Patent Publication Number: US-2011066163-A1

Title: Hemostatic Clip and Hemostatic Clip Operation Apparatus Using the Same

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims priority to and the benefit of Korean Patent Application No. 2009-86286, filed Sep. 14, 2009, the disclosure of which is incorporated herein by reference in its entirety. 
     BACKGROUND 
     1. Field of the Invention 
     The present invention relates to a hemostatic clip and a hemostatic clip operation apparatus using the same. 
     2. Discussion of Related Art In general, since a middle or large diameter arterial blood vessel may cause a serious problem upon bleeding due to even a minor injury, it requires careful attention. During an abdominal operation or laparoscopy, the middle or large diameter blood vessel may bleed due to mistakes or accidents. At this time, a hemostatic clip and a hemostatic clip operation apparatus on which the hemostatic clip is mounted are used to stop bleeding from the surface of the blood vessel. 
     Conventional hemostatic clips are disclosed in U.S. Pat. No. 4,799,481, entitled “Surgical Hemostatic Clips,”, U.S. Pat. No. 4,611,595, entitled “Spring Activated Hemostatic Clip Applicator,” and U.S. Pat. No. 6,346,112, entitled “Hemostatic Clips.” 
     However, when the conventional hemostatic clip is used to stop the bleeding from the middle or large diameter arterial blood vessel, the hemostatic clip may block the entire blood vessel as well as the bleeding area, causing serious problems in blood circulation. Therefore, when the middle or large diameter blood vessel partially bleeds, a novel hemostatic clip and a hemostatic clip operation apparatus that are capable of rapidly stopping bleeding in the bleeding area, without blocking the entire blood vessel, are needed. 
     SUMMARY OF THE INVENTION 
     The present invention is directed to a hemostatic clip capable of rapidly stopping bleeding in a bleeding area, without blocking the entire blood vessel, when a middle or large blood vessel bleeds during an abdominal operation or an operation using an endoscope. 
     The present invention is also directed to a hemostatic clip operation apparatus using the hemostatic clip. 
     Additional aspects of the invention will be set forth in the description which follows, and in part will be apparent from the description, or may be learned by practice of the invention. 
     In an example embodiment, a hemostatic clip includes: a clip body configured to clip a periphery of a bleeding area of a blood vessel to stop bleeding; and a pair of bending parts formed at upper and lower sides of a symmetrical center line of the clip body to symmetrically bend the clip body with respect to the center line. 
     Here, the clip body may have a circular or polygonal closed-loop shape, more preferably, an oval closed-loop shape. 
     In addition, the bending parts may be disposed on a major axis of the clip body. 
     The clip body may further include a pair of hook parts formed at the clip body to hook and remove the hemostatic clip clipped to the bleeding area. 
     Here, the hook parts may project from both left and right sides of the clip body opposite to the bleeding area. 
     In another example embodiment, a hemostatic clip operation apparatus includes: a handle; a first gripper configured to primarily stop bleeding from a bleeding area of a blood vessel; a second gripper configured to receive the first gripper and symmetrically bend a closed-loop shaped-hemostatic clip to secondarily clip a periphery of the bleeding area stopped by the first gripper; and a gripper driver configured to connect the handle to the first and second grippers to be interlocked with operation of the handle to operate sequential stopping of bleeding and clipping of the first and second grippers. 
     Here, the handle may include a handle body, and a pair of operation handles hinged to both sides of the handle body to be pivoted inward and outward. 
     In addition, the gripper driver may include: a push rod movably inserted into the handle body forward and backward; a first link member configured to link the operation handle to the push rod to guide reciprocal movement of the push rod depending on pivotal movement of the operation handle; a first operation rod disposed in front of the push rod, and configured to move forward by the push rod to perform a bleeding-stopping operation of the first gripper; a second operation rod disposed in front of the push rod to receive the first operation rod and move forward by the push rod to perform a clipping operation of the second gripper when the bleeding-stopping operation of the first gripper is completed; a second link member inserted to pass through the center of the push rod and the first operation rod and linked to the first and second grippers at its tip; and a guide case coupled to a tip of the handle body and configured to guide such that a head of the push rod and the second operation rod are inserted into the guide case to move straightly. 
