  87  determines the rotation of the first and second jaws between a closed configuration and an open configuration. 
     Likewise, the proximal ends of the links  68 ,  70  and their pins  80  are connect to the flanges  56 ,  58  of the driver  48  such that proximal retraction of the driver  48  (via drive wire  22 ) causes the pins  80  to follow the reverse path for closing of the jaws  44 ,  46 , and further retraction causes proximal retraction of the jaws  44 ,  46  towards the interior space  43  of the housing  42 . As shown in  FIGS. 9 and 10 , once the jaws  44 ,  46  are positioned in their tissue receiving configuration (open configuration,  FIGS. 1 and 2 ) the medical device  40  and its jaws  44 ,  46  may be around tissue T and the jaws  44 ,  46  rotated back towards their closed position. The tissue T has been shown as a single layer, although multiple layers may be clipped between the jaws  44 ,  46 . The tissue T may thus be grasped by the jaws  44 ,  46 , and further proximal retraction of the drive wire  22  and driver  48  will cause the jaws  44 ,  46  to move longitudinally in a proximal direction (to the left on the page in  FIGS. 9-10 ). Accordingly, it can be seen the medical device provides constant force transmission from the drive wire  22  via the driver  48  and links  68 ,  70  to the jaws  44 ,  46  for smooth opening and closing of the jaws due to translation in both he distal and proximal direction. 
     In order for the medical device  40  to serve as a clip and maintain its grasp on the tissue T, or to maintain the clipping of two layers of tissue against each other, the jaws  44 ,  46  may be locked in position and the drive wire  22  of the medical system  20  disconnected from the medical device  40 . As shown in  FIG. 11 , the interior of the housing  42  also defines a driver guide surface  88  (which guides the driver  48 ) that has a proximal portion  88   p  and a distal portion  88   d . The proximal portion  88   p  of the driver guide surface  88  has a width (measured up and down on the page in  FIG. 11 ) that is greater than a width of the distal portion  88   d  of the driver guide surface  88 . The driver guide surface  88  may be formed by opposing surfaces or C-shaped channels in the housing  42 . The transition between the proximal portion  88   p  and distal portion  88   d  defines a shoulder  89 , and namely two shoulders  89   a ,  89   b  on opposing sides of the housing  42 . The shoulders  89   a ,  89   b  are sized and positioned to engage the locking tabs  52 , and in particular the sloped portions  54 , located on the driver  48 . 
     As shown in  FIG. 11 , when the driver  48  is located within the distal portion  88   d  of the driver guide surface  88 , the locking tabs  52  are forced radially inwardly into firm frictional engagement with the enlarged head  32  and/or the drive wire  22 . Stated another way, the socket  50  formed by the driver  48  that receives the distal head  32  has an entrance which is narrowed by the inward deflection of the locking tabs  52 . In this state depicted in  FIG. 11 , the drive wire  22  is firmly engaged with the driver  48  and hence the first and second jaws  44 ,  46 . When the drive wire  22  and driver  48  are retracted proximally, for example upon grasping tissue as shown in  FIGS. 9-10 , the proximal end of the driver  48  is received within the proximal portion  88   p  of the third guide surface  88  which has a larger width that permits outward movement of the locking tabs  52 . 
     Accordingly, in the state depicted in  FIG. 12 , the locking tabs  52  may be disconnected from the distal head  32  of the drive wire  22 . As such, further proximal movement of the drive wire  22  and its distal head  32  may be used to withdraw the distal head  32  from the socket  50  of the driver  48 . At the same time, the locking tabs  52  move radially outwardly and into engagement with the shoulders  89   a ,  89   b  to lock the device  40  in a state where the tissue T is clipped between the jaws  44 ,  46 . In the event the natural elasticity of the tissue T tends to pull the jaws  44 ,  46  out from the housing towards their extended position, the locking tabs  52  will abut the shoulders  89  of the driver guide surface of the housing  42  to prevent further distal movement or rotation of the jaws  44 ,  46 . Preferably, the locking tabs  52  are formed from a material that is plastically deformable, such as a metal or alloy (e.g. Nitinol), such that they plastically deform outwardly to firmly engage the housing  42  and maintain the tissue T between the jaws  44 ,  46  and the distal end of the housing  42 . 
     Turning now to  FIGS. 13 and 14 , upon still further proximal retraction of the drive wire  22  and distal head  32  (to the right on the page), the enlarged distal head  32  (or other enlarged portion of the drive wire  22 ) will abut the connection block  26 , which is slidably fitted within the distal end  23  of the catheter  24 . Sufficient proximal force on the drive wire  22  will overcome the frictional fit between the connection block  26  and the proximal end of the housing  42 , thus moving the connection block  26  proximally to retract the connection block  26  within the tubular connector  24 , as shown in  FIG. 14 . The catheter  24  can be used to provide a counterforce on the housing  42  while proximally retracting the drive wire  22  and connection block  26 . Accordingly, the drive wire  22 , catheter  24  and connection block  26  may be fully disconnected from the medical device  40 , thereby leaving the first and second jaws  44 ,  46  and the housing  42  in a state having the tissue T clipped between the jaws  44 ,  46  and retained in vivo. The connection block  26  is retained at the distal end  24  of the catheter  24  via the pins  30 , which are positioned within the recessed area  27  to engage the proximal and distal ends of the connection block  26  and limit its longitudinal movement. 
     The elongate catheter  24  (or other elongate tubular member such as a sheath, tube, scope or the like), which slidably encases the drive wire  22 , extends proximally therealong to a proximal end of the system  20 , and has a length suitable for placing the device  40  at any desire location within the body, while the proximal ends of drive wire  22  and catheter  24  are positioned outside of the body for use by the medical professional. Control handles (not shown) for controlling relative translation of the drive wire  22  and catheter  24  are well known in the art, and may be employed at the proximal end of the system  20 . Additional embodiments of the connection/disconnection mechanisms and the medical system  20  may be found in copending application U.S. application Ser. Nos. 13/270,834, 13/270,784, 13/270,852, and 12/971,873, filed on Oct. 11, 2011 and Dec. 17, 2010, the disclosures of which are hereby incorporated by reference in its entirety. 
     The foregoing description of various embodiments of the invention has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise embodiments disclosed. Numerous modifications or variations are possible in light of the above teachings. The embodiments discussed were chosen and described to provide the best illustration of the principles of the invention and its practical application to thereby enable one of ordinary skill in the art to utilize the invention in various embodiments and with various modifications as are suited to the particular use contemplated. All such modifications and variations are within the scope of the invention as determined by the appended claims when interpreted in accordance with the breadth to which they are fairly, legally, and equitably entitled.