Patent Description:
The present disclosure relates to endoscopic devices and, in particular, relates to endoscopic clipping devices for treating tissue along the gastrointestinal tract.

During endoscopic gastrointestinal (GI) procedures, the patient may be at risk of perforation of a wall of the GI tract or may require closure of the GI tract wall as part of the procedure. Hemostasis clips may be used for hemostasis of, for example, mucosal/sub-mucosal defects, bleeding ulcers, arteries, polyps, diverticula, along with closure of luminal tract perforations. Depending on the size of the defect, multiple clips may be used. <CIT> discloses a reloadable hemostasis clipping device.

The invention is defined by the independent claim. Preferred embodiments of the present invention are provided in the dependent claims.

The present disclosure relates to a clipping system for treating tissue. The system includes clip including a pair of clip arms. Each of the clip arms extends from a proximal end to a distal end. Proximal ends of the clip arms are slidably received within a channel of a capsule to be moved between an open configuration and a closed configuration, a proximal end of the capsule including a pair of openings extending through a wall thereof. The system also relates a coupler mounted over the proximal end of the capsule and including a pair of deployment arms and a pair of retention arms, the deployment arms having engaging features received within the openings of the capsule. In addition, the system includes an applicator including an elongated flexible member and a control member extending therethrough. The control member includes a distal end configured to be connected to the clip arms to move the clip arms between the open configuration and the closed configuration, a distal end of the elongated flexible member including a projection extending about a periphery of the distal end thereof to engage corresponding retaining features of the retention arms. The deployment arms and the projection are configured so that, when a pre-determined compressive force is applied to the coupler during deployment of the clip, the deployment arms slide proximally along the projection such that the deployment arms deflect away from the bushing to disengage the engaging features therefrom so that the coupler is separable from the capsule.

In an embodiment, the retention features of the retention arms extend laterally inwardly from an interior surface of the retention arms toward a longitudinal axis of the coupler so that, to couple the bushing to the coupler, the bushing is inserted distally between the retention arms until the projection is moved distally past the retention features.

In an embodiment, the deployment arms include curved portions proximal of the engaging features, the curved portions curved inward toward a longitudinal axis of the coupler so that a diameter of the coupler between the curved portions is smaller than a diameter of the coupler along a remaining portion thereof.

In an embodiment, the each of the retention arms include a first protrusion extending laterally inward from an interior surface thereof, the first protrusion engaging a portion of the capsule to prevent a proximal movement of the capsule relative to the coupler.

In an embodiment, the each of the retention arms include a second protrusion extending laterally inward from an interior surface thereof, the second protrusion positioned distally of the retention features so that, when the bushing is coupled to the coupler, the projection is received between the second protrusion and the engaging features.

In an embodiment, a depth of the second protrusion is selected so that, when the pre-determined compressive force is applied to the coupler, the second protrusion is permitted to slide proximally past the protrusion to engage a proximal end of the protrusion.

In an embodiment, the coupler includes a distal portion extending about the proximal end of the capsule such that the pair of deployment arms and the pair of retention arms extend proximally therefrom.

In an embodiment, the retention arms diametrically oppose one another and the deployment arms diametrically oppose one another.

In an embodiment, the control member is connectable to the clip arms via a yoke configured to separate a proximal portion thereof, which is coupleable to the control member, from a distal portion thereof, which is connected to the proximal ends of the clip arms, when subject to a predetermined threshold force.

The present invention, as defined in claim <NUM>, relates to a clip device for treating tissue. The device includes a clip including a pair of clip arms, each of the clip arms extending from a proximal end to a distal end, proximal ends of the clip arms slidably received within a channel of a capsule to be moved between an open configuration and a closed configuration, a proximal end of the capsule including a pair of openings extending through a wall thereof. In addition, the device includes a coupler mounted over the proximal end of the capsule via a pair of deployment arms including engaging features extending laterally inward from an interior surface thereof to engage the pair of openings of the capsule, the coupler including retention arms configured to engage a corresponding portion of an applicator, the deployment arms are configured so that, when the coupler is drawn proximally against the applicator with a pre-determined force, the deployment arms slide proximally past the corresponding portion of the applicator to deflect the deployment arms out of engagement with the capsule so that the coupler is separable from the capsule.

