Abstract:
A surgical clip cartridge, assembly, and method are provided for the storage, delivery, and loading of clips, such as those used in a surgical ligating process. The surgical clip cartridge includes a base portion extending in a longitudinal direction, the base portion having a bottom surface and defining a mounting groove for attaching the base portion onto a surgical instrument shaft. The base portion further includes a plurality of dividers extending from the base portion in a direction opposite of the bottom surface, and the plurality of dividers may be used to retain individual surgical clips therebetween for subsequent retrieval and loading onto a clip applier. The attachment of the surgical clip cartridge to the surgical instrument shaft enables the surgical clip cartridge to be deployed intracorporeally for use in surgical operations requiring applications of multiple surgical clips.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This patent application claims the priority benefit of U.S. Provisional Patent Application No. 62/199,142, filed Jul. 30, 2015, which is incorporated herein in its entirety by this reference. 
     
    
     TECHNICAL FIELD 
       [0002]    The present disclosure relates to storage, delivery, and loading of clips, such as surgical ligating clips for use in surgical procedures. In particular, the present disclosure relates to a snap-on surgical clip cartridge configured to retain and dispense clips intracorporeally during a surgical operation. 
       DESCRIPTION OF RELATED ART 
       [0003]    Many surgical procedures require vessels or other tissues of the human body to be ligated during the surgical process. For example, many surgical procedures require cutting blood vessels (e.g., veins or arteries), and these blood vessels may require ligation to stop or reduce bleeding. In some instances, a surgeon may wish to ligate the vessel temporarily to reduce blood flow to the surgical site during the surgical procedure. In other instances, a surgeon may wish to permanently ligate a vessel. Ligation of vessels or other tissues can be performed by closing the vessel with a ligating clip, or by suturing the vessel with surgical thread. The use of surgical thread for ligation requires complex manipulations of the needle and suture material to form the knots required to secure the vessel. Such complex manipulations are time-consuming and difficult to perform, particularly in endoscopic surgical procedures, which are characterized by limited space and visibility. By contrast, ligating clips are relatively easy and quick to apply. Accordingly, the use of ligating clips in endoscopic as well as open surgical procedures has grown dramatically. 
         [0004]    Various types of hemostatic and aneurysm clips are used in surgery for ligating blood vessels or other tissues to stop the flow of blood. Such clips have also been used for interrupting or occluding ducts and vessels in particular surgeries, such as sterilization procedures. Typically, a clip is applied to the vessel or other tissue by using a dedicated mechanical instrument commonly referred to as a surgical clip applier, ligating clip applier, or hemostatic clip applier. The clip is permanently left in place after application to the tissue. 
         [0005]    Ligating clips can be classified according to their geometric configuration (e.g., symmetric clips or asymmetric clips), and according to the material from which they are manufactured (e.g., metal clips or polymeric clips). Symmetric clips are generally “C”, “U”, or “V” shaped and thus are substantially symmetrical about a central, longitudinal axis extending between the legs of the clip. Symmetric clips are usually constructed from metals such as stainless steel, titanium, tantalum, or alloys thereof. An example of one such clip is disclosed in U.S. Pat. No. 5,509,920 to Phillips et al. By means of a dedicated clip applier, the metal clip is permanently deformed over the vessel. Asymmetric clips are usually constructed of polymeric material. 
         [0006]    Because clips of the type just described are small and several clips are often used in a surgical procedure, clip holding devices are employed to store and retain multiple clips between the time of their manufacture and/or packaging and ultimate use in a surgical procedure. Numerous surgical clip cartridges have been developed, some of which strive to prevent the clips from becoming unduly loosened or even completely dislodged during shipment and handling. Surgical clip cartridges are intended for use with “manual” clip appliers. 
         [0007]    As used herein, the term “automatic” denotes the kind of clip appliers that retain a plurality of hemostatic clips adjacent to the jaws of a clip applier in a way such that a new clip is automatically fed to the jaws after the previous clip has been crimped into place. An example of an applier that dispenses a plurality of clips for sequential application is disclosed in U.S. Pat. No. 4,509,518 to McGarry et al. 
         [0008]    By contrast, the term “manual” denotes the kind of clip appliers that receive one clip at a time between the jaws, and which have to be reloaded manually after the previous clip has been crimped. These manual instruments usually have a forceps-type design and the reloading operation is generally accomplished by inserting the jaws of the applier into a clip holder or cartridge and engaging or grasping a clip contained therein. The jaws of the clip applier generally have longitudinal grooves to receive the clip legs and can have end-dams at the distal end of each groove to limit distal movement of the clip. The clip is secured in the jaws by the natural resiliency of the clip legs and by the end-dams if they are present. An example of a forceps-type applier having conformal jaws used to grip and maintain alignment of the clip during deformation is disclosed in U.S. Pat. No. 3,326,216 to Wood. 
         [0009]    Many types of surgical clip cartridges currently available contain a plurality of longitudinally spaced clip retaining chambers. A single clip is retained in each chamber by a variety of means, and is removed from its chamber by a forceps-type clip applier that is inserted into the selected clip chamber and secured to the clip sufficiently to overcome whatever clip retention means is utilized, thereby enabling the clip to be removed from the clip chamber. 
         [0010]    Various mechanisms are known by which clips can be retained within the chambers of surgical clip cartridges. In all instances, a desirable goal of such cartridges is to minimize the forces required to load the clip into the applier and to then remove it from the cartridge while maximizing the security with which the clip is held in the cartridge and, subsequently, the applier jaws prior to use. With respect to metallic clips, friction between the clip and the side walls of its individual chamber is often sufficient to retain the clip. The surgical clip cartridges are generally made of molded plastic material, such that the walls of each clip chamber are somewhat resilient and able to be pushed away from each other when the clip applier jaws are inserted into the chamber to retrieve the clip. An example of a cartridge holding the clips in their respective clip chambers by means of frictional engagement with the side walls of each chamber is shown in U.S. Pat. No. 4,076,120 to Carroll et al. Another example of a cartridge holding the clips in their respective clip chambers is shown in U.S. Pat. No. 6,863,672 to Wilson, Jr. 
         [0011]    In some surgical clip cartridges designed for metallic clips, each individual clip chamber is provided with a central post generally conforming to the shape of the open clip although being slightly larger so that when the clip is pushed onto the central post, frictional contact between the legs of the clip and the central post retains the clip within its chamber. Cartridges of this type are shown in U.S. Pat. Nos. 3,270,745; 3,326,216; 3,363,628; 3,439, 522; and 3,439,523, all issued to Wood. 
         [0012]    Cartridges in the related art are also known that retain clips in a partially straightened state by maintaining each clip under tension within its chamber, through the interaction between the central post in the chamber and the central part of the clip and protrusions extending into each chamber toward the central post (from the ends). The clip is retained by having its central hinge part pushed upwardly by the central post and its ends pushed downwardly by the protrusions. Such a cartridge is shown in U.S. Pat. No. 3,713,533 to Reimels and U.S. Pat. No. 4,146,130 to Samuels et al. 