     In addition, the push rod may have a rear end hinged to the first link member to move forward by the first link member when the pair of operation handles are pivoted inward, and move backward by the first link member when the operation handles are pivoted outward. 
     Further, a resilient member may be provided between the push rod and the first operation rod. 
     Here, the resilient member may include a spring configured to push the first operation rod forward by the push rod in a non-compressed state when the pair of operation handles are pivoted inward halfway, and to be compressed not to push the first operation rod forward when the operation handles are pivoted inward completely. 
     Furthermore, when the pair of operation handles are pivoted inward halfway, the resilient member may push the first operation rod using a force of the push rod moving forward, and the first operation rod may move forward to press an outer surface of the first gripper to close the first gripper. 
     In addition, when the operation handle is pivoted inward completely, the resilient member may be compressed to move the push rod forward to push the second operation rod, and the second operation rod may be moved forward to press an outer surface of the second gripper to close the second gripper. 
     Further, when the first gripper is completely closed, the first gripper may have an outer width that gradually increases toward the bleeding area, and the first operation rod may have an inner width smaller than the largest outer width of the first gripper, so that the first operation rod cannot move forward. 
     In addition, instead of omission of the resilient member provided between the push rod and the first operation rod, the operation handle and the hinge coupling part of the first link member may be configured to slide forward and backward upon pivotal movement of the operation handle. 
     Further, the front end of the second operation rod opposite to the second gripper may have a V-shaped groove. 
     Furthermore, the first gripper may include a pair of gripper members connected to a tip of the second link member to be laterally opened and closed. 
     In addition, the second gripper may include a pair of gripper members connected to the second link member in the rear of the first gripper to be laterally opened and closed while receiving the first gripper. 
     Further, the second gripper may have a first gripper receiving groove at a front surface opposite to the first gripper to receive the first gripper when the second gripper is laterally closed. 
     Furthermore, the second gripper may include clip holding parts formed at left and right ends thereof to hold left and right sides of the hemostatic clip, and clip bending parts formed at upper and lower ends thereof to press and bend upper and lower sides of the hemostatic clip. 
     Specific descriptions of other example embodiments will be apparent from the detailed description and the attached drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and other objects, features and advantages of the present invention will become more apparent to those of ordinary skill in the art by describing in detail example embodiments thereof with reference to the attached drawings, in which: 
         FIG. 1  is a perspective view of a hemostatic clip in accordance with an example embodiment of the present invention; 
         FIG. 2  is a plan view of the hemostatic clip shown in  FIG. 1 ; 
         FIG. 3  is a plan view of a hemostatic clip having a polygonal shape; 
         FIG. 4  is a perspective view of a hemostatic clip operation apparatus using a hemostatic clip in accordance with an example embodiment of the present invention; 
         FIG. 5  is an exploded perspective view of the hemostatic clip operation apparatus shown in  FIG. 4 ; 
         FIG. 6  is an enlarged perspective view of portion A of  FIG. 4 ; 
         FIG. 7  is an enlarged perspective view of portion B of  FIG. 4 ; 
         FIG. 8  is a perspective view of an example embodiment of portion C of  FIG. 4 ; 
         FIG. 9  is a perspective view of another example embodiment of portion C of  FIG. 4 ; 
         FIG. 10  is a view showing the hemostatic clip operation apparatus holding the hemostatic clip in accordance with the present invention; 
         FIG. 11  is an enlarged cross-sectional view of portion D of  FIG. 10 ; 
         FIG. 12  is an enlarged perspective view of portion E of  FIG. 10 ; 
         FIG. 13  is a view for explaining a bleeding-stopping operation of a first gripper according to a first operation of the hemostatic clip operation apparatus in accordance with the present invention; 
         FIG. 14  is an enlarged cross-sectional view of portion F of  FIG. 13 ; 
         FIG. 15  is an enlarged perspective view of portion G of  FIG. 13 ; 
         FIG. 16  is a view for explaining a clipping operation of a second gripper according to a second operation of the hemostatic clip operation apparatus in accordance with the present invention; 
         FIG. 17  is an enlarged cross-sectional view of portion H of  FIG. 16 ; 
         FIG. 18  is an enlarged perspective view of portion I of  FIG. 16 ; 
         FIGS. 19 and 20  are views showing a state in which the hemostatic clip clips a bleeding area of a blood vessel using the hemostatic clip operation apparatus in accordance with the present invention; 
         FIG. 21  is a view showing that the hemostatic clip in accordance with the present invention is removed; and 
         FIG. 22  is an enlarged perspective view of portion J of  FIG. 21 . 