In an embodiment, the retention arms include retention features extending laterally inwardly from an interior surface of the retention arms toward a longitudinal axis of the coupler for engaging a corresponding portion of an applicator.

In an embodiment, each of the retention arms include a first protrusion extending laterally inward from an interior surface thereof, the first protrusion engaging a portion of the capsule to prevent a proximal movement of the capsule relative to the coupler.

In an embodiment, each of the retention arms include a second protrusion extending laterally inward from an interior surface thereof, the second protrusion positioned distally of the retention features so that the corresponding portion of the applicator is receivable therebetween.

In an embodiment, a depth of the second protrusion is selected so that, when the pre-determined force is applied to the coupler, the second protrusion is permitted to slide proximally past the corresponding portion of the applicator.

In addition, the present disclosure relates to a method for clipping a target tissue which includes coupling a capsule of a clip to a bushing of an applicator by inserting a distal portion of the bushing through a proximal end of a coupler mounted over a proximal end of a capsule of the clip so that a projection extending from a distal end of the bushing engages a pair of retention arms of the coupler, the coupler mounted over the proximal end of the capsule via engaging features of a pair of deployment arms received within corresponding openings extending through a wall of the capsule, the clip including a pair of clip arms, proximal ends of which are slidably received within a channel of the capsule; coupling a control member of the applicator to proximal ends of the clip arms; inserting the clip to a target area within a body via a working channel of an endoscope; and moving the clip between an open configuration, in which distal ends of clip arms are separated from one another, and closed configurations, in which the distal ends of the clip arms are drawn toward one another, until a target tissue is clipped between the clip arms, wherein the clip is moved between the open and closed configurations via a longitudinal movement of the control member relative to the clip.

In an embodiment, the retention arms include retention features extending laterally inwardly from an interior surface of the retention arms toward a longitudinal axis of the coupler so that the projection of the bushing engages the retention features when the bushing is inserted distally between the retention arms.

In an embodiment, the method further includes deploying the clip from the applicator by applying a pre-determined compressive force to the coupler to cause deployment arms of the coupler to slide proximally along the projection of the bushing so that the deployment arms deflect away from the bushing to disengage the engaging features from the openings of the capsule so that the coupler is separable from the capsule.

In an embodiment, each of the retention arms include a first protrusion extending laterally inward from an interior surface thereof, the first protrusion engaging a portion of the capsule to prevent a proximal movement of the capsule relative to the coupler when the pre-determined compressive force is applied to the coupler.

In an embodiment, each of the retention arms include a second protrusion extending laterally inward from an interior surface thereof so that the projection of the bushing is received between the second protrusion and the retention features, the second protrusion configured so that, when the pre-determined compressive force is applied to the coupler the second protrusion is forced proximally past the projection to engage a proximal end of the projection.

The present disclosure may be further understood with reference to the following description and the appended drawings, wherein like elements are referred to with the same reference numerals. The present disclosure relates to a clipping system and, in particular, relates to a reloadable endoscopic clipping system, in which a clip may be loaded onto a distal end of an applicator prior to an endoscopic procedure. Once a clip has been deployed at a desired target area in the body, the applicator may be reloaded with a new clip. Although shed parts (e.g., parts that are left in a body upon deployment of the clip) generally pass naturally from the body shed parts may become trapped in larger defects after closure.