         [0013]    U.S. Pat. No. 4,696,396 to Samuels discloses another type of cartridge that has a plurality of ribs extending from each side wall of each clip chamber inwardly toward the clip to retain the clip by frictional engagement with the ribs. The aforementioned U.S. Pat. No. 4,146,130 to Samuels et al. shows an alternative embodiment for the situation where clips are intended to be loosely maintained in the cartridge without frictional engagement between the clips and the chamber, the clips in such an event being retained in each cartridge by a covering tape which can be easily severed by the applier as desired. 
         [0014]    While the above cartridges for metal and polymeric clips have been used with adequate results, there are several disadvantages to the composition and structural design of the cartridges that limits their functionality during use. 
         [0015]    First, the cartridges in the related art are typically handheld by an operator or placed on a surface, such as a table or a tray, while the surgical clips are loaded from the clip cartridge and loaded onto a clip applier. The result is that the cartridges in the related art may be prone to being dropped, misplaced, or contaminated during a surgical procedure. Second, the cartridges in the related art are used to supply clips to a clip applier extracorporeally. In other words, the cartridges are maintained outside the patient and away from the operation area. In manual ligation, a clip cartridge containing clips is set within the operating field. The surgeon is restricted to loading a clip from the clip cartridge onto the clip applier outside the patient. Once the clip has been loaded from the cartridge onto the clip applier, the clip applier together with the clip is inserted into the patient to achieve ligation. However, this method requires the surgeon to move back and forth from the operative site to the clip cartridge outside of the patient for reloading, resulting in time loss and direct visualization loss. 
         [0016]    As such, the present disclosure contemplates an improved surgical clip cartridge that allows quicker clip loading with no visualization loss. 
       SUMMARY 
       [0017]    According to one aspect of the present disclosure, a surgical clip cartridge includes a base portion extending in a longitudinal direction, and the base portion has a bottom surface. The surgical clip cartridge further includes a plurality of dividers extending from the base portion in a direction opposite of the bottom surface, and the base portion defines a mounting groove for attaching the base portion onto a surgical instrument shaft. 
         [0018]    In one aspect, the mounting groove extends in a direction parallel to the longitudinal direction of the base portion. In one aspect, the mounting groove includes at least one docking portion, and the docking portion defines at least one concave semi-circular surface that is configured to conform around the surgical instrument shaft. The concave semi-circular surface has a first radius, and the first radius is less than or equal to an outer radius of the surgical instrument shaft to provide an annular fit when the docking portion is attached to the surgical instrument shaft. The concave semi-circular surface revolves about a central longitudinal axis of the docking portion, and the revolution of the concave semi-circular surface is greater than or equal to 180°. In one aspect, a surface of the at least one docking portion includes one or more of a friction material, knurling, notches, and protrusions to prevent axial and/or rotational displacement when the docking portion is attached to the surgical instrument shaft. 
         [0019]    In one aspect, the mounting groove defines at least two docking portions, a first docking portion of the at least two docking portions being located on a proximal end of the base portion in the longitudinal direction, and the second docking portion of the at least two docking portions being located on a distal end of the base portion in the longitudinal direction. In one aspect, the at least one docking portion extends continuously from a proximal end to a distal end of the base portion. 
         [0020]    In one aspect, at least one divider of the plurality of dividers includes at least one wall surface extending away from the base portion in a vertical direction perpendicular to the longitudinal direction. In one aspect, the at least one wall surface is a planar wall surface. In one aspect, the at least one divider includes an upper surface, and the upper surface includes at least a horizontally extending segment and a sloped segment extending upwardly towards the horizontally extending segment and towards a center of the at least one divider. In one aspect, an upper portion of the at least one wall surface includes a latching protrusion, the latching protrusion extending at least in the longitudinal direction. In one aspect, the latching protrusion is for interfacing with at least one portion of a surgical clip, the at least one portion being one of a surface, a depression, and an orifice of the surgical clip. In one aspect, the latching protrusion is configured to prevent movement of a surgical clip in directions perpendicular to the longitudinal direction of the base portion. 
         [0021]    In one aspect, the surgical clip cartridge further comprises a plurality of spacer portions extending from the base portion in a direction opposite of the bottom surface, and a spacer portion of the plurality of spacer portions is disposed between pairs of facing dividers of the plurality of dividers. In one aspect, the spacer portion defines a top surface, the top surface having a concave segment and a convex segment. In one aspect, the spacer portion defines at least one inwardly tapering section and a depth of the inwardly tapering section increases moving from an upper portion of the spacer towards a lower portion of the spacer. 
         [0022]    According to one aspect, a surgical device for storage, delivery, and loading of surgical clips to a clip applier includes a surgical instrument with an elongated shaft extending along a first longitudinal axis. The surgical device further includes a surgical clip cartridge including a base portion extending along a second longitudinal direction. The base portion has a bottom surface and defines a mounting groove to secure the surgical clip cartridge onto at least a portion of the elongated shaft of the surgical instrument. 
         [0023]    In one aspect, the mounting groove includes at least one docking portion, and the docking portion defines a concave semi-circular surface configured to conform around the elongated shaft. The concave semi-circular surface revolves about a central longitudinal axis of the docking portion, and the revolution of the concave semi-circular surface is greater than or equal to 180°. In one aspect, the surgical clip cartridge includes a plurality of dividers extending from the base portion in a direction opposite of the bottom surface, and pairs of facing dividers of the plurality of dividers are configured to receive and retain a surgical clip of the surgical clips therebetween. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0024]      FIG. 1  shows a front perspective view of a ligation clip in accordance with aspects of the disclosure. 
           [0025]      FIG. 2  shows a rear perspective view of the ligation clip of  FIG. 12  in accordance with aspects of the disclosure. 
           [0026]      FIG. 3  shows a side view of the ligation clip of  FIG. 12  in accordance with aspects of the disclosure. 
           [0027]      FIG. 4A  shows a perspective view of a clip applier in accordance with aspects of the disclosure. 
           [0028]      FIG. 4B  shows a perspective view of the clip applier of  FIG. 4A  with a ligation clip loaded in accordance with aspects of the disclosure. 
           [0029]      FIG. 5  shows a top perspective view of a snap-on surgical clip cartridge in accordance with aspects of the disclosure. 
           [0030]      FIG. 6  shows a bottom perspective view of the snap-on surgical clip cartridge of  FIG. 1  in accordance with aspects of the disclosure. 
           [0031]      FIG. 7  shows a front view of the snap-on surgical clip cartridge of  FIG. 1  in accordance with aspects of the disclosure. 
           [0032]      FIG. 8  shows a side view of the snap-on surgical clip cartridge of  FIG. 1  in accordance with aspects of the disclosure. 
           [0033]      FIG. 9  shows a top view of the snap-on surgical clip cartridge of  FIG. 1  in accordance with aspects of the disclosure. 
           [0034]      FIG. 10  shows a bottom view of the snap-on surgical clip cartridge of  FIG. 1  in accordance with aspects of the disclosure. 
           [0035]      FIG. 11  shows a side cross-sectional view of the snap-on surgical clip cartridge of  FIG. 9  at line  9 - 9  in accordance with aspects of the disclosure. 
           [0036]      FIG. 12  shows a perspective cross-sectional view of the snap-on surgical clip cartridge of  FIG. 9  at line  9 - 9  in accordance with aspects of the disclosure. 