     
    
    
     DETAILED DESCRIPTION OF EXAMPLE EMBODIMENTS 
     Example embodiments of the present invention will be described in detail. However, the present invention is not limited to the embodiments disclosed below, but can be implemented in various forms. The following embodiments are described in order to enable those of ordinary skill in the art to embody and practice the present invention. Like reference numerals designate like elements throughout the detailed description. 
     Hereinafter, a hemostatic clip and a hemostatic clip operation apparatus using the same in accordance with an example embodiment of the present invention will be described with reference to the accompanying drawings. In the detailed description, if it is determined that description of conventional functions or constitutions may make the sprit of the invention unclear, detailed description thereof will be omitted. 
       FIG. 1  is a perspective view of a hemostatic clip in accordance with an example embodiment of the present invention, and  FIG. 2  is a plan view of the hemostatic clip shown in  FIG. 1 . 
     As shown in  FIGS. 1 and 2 , a hemostatic clip  10  in accordance with an example embodiment of the present invention may include a clip body  11 , bending parts  13   a  and  13   b,  and hook parts  15   a  and  15   b.    
     The clip body  11  functions to clip a periphery of a bleeding area  3  of an important blood vessel  1  such as a middle or large diameter blood vessel (see  FIG. 19 ), while being held by a second gripper  220  of a hemostatic clip operation apparatus  20 , which will be described below. 
     The clip body  11  may have a symmetrical circular closed loop shape. While the example embodiment illustrates the clip body  11  having a circular shape, the clip body  11  may have a polygonal closed loop shape such as a symmetrical rectangular shape (not shown), a hexagonal shape (see  FIG. 3 ), etc., not limited to the circular shape. Here, the clip body  11  may have a vertical length larger than a lateral length when the clip body  11  is symmetrical with respect to a line connecting the bending parts  13   a  and  13   b  as a centerline to minimize a hemostatic range for the diameter of the blood vessel  1 . At this time, the bending parts  13   a  and  13   b  are disposed on a major shaft Y of the clip body  11 . 
     In addition, the clip body  11  may be formed of a material such as a biocompatible metal. 
     The pair of bending parts  13   a  and  13   b  may be formed at upper and lower sides of the clip body  11  with respect to a centerline thereof such that the clip body  11  is symmetrically bent with respect to the centerline. 
     The bending parts  13   a  and  13   b  may have a predetermined elasticity such that the bending parts  13   a  and  13   b  can be pressed and bent by clip bending parts  220   c  and  220   d  of a second gripper  220 , which will be described below. 
     The pair of hook parts  15   a  and  15   b  may be formed at the clip body  11  such that the hemostatic clip  10  clipped at the bleeding area  3  of the blood vessel  1  can be easily removed using a separate clip removing device  30  (see  FIGS. 21 and 22 ). 
     The hook parts  15   a  and  15   b  may project from both sides of the clip body  11  opposite to the bleeding area  3 . At this time, the hook parts  15   a  and  15   b  may project from both sides of the clip body  11  in a ring shape, and may have a diameter of a head larger than that of an extension part. In the clip removing device  31 , fastening members  31  fastened to the hook part  15   a  and  15   b  may have fastening grooves  31   a  which are formed at an end and widen from a rear part to a front part, such that the fastening members  31  of the clip removing device  30  can be readily fastened to the hook parts  15   a  and  15   b  of the hemostatic clip  10 . 
     In addition, the hook parts  15   a  and  15   b  are configured to be easily fastened to the clip removing device  30 , and to substantially endure an external force pulling out to widen the hemostatic clip  10 , removing the hemostatic clip  10  held therein. 
     While the example embodiment illustrates that the hook parts  15   a  and  15   b  are separately coupled to the clip body  11 , the hook parts  15   a  and  15   b  may be integrally formed with the clip body  11 , not limited thereto. 
       FIG. 4  is a perspective view of a hemostatic clip operation apparatus using a hemostatic clip in accordance with an example embodiment of the present invention,  FIG. 5  is an exploded perspective view of the hemostatic clip operation apparatus shown in  FIG. 4 ,  FIGS. 6 and 7  are enlarged perspective views of portions A and B of  FIG. 4 , respectively, and  FIGS. 8 and 9  are perspective views of example embodiments of portion C of  FIG. 4 . 