Exemplary embodiments of the present disclosure comprise a clip including clip arms slidable within a capsule to move between an open configuration and a closed configuration to clip tissue, as desired. A proximal end of the capsule is loaded onto a bushing at a distal end of an applicator via a coupler which facilitates a releasable connection with the applicator while also minimizing or eliminating the potential for shed parts upon deployment of the clip. Prior to loading of the clip onto the applicator the coupler is coupled to the capsule. Upon deployment of the clip, however, the coupler is detached from the capsule to be removed from the body along with the applicator. It will be understood by those of skill in the art that the terms proximal and distal as used herein, are intended to refer to a direction toward and away from, respectively, a user of the device.

As shown in <FIG>, a reloadable clipping system <NUM> comprises a clip <NUM> configured to be loaded onto an applicator <NUM> via a coupler <NUM> prior to insertion of the system <NUM> into a body to clip target tissue therein. The clip <NUM> includes a pair of clip arms <NUM>, proximal ends of which are slidably received within a capsule <NUM> so that the clip arms <NUM> may move between an open configuration, in which distal ends <NUM> of the clip arms <NUM> are separated from one another, and a closed configuration, in which distal ends <NUM> are drawn toward one another to grip tissue. The coupler <NUM> includes a pair of retention arms <NUM>, which maintain a coupling between the clip <NUM> and, for example, a bushing <NUM> of the applicator <NUM> while the clip <NUM> is moved between the open and closed configurations during use. The coupler <NUM> also include a pair of deployment arms <NUM>, which facilitate deployment of the clip <NUM> from the applicator <NUM>. In particular, as will be described in further detail below, prior to loading of the clip <NUM> onto the applicator <NUM>, the coupler <NUM> is coupled to the capsule <NUM> of the clip <NUM> to facilitate loading of the clip <NUM> onto the applicator <NUM> via the retention arms <NUM>.

During deployment of the clip <NUM> over a target portion of tissue in the body, however, the clip <NUM> is moved proximally relative to the applicator <NUM> so that the deployments arms <NUM> are moved radially outward with respect to a longitudinal axis of the system <NUM>, disengaging the coupler <NUM> from the capsule <NUM> so that the coupler <NUM> may be removed from the body along with the applicator <NUM>. The coupler <NUM> stays attached to the bushing <NUM> even after detaching from the capsule <NUM>. The coupler <NUM> will then have to be removed from the bushing <NUM> by a user prior to loading a new clip <NUM> onto the same applicator <NUM>. Thus, deployment <NUM> of the clip <NUM> does not leave any shed parts in the body. The applicator <NUM> is configured so that, after deployment of the clip <NUM>, a new clip <NUM> may be loaded onto the applicator <NUM> so that the same applicator <NUM> may be used to deliver the new clip <NUM> to a second portion of target tissue in the body. Each clip <NUM> according to this embodiment is stored in a cartridge <NUM>, which facilitates loading of the clip assembly <NUM> onto the applicator <NUM>.

As shown in <FIG>, the clip <NUM> includes the pair of clip arms <NUM>, proximal ends of which are, in this embodiment, connected to one another via a yoke <NUM> slidably received within the capsule <NUM>. In this embodiment, the clip arms <NUM> are biased toward the open configuration so that, when not constrained by the capsule <NUM>, the clip arms <NUM> move under their natural bias to the open configuration in which the distal ends <NUM> of the clip arms <NUM> spread apart from one another to receive tissue therebetween. When the clip arms <NUM> are drawn into the capsule <NUM>, the capsule <NUM> constrains the clip arms <NUM>, holding the distal ends <NUM> together so that tissue may be gripped therebetween. The yoke <NUM> is longitudinally slidable within the capsule <NUM> to move the clip arms <NUM> proximally and distally relative to the capsule <NUM> between the open and closed configurations.