           [0037]      FIG. 13  shows a close-up perspective view of the snap-on surgical clip cartridge in accordance with aspects of the disclosure. 
           [0038]      FIG. 14  shows a side perspective view of a snap-on surgical clip cartridge with clips loaded in accordance with aspects of the disclosure. 
           [0039]      FIG. 15  shows a side perspective view of the snap-on surgical clip cartridge of  FIG. 10 , with a clip removed in accordance with aspects of the disclosure. 
           [0040]      FIG. 16  shows a top perspective view of a snap-on surgical clip cartridge in accordance with aspects of the disclosure. 
           [0041]      FIG. 17  shows a bottom perspective view of the snap-on surgical clip cartridge of  FIG. 16  in accordance with aspects of the disclosure. 
           [0042]      FIG. 18  shows a bottom view of the snap-on surgical clip cartridge of  FIG. 16  in accordance with aspects of the disclosure. 
           [0043]      FIG. 19  shows a side view of the snap-on surgical clip cartridge of  FIG. 16  in accordance with aspects of the disclosure. 
           [0044]      FIG. 20  shows a front view of the snap-on surgical clip cartridge of  FIG. 16  in accordance with aspects of the disclosure. 
           [0045]      FIG. 21  shows a rear view of the snap-on surgical clip cartridge of  FIG. 16  in accordance with aspects of the disclosure. 
           [0046]      FIG. 22  shows a top view of the snap-on surgical clip cartridge of  FIG. 16  in accordance with aspects of the disclosure. 
           [0047]      FIG. 23  shows a front perspective view of a surgical clip cartridge in accordance with aspects of the disclosure. 
           [0048]      FIG. 24  shows a rear perspective view of the surgical clip cartridge of  FIG. 23  in accordance with aspects of the disclosure. 
           [0049]      FIG. 25  shows a three-dimensional rendering of the snap-on surgical clip cartridge of  FIG. 1  in accordance with aspects of the disclosure. 
           [0050]      FIG. 26  shows a three-dimensional rendering of the snap-on surgical clip cartridge of  FIG. 16  in accordance with aspects of the disclosure. 
           [0051]      FIG. 27  shows a three-dimensional rendering of the surgical clip cartridge of  FIG. 23  in accordance with aspects of the disclosure. 
           [0052]      FIG. 28  shows a surgical assembly including a surgical clip cartridge attached to a surgical instrument in accordance with aspects of the disclosure. 
           [0053]      FIGS. 29A-29H  show an exemplary method of using the surgical clip cartridge in a procedure in accordance with aspects of the disclosure. 
       
    
    
     DETAILED DESCRIPTION 
       [0054]    Now referring to the drawings, wherein like reference numerals refer to like elements, exemplary aspects of the present disclosure will now be discussed. 
         [0055]      FIGS. 1-3  shows an exemplary surgical clip  100  that may be used with the surgical clip cartridges of the present disclosure. The surgical clip  100  may be a hemostatic clip that is capable of being latched around a vessel or other type of tissue to ligate the vessel and thereby stop or reduce the flow of fluid through the vessel. The surgical clip  100  may be constructed from any suitable biocompatible material, such as metals and/or polymers. 
         [0056]    In one aspect, the surgical clip  100  may comprise a first leg  110  and a second leg  120 . The first leg  110  and the second leg  120  may be joined together at their proximal ends by an integral hinge section  130 . The integral hinge section  130  may define a latching orifice  135 , as will be described in further detail below. 
         [0057]    The first leg  110  may define an inner concave surface  112  and an outer convex surface  114 . The first leg  110  may transition to a curved, C-shaped hook section  140  at a distal end thereof. The C-shaped hook section  140  may define a beveled surface  146 . An intersection between the beveled surface  146  and the first leg  110  may define a latching recess  148 . A pair of bosses  142 ,  144  may extend laterally away from the first leg  110 . 
         [0058]    The second leg  120  may define an inner convex surface  122  and an outer concave surface  124 . The second leg  120  may transition into a hook section  40  at a distal end thereof. The distal end of the second leg  120  may further define a tip section  150 . A pair of bosses  152 ,  154  may extend laterally away from the second leg  120 . The pair of bosses  152 ,  154  may each include at least one tissue penetrating teeth  156 ,  158 , and the penetrating teeth  156 ,  158  may be oriented towards the first leg  110 . 
         [0059]    Turning to  FIGS. 4A and 4B , an exemplary clip applier  200  is shown, and the clip applier  200  may be used to grasp and apply the surgical clip  100  onto a target vessel or other type of tissue. In one aspect, clip applier  200  may comprise a pair pivotable jaws  210 ,  220 . The first jaw  210  of the pivotable jaws may include a pair of notches  212 ,  214 . The second jaw  220  of the pivotable jaws may also include a pair of notches  222 ,  224 . In one aspect, the clip applier  200  may be used to retrieve and load the surgical clip, for example, from a surgical clip cartridge. 
         [0060]    The clip applier  200  may be positioned about the surgical clip  100 . The notches  212 ,  214  of the first jaw  210  may be configured to receive and lock the bosses  142 ,  144  of the first leg  110 , and the notches  222 ,  224  of the second jaw  220  may be configured to receive and lock the bosses  152 ,  154  of the second leg  120 . Alternatively, the notches  212 ,  214  of the first jaw  210  may be configured to receive and lock the bosses  152 ,  154  of the second leg  120 , and the notches  222 ,  224  of the second jaw  220  may be configured to receive and lock the bosses  142 ,  144  of the first leg  110 . Once secured, a distal end of the clip applier  200 , including the surgical clip  100 , may be directed towards the target vessel or tissue. The first jaw  210  and the second jaw  220  may then be squeezed or forced closed towards each other. As this occurs, the first leg  110  and the second leg  120  of the surgical clip  100  may close upon the target vessel or tissue between the inner concave surface  112  and the inner convex surface  122 . When sufficient force is applied via the clip applier  200 , the tip section  150  may be forced past the beveled surface  146  and into the latching recess  148 , thereby locking the two legs  110 ,  120  together. As discussed above, the surgical clip cartridges in the related art require that the surgeon move away from the operative site to retrieve additional clips, thereby resulting in time loss and direct visualization loss. 
         [0061]      FIGS. 5-15  show views of a first exemplary surgical clip cartridge  300  in accordance with aspects of the present disclosure.  FIGS. 16 and 17  further show the surgical clip cartridge  300  loaded with clips, such as the surgical clips  100  discussed above. Of course, other types of clips may be used with the surgical clip cartridge  300 . In one aspect, the surgical clip cartridge  300  may include a base portion  310  extending in a longitudinal direction, and the base portion  310  may have at least a bottom surface  312 . The surgical clip cartridge  300  may include a plurality of dividers  320  extending from the base portion  310  in a direction opposite of the bottom surface  312 . 