     As shown in  FIGS. 4 to 9 , the hemostatic clip operation apparatus  20  in accordance with an example embodiment of the present invention may include a handle  100 , a first gripper  210 , a second gripper  220 , and a gripper driver  300 . 
     The handle  100  functions to directly apply an external force to the gripper driver  300  to perform a bleeding-stopping and clipping operation of the first and second grippers  210  and  220  in a state in which a surgeon holds the handle  100 . 
     The handle  100  may include a handle body  110 , and a pair of operation handles  121  and  122  pivotally hinged inward and outward at both sides of the handle body  110 . Here, the handle body  110  may have a hole  111  formed at a tip thereof and through which a push rod  310 , a second link member  330  and a guide case  370  are inserted, and open surfaces  113  formed at both sides thereof such that the pair of operation handles  121  and  122  are pivoted inward to be received therein. In addition, front ends of the operation handles  121  and  122  are hinged to the handle body  110 , and rear ends of the operation handles  121  and  122  are linked to the push rod  310  by the first link member  320 , which will be described below. Further, the rear ends of the operation handles  121  and  122  may have finger insertion parts  121   a  and  122   a  into which a surgeon can insert his/her fingers to hold them. 
     The first gripper  210  functions to primarily stop bleeding from the bleeding area  3  of the blood vessel  1 . More specifically, when the pair of operation handles  121  and  122  are pivoted inward halfway, a first operation rod  350  moves forward to press an outer surface of the first gripper  210  so that the first gripper  210  closes the bleeding area  3  to primarily stop bleeding. 
     The first gripper  210  may be constituted by a pair of gripper members  211  and  212  connected to the tip of the second link member  330  to be laterally opened and closed. Here, when the first gripper  210  is completely closed, the first gripper  210  may have an outer width that gradually increases toward the bleeding area such that the first operation rod  350  cannot move forward, and the first operation rod  350  may have an inner width smaller than the largest outer width of the first gripper  210 . 
     The second gripper  220  functions to symmetrically bend the closed-loop shaped hemostatic clip  10  shown in  FIGS. 1 and 2  and secondarily clip a periphery of the bleeding area  3  stopped by the first gripper  210 . More specifically, when the pair of operation handles  121  and  122  are pivoted inward completely, a second operation rod  360  moves forward to pressure the periphery of the second gripper  220  so that the second gripper  220  is closed to secondarily clip the periphery of the bleeding area  3 . 
     The second gripper  220  may be constituted by a pair of gripper members  221  and  222  connected to receive the first gripper  210  in the second link member  330  in the rear of the first gripper  210  and to be laterally opened and closed. While this example embodiment illustrates a constitution in which the pair of gripper members  221  and  222  are symmetrically coupled to form a “+” shape and laterally opened and closed with respect to a center cross line, the second gripper  220  may have various constitutions, not limited thereto. 
     The second gripper  220  is configured to receive the first gripper  210 . For example, the second gripper  220  may have first gripper receiving grooves  221   a  and  222   a  larger than the first gripper  210  and opposite to the first gripper  210  so that the first gripper  210  is accommodated in the second gripper  220  upon closing of the second gripper  220 . 
     The second gripper  220  may include clip holding parts  220   a  and  220   b  formed at left and right ends thereof to hold left and right sides of the hemostatic clip  10 , and clip bending parts  220   c  and  220   d  formed at upper and lower ends thereof to press and bend upper and lower sides of the hemostatic clip  10 . Here, the clip holding parts  220   a  and  220   b  and the clip bending parts  220   c  and  220   d  may be formed at the second gripper  220  to form a stepped groove to prevent separation of the hemostatic clip  10  from the held state. 
     The gripper driver  300  functions to drive a sequential stopping of bleeding and clipping operation of the first and second grippers  210  and  220  according to a moving operation of the handle  100 . 
     The gripper driver  300  is configured to connect the handle  100  to the first and second grippers  210  and  220 . For this purpose, the gripper driver  300  may include a push rod  310 , a first link member  320 , a second link member  330 , a first operation rod  350 , a second operation rod  360 , and a guide case  370 . 