Each of the clip arms <NUM> extends from a proximal end connected to the yoke <NUM> to the distal end <NUM>. The distal ends <NUM> of one or both of the clip arms <NUM> may include a tip extending laterally inward toward the other clip arm <NUM> with the tips including, for example, teeth, protrusions, spikes or other structures configured to grip tissue between the distal ends <NUM>. One or both of the clip arms <NUM> may also include a locking feature configured to lock the clip arms <NUM> in the tissue gripping configuration after target tissue has been gripped as desired by the clip arms <NUM>. In one embodiment, one or both of the clip arms <NUM> includes a locking tab extending laterally outward therefrom configured to engage a portion of the capsule <NUM> when the clip arms <NUM> have been drawn into the capsule <NUM> by a predetermined distance. For example, the locking tabs may be received within correspondingly sized, shaped and positioned locking windows extending laterally into or through a wall of the capsule <NUM> to lock the clip arms <NUM> relative to the capsule <NUM>, in the tissue gripping configuration.

The yoke <NUM> is connected to the proximal ends of the clip arms <NUM> and is configured to be connected to an enlarged distal end <NUM> of a control member <NUM> of the applicator <NUM>. In one embodiment, the yoke <NUM> of this embodiment includes a proximal portion <NUM> and a distal portion (not shown) configured to be separated from one another when subject to a force exceeding a predetermined threshold value. The proximal portion <NUM> and distal portion may, for example, be connected to one another via a welding, a decreased diameter portion, or an adhesive that breaks or otherwise separates when pre-determined force is exerted thereon. The distal portion may engage proximal portions of the clip arms <NUM> via, for example, a pair of protrusions extending through openings along proximal portions of the clip arms <NUM> so that the clip arms <NUM> are held in position relative to one another.

The proximal portion <NUM> is configured to engage the enlarged distal end <NUM> of the control member <NUM>. In one embodiment, the proximal portion <NUM> includes a cavity <NUM> sized and shaped to receive the enlarged distal end <NUM> and a longitudinal slot <NUM> extending proximally from the cavity <NUM> to a proximal end <NUM> of the yoke <NUM>. The longitudinal slot <NUM> is sized and shaped to receive a portion of the control member <NUM> extending proximally from the enlarged distal end <NUM>.

In one embodiment, an opening of the longitudinal slot <NUM> at the proximal end <NUM> includes an angled surface <NUM> tapering toward a distal end thereof to facilitate insertion of the enlarged distal end <NUM> distally through the longitudinal slot <NUM> and into the cavity <NUM> during loading the clip <NUM> onto the applicator <NUM>. The cavity <NUM> and the longitudinal slot <NUM> are configured so that, once the enlarged distal end <NUM> has been forced through the slot <NUM> into the cavity <NUM>, the slot <NUM> retracts in diameter to prevent the enlarged distal end <NUM> from being proximally withdrawn therefrom. Thus, longitudinal movement of the control member <NUM> relative to the capsule <NUM> moves the clip arms <NUM> between the open and the closed configurations.

The capsule <NUM> extends longitudinally from a proximal end <NUM> to a distal end <NUM> and includes a channel <NUM> extending longitudinally therethrough. The channel <NUM> is sized and shaped to slidably receive the yoke <NUM> and the clip arms <NUM> therein. As described above, the capsule <NUM> of this embodiment also includes locking structures (e.g., locking recesses or windows) for engaging corresponding locking features (e.g., locking tabs) of the clip arms <NUM>. The capsule <NUM>, in this embodiment, also includes openings <NUM> extending through a wall thereof along the proximal end <NUM>. The openings <NUM> are sized, shaped and configured to receive an engaging feature <NUM> of the deployment arms <NUM> of the coupler <NUM>, as will be described in further detail below.