         [0062]    The base portion  310  may define a mounting groove  314  for attaching the base portion  310  onto a surgical instrument shaft, as will be described in further detail below with reference to  FIG. 26 . The mounting groove  314  may extend along the longitudinal direction. The mounting groove  314  may include at least one docking portion  316   a ,  316   b , the at least one docking portion  316   a ,  316   b  may define a concave semi-circular surface configured to conform around the surgical instrument shaft. In one aspect, the concave semi-circular surface may have a first radius, and the first radius may be less than or equal to an outer radius of the surgical instrument shaft in order to provide an interference fit or an annular fit when the docking portion  316   a ,  316   b  is attached to the surgical instrument shaft. The interference or annular fit may utilize the flexibility the docking portion  316   a ,  316   b  to at least partially surround the surgical instrument shaft and maintain a snap-on attachment utilizing a hoop-strain attribute of the docking portion  316   a ,  316   b.    
         [0063]    The concave semi-circular surface may revolve about a central longitudinal axis of the docking portion  316   a ,  316   b , and the revolution of the concave semi-circular surface may be greater than or equal to 180°. In one aspect, the angle of revolution is between about 180° to 270°. For example, the angle of revolution of the concave semi-circular surface may be between about 185° to 270°, or between about 220° to 245° to ensure a secure fit about the surgical instrument shaft, when attached, while enabling the surgical clip cartridge  300  to be snapped-on or snapped-off of the surgical instrument shaft using the force of a user&#39;s hands, for example. It will be appreciated by one skilled in the art, in view of the present disclosure, that the arc length and the revolution of the arc may be selected based on a size or radius of the surgical instrument shaft that the surgical clip cartridge  300  is intended to attach on to. Additionally or alternatively, the arc length and the revolution of the arc may be selected based on the material properties of the surgical clip cartridge  300 , such as the resiliency, to ensure that the at least one docking portion  316   a ,  316   b  can be displaced sufficiently to engage and secure the surgical clip cartridge  300  onto the surgical instrument shaft without damage or failure during the product life. 
         [0064]    In one aspect, the concave semi-circular surface of the at least one docking portion  316   a ,  316   b  may include one or more of a friction material, knurling, notches, and protrusions to prevent axial or rotational displacement when the docking portion  316   a ,  316   b  is attached to the surgical instrument shaft. The addition of one or more of the above surface features may prevent the base portion  310  from shifting relative to the surgical instrument shaft, thereby promoting accuracy and repeatability when a surgeon attempts to retrieve a clip  100  from the surgical clip cartridge  300  during a surgical procedure. In one aspect, the docking portion  316   a ,  316   b  and the surgical instrument shaft may include corresponding ribs and grooves to prevent axial and/or radial movement of the surgical clip cartridge  300  relative to the surgical instrument shaft once the surgical clip cartridge  300  has been mounted to the surgical instrument shaft. 
         [0065]    In one aspect, as best shown in  FIGS. 6 and 10 , the mounting groove  314  may define at least two docking portions  316   a ,  316   b , a first docking portion  316   a  of the at least two docking portions may be disposed on a proximal end of the base portion  310  in the longitudinal direction, and second docking portion  316   b  of the at least two docking portions being located on a distal end of the base portion  310  in the longitudinal direction. In one aspect, the at least one docking portion may extend continuously from a proximal end to a distal end of the base portion. 
         [0066]    In one aspect, as best shown in  FIGS. 5, 7, 9, 11, 12, and 13 , the surgical clip cartridge  300  may include a plurality of dividers  320 . Each of the plurality of dividers  320  may include at least one wall surface  322  extending away from the base portion  310  in a vertical direction perpendicular to the longitudinal direction. The at least one wall surface  322  may be a planar wall surface, although other surface contours promoting the insertion and removal of clips are of course contemplated. In one aspect, the at least one divider  320  may include an upper surface, and the upper surface may include a horizontally extending segment  324  and at least one sloped segment  326  extending upwardly towards the horizontally extending segment and towards a center of the at least one divider  320 . In one aspect, the upper surface of the at least one divider  320  may generally define a trapezoidal shape. The trapezoidal shape of the at least one divider  320  may provide clearance and promote greater maneuverability of the surgical clip  100  once it has been disengaged from the surgical clip cartridge  300 . For example, the sloped segments  326  may enable the C-shaped hook section  140  and/or the tip section  150  of the surgical clip  100  to clear the at least one divider  320  more quickly and allow the surgical clip  100  to be maneuvered along the longitudinal direction without interference with the surgical clip cartridge  300 . The increased maneuverability may be particularly beneficial when the surgical clip cartridge  300  is used intracorporeally where there is a limited amount of space within the body cavity of a patient. 
         [0067]    As shown in  FIG. 14 , the surgical clip  100  may be moved in the axial direction relative to the surgical clip cartridge  300  even though portions of the surgical clip  100  overlaps with an upper most portion of the surgical clip cartridge  300 . Additionally, the sloped segment  326  may prevent the surgical clip  100  from snagging the surgical clip cartridge  300  in the event the surgical clip  100  is maneuvered laterally before the surgical clip  100  has completely cleared from the surgical clip cartridge  300 . The sloped segment  326  may allow the C-shaped hook section  140  and/or the tip section  150  to ride along the sloped segment  326  to clear the surgical clip cartridge  300  without snagging during an operation. 
         [0068]    In one aspect, an upper portion of the at least one wall surface  322  includes a latching protrusion  328 . The latching protrusion  328  may extend from the at least one wall surface  322 . The latching protrusion  328  may be used for interfacing with at least a portion of a surgical clip  100 , such a surface, a depression, and/or an orifice of the surgical clip  100 . In one aspect, the interfacing portion of the surgical clip  100  may be the latching orifice  135  disposed at the integral hinge section  130  of the surgical clip  100 . In one aspect, the latching protrusion  328  may be configured to prevent movement of a surgical clip  100  in directions perpendicular to the longitudinal direction of the base portion  310 . For example, the surgical clip  100  may be inserted into the surgical clip cartridge  300  such that the latching protrusion  328  is at least partially inserted into the latching orifice  135 . In this arrangement, the latching orifice  135  and the latching protrusion  328  may be sized to limit or prevent any play or movement of the surgical clip  100  relative to the surgical clip cartridge  300 . However, once a predetermined threshold force is applied to the surgical clip  100 , via the clip applier  200  for example, the surgical clip  100  may be released from the latching protrusion  328 . 
         [0069]    As shown in  FIGS. 7, 9, 11, 12, and 13 , the surgical clip cartridge  300  may further comprise a plurality of spacer portions  330 . The spacer portions  330  may extend from the base portion  310  in a direction opposite of the bottom surface  312 . The spacer portion  330  of the plurality of spacer portions may be disposed between pairs of facing dividers  320  of the plurality of dividers. In one aspect, a width of the spacer portions  330  extending between a pair of dividers  320  may be at least a maximum width of the surgical clip  100 . For example, the width of the spacer portions may be at least as wide as a lateral width of the pair of bosses  152 ,  154  of the surgical clip  100  (as shown in  FIG. 1 ). In one aspect, as shown in  FIG. 9 , each pair of facing dividers  320  may include at least two latching protrusion  328  to interface with the latching orifice  135  of the surgical clip  100 . 