     The push rod  310  is disposed in the handle body  110  and a head  311  of the push rod  310  is movably inserted through a hole  111  formed at the tip of the handle body  110  forward and backward. 
     The push rod  310  may include the head  311 , and a rod extension part  312  extending rearward from the head  311 . 
     Here, contact areas of the head  311  of the push rod  310  and the second operation rod  360  may be equal to each other so that the head  311  of the push rod  310  pushes the second operation rod  360  forward when the pair of operation handles  121  and  122  are pivoted inward completely. 
     The rod extension part  312  of the push rod  310  may be connected to the first link member  320  by a hinge  312   a  such that the push rod  310  moves forward by the first link member  320  when the pair of operation handles  121  and  122  are pivoted inward and the push rod  310  moves backward by the first link member  320  when the operation handles  121  and  122  are pivoted outward. 
     In addition, the push rod  310  may have a hole  310   a  through which the second link member  330  is inserted forward and backward. 
     The first link member  320  links the operation handles  121  and  122  to the push rod  310  to guide reciprocal movement of the push rod  310  depending on pivotal movement of the operation handles  121  and  122 . 
     When a spring  340  is installed between the push rod  310  and the first operation rod  350 , as shown in  FIG. 8 , the operation handles  121  and  122  are hinged to the first link member  320 , and a hinge coupling part  321  may be fixed to the operation handle  121  and  122 . Therefore, when the pair of operation handles  121  and  122  are pivoted inward completely, the push rod  310  moves forward to push the second operation rod  360  so that the spring  340  is compressed not to push the first operation rod  350 . 
     On the other hand, when the spring  340  is not installed between the push rod  310  and the first operation rod  350 , as shown in  FIG. 9 , the operation handles  121  and  122  are hinged to the first link member  320 , and the hinge coupling part  322  is inserted into slide guide grooves  323  formed in inner surfaces of the operation handles  121  and  122  to be slid forward and backward upon pivotal movement of the operation handles  121  and  122 . Therefore, when the pair of operation handles  121  and  122  are pivoted inward completely, the push rod  310  moves forward to push the second operation rod  360  so that the hinge coupling part  322  moves backward along the slide guide groove  323  not to push the first operation rod  350 . 
     The second link member  330  has a long-plated rod shape, and is inserted to pass through the push rod  310 , the spring  340 , and the first operation rod  350 . The second link member  330  may have a length larger than the entire straight length of the push rod  310 , the spring  340  and the first operation rod  350 . The second link member  330  may have two link holes  331  and  332  formed at its tip to be linked to the first and second grippers  210  and  220 , respectively. 
     The first operation rod  350  is disposed in front of the push rod  310 , and functions to move forward by the push rod  310  to make the first gripper  210  perform the stopping of bleeding. 
     The first operation rod  350  may have a rectangular or circular hollow rod shape through which the second link member  330  can be inserted. In addition, the first operation rod  350  has an elongated hole  351  formed at its tip so that the second gripper  220  is coupled to a link pin  333  inserted through the link hole  332  of the second link member  330  and the elongated hole  351  of the first operation rod  350 . 
     In addition, a resilient member  340  may be installed between the push rod  310  and the first operation rod  350 . Here, a sealing member  341  is disposed at a rear end of the first operation rod  350  to be in contact with a tip of the resilient member  340 . Here, the resilient member  340  may be a spring (hereinafter, referred to by reference numeral  340 ) having a predetermined elasticity such that the push rod  310  moves forward to push the first operation rod  350  forward when the pair of operation handles  121  and  122  are pivoted inward halfway in a state in which the spring  340  is not compressed, and the first operation rod  350  is not pushed forward anymore when the operation handles  121  and  122  are pivoted inward completely to compress the spring  340 . Therefore, when the pair of operation handles  121  and  122  are pivoted inward halfway, the push rod  310  moves forward to make the spring  340  push the first operation rod  350 , and the first operation rod  350  moves forward to press a rear part of the periphery of the first gripper  210  forward, closing the first gripper  210 . In addition, when the operation handles  121  and  122  are pivoted inward completely, the spring  340  is compressed to move the push rod  310  forward to push the second operation rod  360 , and thus, the second operation rod  360  moves forward to press a rear part of the periphery of the second gripper  220  forward, closing the second gripper  220 . 