As described above, the coupler <NUM> is coupled to the proximal end <NUM> of the capsule <NUM> of the clip <NUM> prior to loading of the clip <NUM> onto the applicator <NUM>. In this embodiment, the coupler <NUM> includes a distal portion <NUM> sized and shaped to be mounted over the capsule <NUM>, the pair of retention arms <NUM> and the pair of deployment arms <NUM> extending proximally therefrom. The coupler <NUM>, in this embodiment, may be formed of a stainless steel material and manufactured via, for example, metal stamping and rolling. As shown in <FIG>, in one embodiment, the distal portion <NUM> may be substantially ring shaped, with the retention arms <NUM> substantially diametrically opposing one another and the deployment arms <NUM> substantially diametrically opposing one another so that the retention arms and the deployment arms <NUM> alternate about a periphery of the coupler <NUM>. In one embodiment, each of the retention arms <NUM> and the deployment arms <NUM> may be equally spaced from one another.

Each retention arm <NUM> includes a first protrusion <NUM> extending laterally (e.g., radially inward) from an interior surface <NUM> (i.e., a surface of the retention arms <NUM> which, in an operative configuration, faces toward the bushing <NUM>) thereof along a distal portion thereof and a second protrusion <NUM> extending laterally (e.g., radially inward) from the interior surface <NUM> proximally of the first protrusion <NUM>. The first protrusion <NUM> is sized, shaped and configured so that the coupler <NUM> may be slid distally over the proximal end <NUM> of the capsule <NUM> until the first protrusion <NUM> engages a portion of the capsule <NUM>, preventing the coupler <NUM> from being moved any further distally relative thereto. Proximally of the second protrusion <NUM>, the retention arm <NUM> includes a retention feature <NUM> configured as a protrusion extending laterally (e.g., radially inward) from the interior surface <NUM> to, as will be described in further detail below, engage a portion of the bushing <NUM> during a loading of the clip <NUM> onto the applicator <NUM>. The retention feature <NUM> may be shaped to facilitate a distal insertion of a portion of the bushing <NUM> therepast (or a proximal movement of the coupler <NUM> over a portion of the bushing <NUM>) during loading of the clip <NUM>. In particular, the retention feature <NUM> may include an angled surface <NUM> tapering toward a proximal end thereof.

The second protrusion <NUM> is configured such that, when the retention feature <NUM> engages a corresponding portion of the bushing <NUM>, a distal end <NUM> of the bushing <NUM> engages the second protrusion <NUM>, preventing the bushing <NUM> from being moved any further distally relative to the coupler <NUM> during loading of the clip <NUM> onto the applicator <NUM> and during opening and closing of the clip <NUM>. A depth of the second protrusion <NUM> (i.e., a distance by which the second protrusion extends from the interior surface <NUM>) is, however, selected so that, when a pre-determined compressive force is applied to the coupler <NUM> during deployment of the clip <NUM> the second protrusion <NUM> is permitted to move proximally past the distal end <NUM> of the bushing <NUM> (i.e., the second protrusion <NUM> is sized and shaped to dictate deployment force), as will be described in further detail below. Additionally, the second protrusion <NUM> serves as a retention feature for the coupler <NUM> to stay engaged with the bushing <NUM> after the couple <NUM> separates from the capsule <NUM>. It will be understood by those of skill in the art, that in some embodiments, the retention arms <NUM> may include more than one of each of the first protrusion <NUM>, second protrusion <NUM> and the retention feature <NUM>.

Each deployment arm <NUM> includes the engaging feature <NUM> along a distal portion thereof. The engaging feature <NUM> extends laterally inward from an interior surface <NUM> of the deployment arm <NUM> (i.e., a surface of the deployment arm <NUM> facing toward the bushing <NUM>, in the operative configuration). The engaging feature <NUM> is configured so that, when the coupler <NUM> is assembled with the clip <NUM> prior to loading of the clip <NUM>, the coupler <NUM> may be moved distally over the proximal end <NUM> of the capsule <NUM> until the engaging feature <NUM> is snapped into a corresponding one of the openings <NUM> of the capsule <NUM> and the first protrusion <NUM> engages the capsule <NUM> preventing further distal movement of the coupler <NUM> relative to the capsule <NUM>.