         [0070]    In one aspect, as best shown in  FIGS. 11-13 , the spacer portion  330  may define a top surface  332 , and the top surface  332  may have a concave segment  333  and a convex segment  334 . The concave segment  333  and a convex segment  334  may have a profile complementary to the inner convex surface  122  and the inner concave surface  112 , respectively, of the surgical clip  100 . The complementary profiles may help minimize unwanted displacement or play of the surgical clip  100 , relative to the surgical clip cartridge  300 , when the surgical clip  100  is being retrieved and withdrawn from the surgical clip cartridge  300 . Additionally, or alternatively, the complementary profiles may assist in the loading of the surgical clips  100  onto surgical clip cartridge  300  by providing a limit or a stop as the surgical clips  100  are inserted downwardly towards the base portion  310 . 
         [0071]    In one aspect, as best shown in  FIGS. 11 and 12 , the spacer portion  330  may define at least one inwardly tapering section  335 ,  336 . A depth of the inwardly tapering sections  335 ,  336  may increase when moving from an upper portion of the spacer towards a lower portion of the spacer portion  330  towards the base portion  310 . In other words, the depth of the inwardly tapering sections  335 ,  336 , relative to a central axis of the respective spacer portion  330 , increases when moving from the top of the spacer portion  330  towards the base portion  310 , as shown in  FIG. 11 . In one aspect, as the clip applier  200  is used to retrieve the surgical clip  100  from the surgical clip cartridge  300  (the trajectory of which is generally illustrated in  FIGS. 14 and 15 ), the legs  110 ,  120  of the surgical clip  100  may be biased inward in order for the bosses  142 ,  144 ,  152 ,  154  to engage with the notches  212 ,  214 ,  222 ,  224  of the clip applier  200 . The inwardly tapering section  335 ,  336  may enable the legs  110 ,  120  to flex a sufficient amount for the clip applier  200  to engage with the surgical clip  100 . The clip applier  200  may then subsequently be maneuvered upwardly, against the latching protrusions  328  to disengage and release the surgical clip  100  from the surgical clip cartridge  300 . 
         [0072]    In one aspect, as shown in  FIGS. 14 and 15 , the surgical clip cartridge  300  may include nine dividers  320  and two end supporting walls  318 , and the dividers  320  and supporting walls  318  may be used to retain up to ten surgical clips  100 . In one aspect, the surgical clip cartridge  300  may be configured to retain between four to twenty surgical clips  100 . In one aspect, surgical clip cartridge  300  may be configured to retain four and twelve surgical clips  100 . 
         [0073]    In one aspect, as shown in  FIGS. 5, 7, and 9 , a plurality of ribs  319  may be provided between the end supporting walls  318  and the docking portion  316   a ,  316   b . The plurality of ribs  319  may define a convex or curvilinear tapering profile that narrows towards extreme longitudinal ends of the surgical clip cartridge  300 . The tapering ribs  319  may promote insertion and removal of the clip cartridge  300  into and out of the body cavity during a surgical operation. The tapering ribs  319  may further promote or enable flexing of the docking portion  316   a ,  316   b  when the surgical clip cartridge  300  is snapped-on or snapped-off of the surgical instrument shaft. 
         [0074]    Referring back to  FIG. 6 , the surgical clip cartridge  300  may include one or more light sources  340 , which may be used to illuminate the body cavity during a surgical procedure. The one or more light sources  340  may be in the form of light-emitted diodes, however, other illumination sources are of course contemplated as will be appreciated by one skilled in the art in view of the present disclosure. For example, other illumination sources may include, but are not limited to, incandescent light, UV light, infrared light, and luminescence. The one or more light sources  340  may be powered by a sealed internal battery housed within the surgical clip cartridge  300 . The one or more light sources  340  may further be connected to one or more electrical switches  350 ,  360  located on the surgical clip cartridge  300 . Alternatively, the one or more light sources  340  may be powered externally via electrical contacts on the surgical clip cartridge  300  that may be connected to corresponding electrical contacts on the surgical tool shaft (not shown). An electric switch may further be provided on a handle attached to the surgical tool shaft to actuate the one or more light sources  340 . 
         [0075]    In one aspect, the one or more light sources  340  may be primarily aimed at directions other than a direction in which the surgical clips are retrieved and removed from the surgical clip cartridge  300  to prevent glare. In particular, where visual sight of the surgical clips via a camera or other visual means within the body cavity is needed during retrieval from the surgical clip cartridge, the orientation of the one or more light sources  340  away from a direction of retrieval may prevent light from being directed towards the camera or other visual means. Instead, the one or more light sources  340  may be directed in other directions to provide general illumination within the body cavity. Additionally or alternatively, the one or more light sources  340  may be oriented to direct light towards a distal end of the surgical tool shaft, when the surgical clip cartridge is mounted to the surgical tool shaft, in order to provide illumination to a surgical area, particularly when the surgical tool shaft is installed with an end effector for performing a surgical procedure, as will be appreciated by one skilled in the art in view of the present disclosure. 
         [0076]    In one aspect as shown in  FIG. 6 , the electrical switch  350  may be located on a mounting surface of the at least one docking portion  316   a ,  316   b . The electrical switch  350  may be actuated or depressed as the surgical clip cartridge  300  is mounted onto the surgical instrument shaft via the at least one docking portion  316   a ,  316   b . Once the switch  350  is actuated or depressed, the one or more light sources  340  may be activated to provide illumination. The electrical switch  350  may subsequently be released by removing the surgical clip cartridge  300  from the surgical instrument shaft thereby deactivating the one or more light sources  340 . 
         [0077]    Additionally or alternatively, the electrical switch  360  may be disposed on a distal or proximal end of the base portion  310 . The electrical switch  360  may be actuated manually be an operator prior to, during, or after the surgical clip cartridge  300  has been mounted to the surgical instrument shaft. By actuating the electrical switch  360 , the one or more light sources  340  may be activated to provide illumination. The electrical switch  360  may be actuated again to deactivate the one or more light sources  340 . 
         [0078]    Turning to  FIGS. 16-22 , a second exemplary surgical clip cartridge  400  is shown. The surgical clip cartridge  400  may include a generally elongated circular or elliptical body  410  extending in a longitudinal direction. The body  410  may define a mounting groove  414  for attaching the body  410  onto a surgical instrument. The mounting groove  414  may extend along the longitudinal direction. The mounting groove  414  may include at least one docking portion  416   a ,  416   b , and the at least one docking portion  416   a ,  416   b  may define a concave semi-circular surface configured to conform around the surgical instrument shaft. In one aspect, the concave semi-circular surface may have a first radius, and the first radius may be less than or equal to an outer radius of the surgical instrument shaft in order to provide an interference fit when the docking portion  416   a ,  416   b  is attached to the surgical instrument shaft. The concave semi-circular surface may revolve about a central longitudinal axis of the docking portion  416   a ,  416   b , and the revolution of the concave semi-circular surface may be greater than or equal to 180°. In one aspect, the angle of revolution is between about 180° to 270°. For example, the angle of revolution of the concave semi-circular surface may be between about 185° to 270°, or between about 220° to 245° to ensure a secure fit about the surgical instrument shaft, when attached, while enabling the surgical clip cartridge  400  to be snapped-on or snapped-off of the surgical instrument shaft using the force of a user&#39;s hands, for example. It will be appreciated by one skilled in the art, in view of the present disclosure, that the arc length and the revolution of the arc may be selected based on a size or radius of the surgical instrument shaft that the surgical clip cartridge  400  is intended to attach on to. Additionally or alternatively, the arc length and the revolution of the arc may be selected based on the material properties of the surgical clip cartridge  400 , such as the resiliency, to ensure that the at least one docking portion  416   a ,  416   b  may displace sufficiently to engage and secure the surgical clip cartridge  400  to the surgical instrument shaft without damage or failure during the product life. 