     The second operation rod  360  is disposed in front of the push rod  310  to receive the first operation rod  350  therein. The second operation rod  360  functions to perform a clipping operation of the second gripper  220  by a forward-moving force of the push rod  310  when the stopping of bleeding by the first gripper  210  is completed. 
     The second operation rod  360  may have a rectangular or circular hollow rod shape such that the first operation rod  350  is inserted. In addition, contact areas of the rear end of the second operation rod  360  and the head  311  of the push rod  310  may be equal to each other such that the head  311  of the push rod  310  can push the second operation rod  360  forward when the operation handles  121  and  122  are pivoted inward completely. 
     Further, the second operation rod  360  may have a V-shaped groove  361  formed at its tip opposite to the second gripper  220  such that the second operation rod  360  moves forward to press the periphery of the second gripper  220  to close the second gripper  220  and at the same time receive the rear end of the closed second gripper  220 . While this example embodiment illustrates the second gripper  220  having the V-shaped groove formed at its tip, the second gripper  220  may have a U-shaped groove, not limited thereto. 
     The guide case  370  is inserted into the hole  111  formed at the tip of the handle body  110  to be coupled thereto such that the head  311  of the push rod  310  and the second operation rod  360  are inserted to be guided straightly. Here, the guide case  370  has an inner diameter substantially the same as or slightly larger than outer diameters of the head  311  of the push rod  310  and the second operation rod  360 . 
     While this example embodiment illustrates the guide case  370  having a rectangular hollow rod shape, the guide case  370  may have a circular hollow rod shape, not limited thereto. 
     Hereinafter, operations of the hemostatic clip operation apparatus using the hemostatic clip in accordance with the present invention will be described in detail with reference to  FIGS. 10 to 18 . 
       FIG. 10  is a view showing the hemostatic clip operation apparatus holding the hemostatic clip in accordance with the present invention,  FIG. 11  is an enlarged cross-sectional view of portion D of  FIG. 10 , and  FIG. 12  is an enlarged perspective view of portion E of  FIG. 10 . 
     As shown in  FIGS. 10 to 12 , the hemostatic clip  10  in accordance with the present invention may be mounted in the hemostatic clip operation apparatus  20  and used therewith. The operation handles  121  and  122  of the handle  100  of the hemostatic clip operation apparatus  20  are pivoted outward to hold the hemostatic clip  10  to the second gripper  220  in a state in which both the first gripper  210  and the second gripper  220  are widened. That is, the first gripper  210  and the second gripper  220  maintain the widened state in a state in which the hemostatic clip  10  is mounted in the hemostatic clip operation apparatus  20 . At this time, the clip holding parts  220   a  and  220   b  formed at left and right ends of the second gripper  220  hold left and right sides of the clip body  11 , respectively, and the clip bending parts  220   c  and  220   d  formed at upper and lower ends of the second gripper  220  press upper and lower sides of the clip body  11  to bend the clip body  11 . In addition, the first gripper  210  is disposed inside the widened second gripper  220  and directed to a center open surface of the clip body  11 . 
     When a middle or large diameter blood vessel such as an arterial blood vessel  1  partially bleeds, a surgeon can sequentially operate the first and second grippers  210  and  220  to make the hemostatic clip  10  clip the bleeding area  3  to stop the bleeding through a stepped gripping operation of the handle  100  of the hemostatic clip operation apparatus  20 . The clipping operation of the bleeding area  3  according to the sequential operation of the hemostatic clip operation apparatus  20  will be described in detail with reference to  FIGS. 13 to 18 . 
       FIG. 13  is a view for explaining a bleeding-stopping operation of a first gripper according to a first operation of the hemostatic clip operation apparatus in accordance with the present invention,  FIG. 14  is an enlarged cross-sectional view of portion F of  FIG. 13 , and  FIG. 15  is an enlarged perspective view of portion G of  FIG. 13 . 