In this embodiment, the engaging feature <NUM> includes an angled surface <NUM>, which tapers toward a distal end thereof, to facilitate distal movement of the coupler <NUM> over the capsule <NUM> during the assembly of the coupler <NUM> with the capsule <NUM>. It will be understood by those of skill in the art that, once the coupler <NUM> is assembled with the clip <NUM>, the angled surface <NUM> of the engaging feature <NUM> prevents a proximal movement of the coupler <NUM> relative to the capsule <NUM>, while the first projections <NUM> prevents a distal movement of the coupler <NUM> relative to the capsule <NUM>.

Each deployment arm <NUM> also includes a curved portion <NUM> proximal of the engaging feature <NUM>. The curved portion <NUM> is curved inward toward a longitudinal axis of the coupler <NUM> so that a distance between the curved portions <NUM> of the pair of deployment arms <NUM> is smaller than a distance between remaining portions of the deployment arms <NUM>. For example, a diameter between the curved portions <NUM> is smaller than a diameter of a remaining portion of the coupler <NUM>. Thus, as will be described in further detail below, when the curved portions <NUM> are moved proximally over a portion of the bushing <NUM>, the deployment arms <NUM> deflect radially outward so that the engaging features <NUM> are disengaged from the openings <NUM> of the capsule <NUM>.

Although the deployment arms <NUM> are shown and described as including curved portions <NUM>, it will be understood by those of skill in the art that the deployment arms <NUM> may include other structure or features for engaging the bushing <NUM> to cause an outward deflection or deformation of the deployment arms <NUM>. It will also be understood by those of skill in the art that a force required to deflect or deform the deployment arms <NUM> may be controlled by adjusting a length and/or width of the deployment arms <NUM> or a distance between the curved portions <NUM>. It will also be understood by those of skill in the art that a depth of the engaging features <NUM> (i.e., a distance by which the engaging feature <NUM> extends from the interior surface <NUM>) may also be adjusted to increase or decrease a retention of the coupler <NUM> onto the capsule <NUM>.

As shown in <FIG>, the applicator <NUM> includes a flexible member <NUM> such as, for example, a catheter extending from a proximal end connected to a handle portion <NUM> that remains outside of the body during the clipping of target tissue, to a distal end including, for example, the bushing <NUM> for connecting the applicator <NUM> to the clip <NUM>. The control member <NUM> extends through the flexible member <NUM> from a proximal end connected to the handle portion <NUM>, which includes actuators for controlling a movement of the clip <NUM> once the clip <NUM> has been loaded onto the applicator <NUM>, to the enlarged distal end <NUM>.

In an embodiment, the bushing <NUM> is connected to the distal end of the flexible member <NUM> and is configured to be connected to the clip <NUM> via the coupler <NUM>, which is preassembled with the clip <NUM>. The bushing <NUM> extends from a proximal end <NUM> to a distal end <NUM> and includes a channel <NUM> extending therethrough so that, when the bushing <NUM> is coupled to the clip <NUM> via the coupler <NUM>, the channel <NUM> of the bushing <NUM> is substantially aligned with the channel <NUM> of the capsule <NUM>. In an embodiment, the distal end <NUM> of the bushing <NUM> includes a projection <NUM> extending about a periphery of the bushing <NUM>, the projection <NUM> extending radially outward from an exterior surface <NUM> along the distal end <NUM>. A distal end <NUM> of the projection <NUM> is tapered to facilitate insertion of the projection <NUM> distally past the retention feature <NUM>. The proximal end <NUM> of the projection <NUM> is configured to engage the retention feature <NUM>. As described above, when the clip <NUM> is loaded onto the applicator <NUM> by moving the projection <NUM> distally past the retention feature <NUM>, the projection <NUM> is received between the second projection <NUM> and the retention feature <NUM>, holding the projection <NUM> therebetween during use of the clip <NUM> - e.g., opening and closing of the clip arms <NUM>.