         [0079]    In one aspect, the concave semi-circular surface of the at least one docking portion  316   a ,  316   b  may include one or more of a friction material, knurling, notches, and protrusions to prevent axial or rotational displacement when the docking portion  416   a ,  416   b  is attached to the surgical instrument shaft. The addition of one or more of the above surface features may prevent the body  410  from shifting relative to the surgical instrument shaft, thereby promoting accuracy and repeatability when a surgeon attempts to retrieve a clip  100  from the surgical clip cartridge  400  during a surgical procedure. In one aspect, the docking portion  416   a ,  416   b  and the surgical instrument shaft may include corresponding ribs and grooves to prevent axial and/or radial movement of the surgical clip cartridge  400  relative to the surgical instrument shaft once the surgical clip cartridge  400  has been mounted to the surgical instrument shaft. 
         [0080]    In one aspect, the body  410  may define a plurality of clip slots  420  arranged end-to-end relative to one another. Each of the clip slots  420  may be configured to receive and/or dispense the surgical clip  100  in a direction that is perpendicular to the longitudinal direction. In one aspect, the clip slots  420  may include a central portion  422  and an outer portion  424 . The central portion  422  may include at least two latching protrusion  428  to interface with the latching orifice  135  of the surgical clip  100 . In one aspect, the body  410  may include a total of four clip slots  420 . However, it will be appreciated by one skilled in the art in view of the present disclosure, that the number of clip slots  420  provided on the body  410  may be selected based on the number of clips desired for a surgical operation and/or the available length provided on the surgical instrument shaft. In one aspect, the body  410  may have between four and twenty clip slots. In one aspect, the body  410  may have between four and eight clip slots. 
         [0081]    As shown in  FIGS. 16 and 20 , one surgical clip  100  may be stored within each of the clip slots  420 , and the clip applier  200  may be inserted into the clip slots  420  to retrieve the surgical clip  100  retained therein. Once the clip applier  200  has been inserted into one of the clip slots  420 , the clip applier  200  may be positioned about the surgical clip  100 . In one aspect, the notches  212 ,  214  of the first jaw  210  may be configured to receive and lock the bosses  142 ,  144  of the first leg  110 , and the notches  222 ,  224  of the second jaw  220  may be configured to receive and lock the bosses  152 ,  154  of the second leg  120 . Alternatively, the notches  212 ,  214  of the first jaw  210  may be configured to receive and lock the bosses  152 ,  154  of the second leg  120 , and the notches  222 ,  224  of the second jaw  220  may be configured to receive and lock the bosses  142 ,  144  of the first leg  110 . The clip applier  200  may then be withdrawn from the clip slot  420 . During the withdrawal process, the surgical clip  100  may be disengaged from the surgical clip cartridge  400  once a predetermined threshold force is applied to the surgical clip  100 , via the clip applier  200  for example, such that the surgical clip  100  may be released from the latching protrusion  428 . 
         [0082]    In one aspect, as shown in  FIGS. 16-19 , a proximal and distal ends  418   a ,  418   b  of the surgical clip cartridge  400  may be rounded, filleted, and/or chamfered to promote insertion and removal of the clip cartridge  400  into and out of the body cavity during a surgical operation. 
         [0083]    Referring back to  FIG. 16 , the surgical clip cartridge  400  may include one or more light sources  440 , which may be used to illuminate the body cavity during a surgical procedure. The one or more light sources  435  may be in the form of light-emitted diodes, however, other illumination sources are of course contemplated as will be appreciated by one skilled in the art in view of the present disclosure. For example, other illumination sources may include, but are not limited to, incandescent light, UV light, infrared light, and luminescence. The one or more light sources  435  may be powered by a sealed internal battery housed within the surgical clip cartridge  400 . The one or more light sources  440  may further be connected to an electrical switch  440  located on the surgical clip cartridge  400 . Alternatively, the one or more light sources  435  may be powered externally via electrical contacts on the surgical clip cartridge  400  that may be connected to corresponding electrical contacts on the surgical tool shaft (not shown). An electric switch may further be provided on a handle attached to the surgical tool shaft to selectively actuate the one or more light sources  435 . 
         [0084]    In one aspect, the one or more light sources  435  may be primarily aimed at directions other than a direction in which the surgical clips are retrieved from the surgical clip cartridge  400  to prevent glare. As shown in  FIGS. 16 and 18 , the one or more light sources  435  may be oriented to direct light towards a distal and/or proximal end of the surgical tool shaft, when the surgical clip cartridge is mounted to the surgical tool shaft, in order to provide illumination to a surgical area, particularly when the surgical tool shaft is installed with an end effector for performing a surgical procedure, as will be appreciated by one skilled in the art in view of the present disclosure. 
         [0085]    In one aspect, the electrical switch  440  may be located on a mounting surface of the at least one docking portion  416   a ,  416   b . The electrical switch  440  may be actuated or depressed as the surgical clip cartridge  400  is mounted onto the surgical instrument shaft via the at least one docking portion  416   a ,  416   b . Once the switch  440  is actuated or depressed, the one or more light sources  440  may be activated to provide illumination. The electrical switch  440  may subsequently be released by removing the surgical clip cartridge  400  from the surgical instrument shaft thereby deactivating the one or more light sources  435 . 
         [0086]    Turning to  FIGS. 23 and 24 , a third exemplary surgical clip cartridge  500  is shown. The surgical clip cartridge  500  may include a generally elongated circular or elliptical body  510  extending in a longitudinal direction. The circular or elliptical body  510  may include a proximal end  512  and a distal end  514 . The proximal end  512  may include a tool engaging slot  516  configured to receive and lock a distal end of a surgical tool shaft. The distal end of the surgical tool shaft may include lateral protrusions for insertion into the tool engaging slot  516  and to enable both the surgical tool shaft and the surgical clip cartridge  500 . The distal end  514  of the surgical clip cartridge  500  may include a clip feeding slot  518  configured to receive and dispense clips, such as but not limited to surgical clips  100  discussed above. Of course, other types of clips may be used with the surgical clip cartridge  500 . 
         [0087]    In one aspect, the surgical clip cartridge  500  is configured to store a plurality of surgical clips  100 , sequentially in abutting fashion, within an interior lumen or chamber of the surgical clip cartridge  500 . A spring mechanism may be provided to advance the surgical clips  100  toward the clip feeding slot  518  as a preceding surgical clip  100  is removed. The surgical clips  100  may be removed from the clip feeding slot  518  by inserting the pair pivotable jaws  210 ,  220  of the clip applier  200  into then clip feeding slot  518 , generally in the longitudinal direction. The pair pivotable jaws  210 ,  220  may then engage the bosses  142 ,  144 ,  152 ,  154 . The outermost surgical clip  100  may then be withdrawn from the clip feeding slot  518  using the clip applier  200 . 