     As shown in  FIGS. 13 to 15 , when a surgeon grips the handle  100  of the hemostatic clip operation apparatus  20  inward halfway, the first gripper  210  is closed to primarily stop bleeding from the bleeding area  3  of the blood vessel  1 . More specifically, when the pair of operation handles  121  and  122  of the handle  100  are pivoted inward halfway, a force applied by the handle  100  is transmitted through the first link member  320  connected to the operation handles  121  and  122  to move the push rod  310  forward. As the push rod  310  moves forward, the spring  340  in front of the push rod  310  first pushes the first operation rod  350 , and the first operation rod  350  moves forward to press the periphery of the first gripper  210  to close the first gripper  210 , primarily stopping the bleeding from the bleeding area  3 . Here, since the first gripper  210  has an outer width that gradually increases toward the bleeding area  3  and the first operation rod  350  has an inner width smaller than the largest outer width of the first gripper  210 , when the first gripper  210  is completely closed, the first operation rod  350  can no longer move forward. 
       FIG. 16  is a view for explaining a clipping operation of a second gripper according to a second operation of the hemostatic clip operation apparatus in accordance with the present invention,  FIG. 17  is an enlarged cross-sectional view of portion H of  FIG. 16 , and  FIG. 18  is an enlarged perspective view of portion I of FIG.  16 . 
     As shown in  FIGS. 16 to 18 , when the first gripper  210  is completely closed to primarily stop the bleeding from the bleeding area  3  and continuously apply a force to move the handle  100  inward completely, the second gripper  220  bends the hemostatic clip  10  to secondarily clip the periphery of the bleeding area  3 . More specifically, when the pair of operation handles  121  and  122  are pivoted inward completely in a state in which the first gripper  210  stops the bleeding from the bleeding area  3 , since the first operation rod  350  can no longer move forward, the spring  340  pressing the first operation rod  350  is compressed to move the push rod  310  forward to push the second operation rod  360  forward. Here, since the second operation rod  360  has a V- or U-shaped groove  361  formed at its surface in contact with the second gripper  220 , the second operation rod  360  moves forward to press the rear part of the periphery of the second gripper  220  forward, and thus, the second gripper  220  is closed to symmetrically bend the hemostatic clip  10 , secondarily stopping the bleeding from the bleeding area  3 . 
       FIGS. 19 and 20  are views showing a state in which the hemostatic clip clips the bleeding area of the blood vessel using the hemostatic clip operation apparatus in accordance with the present invention. 
     As shown in  FIGS. 19 and 20 , when a middle or large diameter blood vessel such as the arterial blood vessel  1  partially bleeds, only the bleeding area  3  is partially clipped to stop the bleeding, without blocking the entire blood vessel, maintaining the function of the blood vessel  1 . Therefore, the hemostatic clip  10  and the hemostatic clip operation apparatus  20  using the same in accordance with the present invention are appropriate to stop bleeding from the middle or large diameter blood vessel  1 , the entire blocking of which may cause serious problems, upon bleeding. 
     As described above, the hemostatic clip operation apparatus  20  in accordance with the present invention has a multi-structure of the first and second grippers  210  and  220  having the function of precisely clipping the hemostatic clip  10  at the bleeding area, in addition to the function of simply clipping the hemostatic clip  10 . In addition, the hemostatic clip  10  in accordance with the present invention also has a function of removing the clipped hemostatic clip  10  using the clip removing device  30 , in addition to the function of clipping the bleeding area  3  of the blood vessel  1  to stop bleeding. 
     As can be seen from the foregoing, a hemostatic clip operation apparatus in accordance with the present invention can perform a function of precisely clipping a hemostatic clip at a bleeding area, in addition to a function of simply clipping the hemostatic clip using a multi-structure of first and second grippers. 
     In addition, a surgeon can easily stop bleeding from a blood vessel using the hemostatic clip by sequentially operating the first and second grippers through a step-by-step gripping operation of a handle of the hemostatic clip operation apparatus. 
     Further, when a middle or large diameter blood vessel such as an arterial blood vessel partially bleeds, it is possible to maintain the function of the blood vessel by partially clipping the bleeding area only, without blocking the entire blood vessel. Therefore, the hemostatic clip and the hemostatic clip operation apparatus using the same in accordance with the present invention are appropriate to stop bleeding from the middle or large diameter blood vessel, the entire blocking of which may cause serious problems, upon bleeding. 
     Furthermore, the hemostatic clip in accordance with the present invention can be readily removed when clipped to the blood vessel using a clip removing device, in addition to the function of clipping the bleeding area of the blood vessel. 
     While the invention has been shown and described with reference to certain example embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.