         [0088]    In one aspect, as shown in  FIGS. 22 and 23 , the proximal end  512  and the distal end  514  of the surgical clip cartridge  500  may be rounded, filleted, and/or chamfered to promote insertion and removal of the clip cartridge  500  into and out of the body cavity during a surgical operation. 
         [0089]      FIGS. 25, 26, and 27  show three-dimensional renderings of the first surgical clip cartridge  300 , second surgical clip cartridge  400 , and third surgical clip cartridge  500 , respectively.  FIG. 28  shows a surgical assembly comprising a surgical tool  600  with an elongated shaft  610  and an end effector  620  disposed at a distal end of the elongated shaft  610 . In one aspect, the end effector may be a grasper. In one aspect, any one or more of the first surgical clip cartridge  300 , second surgical clip cartridge  400 , and third surgical clip cartridge  500 , may be attached to the elongated shaft  610 . As specifically shown in  FIG. 26 , the first surgical clip cartridge  300  is attached to the elongated shaft  610  via the at least one docking portion  316   a ,  316   b , as described above. In one aspect, a diameter of the elongated shaft  610  may be between 1 mm and 100 mm. 
         [0090]    A system and a method of using a surgical clip cartridge during a surgical procedure will now be discussed. In one aspect, the surgical procedure may be minimally invasive surgery (such as micro-laparoscopic or needlescopic surgery) where instruments and/or accessories may be introduced into a body cavity through relatively small ports to reduce pain, improve recovery time, and minimize scarring. The small ports may be less than 3 mm in diameter, and in select aspects may be between 1 mm to 3 mm. The use of such small ports may help minimize triangulation issues and improve maneuverability in comparison with surgical operations where multiple instruments are inserted in parallel through a single larger opening. Even with the use of smaller ports, a single larger port may be provided to pass larger components into the body cavity, such an interchangeable end effector. 
         [0091]    Referring to  FIGS. 29A-29H , an exemplary micro-laparoscopic system  1000  including a snap-on surgical clip cartridge, such as the surgical clip cartridge  300 ,  400 ,  500  discussed above, is shown. As shown in  FIG. 29A , the micro-laparoscopic system  1000  may include a surgical tool  1100  and an access port  1200 . The surgical tool  1100  may comprise a handle portion  1110  and an elongated needle shaft  1120 . The elongated needle shaft  1120  may have a maximal outer diameter of 3 mm, and in one aspect, the diameter of the elongated needle shaft  1120  is between 1 mm and 3 mm. The elongated needle shaft  1120  may include a needle tip  1130  located at a distal end thereof. The needle tip  1130  may be a beveled or sharp needle tip configured to puncture through body tissue and may be used to puncture through a body wall and into a body cavity. 
         [0092]    In one aspect, the needle tip  1130  of the surgical tool  1100  may be directed adjacent to a body cavity wall. Pressure in a distal direction may be applied to the elongated needle shaft  1120  and the needle tip  1130 . As pressure is being applied to the body cavity wall via the needle tip  1130 , an incision or opening  1250  may be formed in the body cavity wall. As the incision or opening  1250  is formed, the needle tip  1130  and at least a portion of the elongated needle shaft  1120  may be advanced to enter into the body cavity. 
         [0093]    The access port  1200  may be provided at a location remote from the incision or opening  1250 . In one aspect, the access port  1200  may define an interior lumen with a maximal internal diameter of between 3 mm to 30 mm. In one aspect, the access port  1200  may be introduced and employed through an umbilicus of the patient. Once the access port  1200  has been positioned in and/or on the body wall, and once the elongated needle shaft  1120  has been inserted into the body cavity via the incision or opening  1250 , the needle tip  1130  and the elongated needle shaft  1120  may be guided from inside the body cavity to an external environment outside the body cavity, by entering a distal end of the access port  1200 , passing through the interior lumen of the access port  1200 , and exiting a proximal end of the access port  1200  as generally shown in  FIGS. 29A and 29B . 
         [0094]    As shown in  FIG. 29B , once the distal end of the elongated needle shaft  1120  is extended from the access port  1200  to the external environment, the surgical clip cartridge  300 ,  400  may be attached to an outer surface of the elongated needle shaft  1120 . For example, a snap-on surgical clip cartridge, such as the surgical clip cartridge  300 ,  400  may be snapped onto the outer surface of the elongated needle shaft  1120 , as shown in  FIG. 29C . Alternatively, a snap-on clip cartridge, such as the surgical clip cartridge  500  may be secured onto or over the needle tip  1130  of the elongated needle shaft  1120 . Once the snap-on clip cartridge has been secured to the elongated needle shaft  1120 , the elongated needle shaft  1120  and the snap-on clip cartridge  300 ,  400  may be withdrawn into the body cavity via the access port  1200 , as shown in  FIG. 29D . The process may then be reversed, as generally shown in  FIGS. 29G and 29H , in order to remove or snap-off the clip cartridge  300 ,  400  from the elongated needle shaft  1120  such that the surgical tool  1100  can be removed from the patient, via the initial incision or opening  1250 , without creating a larger incision. 
         [0095]    In addition to attaching or snapping on the surgical clip cartridge  300 ,  400  onto the outer surface of the elongated needle shaft  1120 , as shown generally in  FIGS. 29B and 29C , an end effector tool  700  may also be attached to the distal end of the elongated needle shaft  1120 . The end effector tool  700  may be one of graspers, scissors, clamp, a cauterizing end, a biopsy probe, a snare loop, a needle knife, a camera and a light source. Of course, other tools and end effectors for the surgical tool  1100  are of course contemplated. 
         [0096]    As shown in  FIG. 29E , once the surgical clip cartridge  300 ,  400  mounted onto the elongated shaft  1120  has been withdrawn into the body cavity, a clip applier such as the clip applier  200  (shown and discussed with reference to  FIGS. 4A and 4B  above) may be used within the body cavity to apply a plurality of surgical clips. In particular, the first jaw  210  and the second jaw  220  of the clip applier  200  may be introduced through the access port  1200  and guided towards the surgical clip cartridge  300 ,  400  such that surgical clips  100  may be retrieved from the surgical clip cartridge  300 ,  400  while within the body cavity. 
         [0097]    As generally shown in  FIGS. 29E and 29F , a first surgical clip may be retrieved using the clip applier  200  from the surgical clip cartridge  300 ,  400 . The first surgical clip may then be applied to clamp at least one portion of a vessel or piece of tissue located in at least one operation location within the body cavity. While remaining within the body cavity, the clip applier  200  may then retrieve a second surgical clip from the surgical clip cartridge  300 ,  400 . The second surgical clip may then be applied to clamp the same or another portion of the vessel or piece of tissue. Alternatively, the second surgical clip may be applied to a different vessel or piece of tissue within the body cavity. Additional surgical clips may be retrieved from the surgical clip cartridge  300 ,  400  and applied by the clip applier  200  without either the clip applier  200  or the surgical clip cartridge  300 ,  400  from having to be removed from the body cavity. 
         [0098]    By providing the surgical clip cartridge  300 ,  400  within the body cavity, a shorter travel distance is required between reloading of the clip applier  200 , and reloading can be accomplished intracorporeally, thereby providing a more efficient ligation process and reducing contamination or complications that may arise by having a surgeon repeatedly remove and re-insert a clip applier into and out of the body cavity for reloading purposes. 
         [0099]    An exemplary surgical method of using the micro-laparoscopic system  1000  will now be described. The surgical method may include a step of providing the surgical clip cartridge  300 ,  400 , the surgical tool  1100  with the elongated needle shaft  1120 , and the access port  1200 . The surgical clip cartridge may include between four and eight clip slots for transporting a corresponding number of surgical clips. The access port  1200  may be inserted into a first opening of the body cavity wall such that at least a portion of the access port  1200  extends into the body cavity. In one aspect, the first opening may be created as pressure is applied against the body cavity wall via the access port  1200 . In one aspect, the first opening may be formed at the umbilicus of the patient. In one aspect, the access port  1200  may define a lumen having an internal diameter of between 3 mm to 30 mm, and the first opening may have a minimum diameter of greater than 3 mm. 
         [0100]    The method may comprise a step of inserting the elongated needle shaft  1120  into the body cavity via a second opening, the second opening being remote from the first opening. In one aspect, the needle tip  1130  of the elongated needle shaft  1120  may be used to puncture the body cavity wall to thereby forming the second opening. In one aspect, the maximal outer diameter of the elongated needle shaft is 3 mm or less, and the second opening formed may have a maximal diameter of approximately 3 mm or less. 
         [0101]    The method may comprise a step of orienting the needle tip  1130  of the elongated needle shaft  1120  towards a distal opening of the access port  1200  that is extended into the body cavity. The needle tip  1130  and at least a distal portion of the elongated needle shaft  1120  may be guided through the lumen of the access port  1200  and out a proximal opening of the access port  1200 . Once at least the distal portion of the elongated needle shaft  1120  passes through the proximal opening of the access port  1200  and is accessible in the external environment outside the body cavity, the surgical clip cartridge  300 ,  400  may be attached to the outer surface of the elongated needle shaft  1120 . The surgical clip cartridges  300 ,  400  may be secured to the elongated needle shaft  1120  via at the least one docking portion  316   a ,  316   b ,  416   a ,  416   b  using a snap-on or annular fit. The at least one docking portion  316   a ,  316   b ,  416   a ,  416   b  may flex as it is being attached to the elongated needle shaft  1120  and may at least partially surround the elongated needle shaft  1120  once attached. The at least one docking portion  316   a ,  316   b ,  416   a ,  416   b  may be slightly expanded once attached to the elongated needle shaft  1120  and may grip the elongated needle shaft  1120  through the presence of hoop strain or stress. 
         [0102]    While the distal end of the elongated needle shaft  1120  remains extended from the proximal end of the access port  1200  and accessible to the external environment outside the body cavity, an end effector tool  700  may be mounted to the distal end of the elongated needle shaft  1120 . In one aspect, the end effector tool  700  may be one of graspers, scissors, clamp, a cauterizing end, a biopsy probe, a snare loop, a needle knife, a camera and a light source. 
         [0103]    Once the surgical clip cartridge  300 ,  400  has been attached to the elongated needle shaft  1120 , both the surgical clip cartridge  300 ,  400  and the distal end of the elongated needle shaft  1120  may be withdrawn into the body cavity via the lumen of the access port  1200 . A plurality of surgical clips carried by the surgical clip cartridge  300 ,  400  may then be retrieved from the surgical clip cartridge  300 ,  400  while it is within the body cavity. 
         [0104]    In one aspect, a distal end of the clip applier  200  may be inserted into the body cavity via the access port  1200 . The distal end of the clip applier  200  may include a pair of jaws or other grasping mechanism. The pair of jaws or other grasping mechanism may be maneuvered to at least a first slot of the surgical clip cartridge  300 ,  400 . The pair of jaws may then engage and retrieve a first surgical clip retained within the first slot of the surgical clip cartridge  300 ,  400 . The clip applier  200  may then be directed towards an operation location where the first surgical clip is latched and secured around a target vessel or other type of tissue. The pair of jaws or other grasping mechanism may then be maneuvered to a second slot of the surgical clip cartridge  300 ,  400  such that a second surgical clip may be retrieved from the second slot of the surgical clip cartridge  300 ,  400 . The clip applier  200  may then be directed towards an operation location where the second surgical clip is latched and secured around target vessel or other type of tissue, which may be the same target vessel or tissue secured by the first surgical clip or it may be different target vessel or tissue as required by the procedure. This process may be repeated such that additional surgical clips may be retrieved from the surgical clip cartridge  300 ,  400  and applied without having to remove the clip applier  200  from within the body cavity. If present, the end effector tool  700  may be used to perform a procedure within the body cavity while the surgical clip cartridge  300 ,  400  is mounted to the elongated needle shaft  1120 . 
         [0105]    Once the number of surgical clips held by the surgical clip cartridge  300 ,  400  have been exhausted, or once the surgical clips are no longer needed for the operation, the clip applier  200  may be withdrawn from the body cavity by passing the distal end of the clip applier  200  back through the lumen of the access port  1200  and out to the external environment. Both the surgical clip cartridge  300 ,  400  and the distal end of the elongated needle shaft  1120  may also pass through the lumen of the access port  1200  such that at least the surgical clip cartridge  300 ,  400  is accessible in the external environment. The surgical clip cartridge  300 ,  400  may then be detached from the elongated needle shaft  1120 . If present, the end effector tool  700  may also be removed from the distal end of the elongated needle shaft  1120 . 
         [0106]    The distal end of the elongated needle shaft  1120  may be withdrawn back into the body cavity via the lumen of the access port  1200 . The surgical tool  1100 , including distal end of the elongated shaft  1120 , may be completely withdrawn from the body cavity by maneuvering the surgical tool  1100  in a proximal direction from the body cavity wall such that the distal end of the elongated shaft  1120  is passes through and exits via the second opening. Although exemplary steps for a surgical method is presented above, variations and modifications to the steps, including rearrangement of the order and sequence, will be appreciated by one skilled in the art in view of the present disclosure. 
         [0107]    The surgical clip cartridges described in the present disclosure may be used in a variety of surgical procedure, including intracorporeal feeding of surgical clips, to reduce surgery time and to minimize visualization loss of the surgeon as a result of clip reloading. The methods and systems of the present disclosure, as described above and shown in the drawings, provide surgical clip cartridges with superior properties to provide surgeons with additional flexibility and maneuverability during operation. 
         [0108]    While the apparatus and methods of the present disclosure have been shown and described, it will be appreciated that the foregoing description provides examples of the surgical clip cartridge, which may be used with a surgical instrument. However, it is contemplated that other implementations of the disclosure may differ in detail from the foregoing examples. Each aspect of the disclosure may be used individually or in combination with one another, as will be understood by one skilled in the art in view of the present disclosure. All references to the disclosure or examples thereof are intended to reference the particular example being discussed at that point and are not intended to imply any limitation as to the scope of the disclosure more generally. All language of distinction and disparagement with respect to certain features is intended to indicate a lack of preference for those features, but not to exclude such from the scope of the disclosure entirely unless otherwise indicated. 
         [0109]    Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context.