Prior to being loaded on the applicator <NUM>, the clip <NUM> of this embodiment is stored in the cartridge <NUM>, which is configured to facilitate loading of the clip assembly <NUM> on the applicator <NUM>. The cartridge <NUM>, as shown in <FIG>, is configured as a storage container including a base <NUM> and lid (not shown), within which a space <NUM> sized and shaped to house the clip <NUM> is defined. It should be noted that although <FIG> shows only the base <NUM> of the cartridge <NUM>, a corresponding lid is coupled to the base <NUM> to completely enclose the clip <NUM>. In this embodiment, the clip <NUM> is stored within the cartridge <NUM> in the open configuration, with the coupler <NUM> preassembled with the capsule <NUM>. Extending proximally from the space <NUM> is a longitudinal slot <NUM> through which the distal portion of the applicator <NUM> is inserted to be coupled to the clip assembly <NUM>, as will be described in further detail below.

During loading of the clip <NUM> onto the applicator <NUM>, a distal portion of the applicator <NUM>, including the bushing <NUM>, is inserted through the longitudinal slot <NUM> of the cartridge <NUM>, which houses the assembled clip <NUM> and coupler <NUM>. As described above, the coupler <NUM> is mounted over the proximal end <NUM> of the capsule <NUM> such that the engaging features <NUM> of the deployment arms <NUM> are received within the corresponding openings <NUM> of the capsule <NUM> and the first projections <NUM> engage a portion of the capsule <NUM>. In one embodiment, the distal end <NUM> of the bushing <NUM> may be moved distally between the retention arms <NUM> of the coupler <NUM> so that the projection <NUM> is moved distally therepast and is received between the second projection <NUM> and the retention feature <NUM>, as shown in <FIG>. Once the bushing <NUM> is coupled to the clip <NUM> via the coupler <NUM>, the control member <NUM> is moved distally relative to the bushing <NUM> to be coupled to the clip arms <NUM> via the yoke <NUM>. In particular, the enlarged distal end <NUM> of the control member <NUM> may be inserted into the cavity <NUM> of the yoke <NUM> via the slot <NUM>.

In another embodiment, the control member <NUM> may be coupled to the yoke <NUM> prior to coupling the bushing <NUM> to the coupler <NUM> so that upon coupling the control member <NUM> to the yoke <NUM>, the capsule <NUM> may be moved proximally relative to the bushing <NUM> via a proximal motion of the control member <NUM> so that the coupler <NUM> is moved proximally over the distal end <NUM> of the bushing <NUM> to engage the projection <NUM>. Once both the control member <NUM> and the bushing <NUM> have been coupled to the clip <NUM>, loading of the clip <NUM> onto the applicator <NUM> is complete, and the clip <NUM> may be drawn proximally out of the cartridge via the longitudinal slot <NUM>.

In use, after the clip <NUM> has been loaded onto the applicator <NUM>, the clip <NUM>, in the closed configuration, is inserted into the body to a location adjacent to target tissue via, for example, a working channel of an endoscope. Once the clip <NUM> has reached the target tissue, the clip <NUM> is moved toward the open configuration to receive the target tissue between the distal ends <NUM> of the clip arms <NUM>. The clip <NUM> may be moved between the open and the closed configurations until the target tissue has been clipped between the clip arms <NUM>, as desired. Once the clip <NUM> is in the closed configuration clipping the target tissue as desired, the control member <NUM> (e.g., via actuators of the handle portion <NUM>) is moved proximally with respect to the capsule <NUM> until locking features of the clip arms <NUM> engage corresponding locking structures of the capsule <NUM>, locking the clip arms <NUM> relative to the capsule <NUM> in the closed configuration.

To free the clip <NUM> from the applicator <NUM>, the control member <NUM> is drawn further proximally until the coupler <NUM> is drawn proximally against the bushing <NUM> and a compressive load on the coupler <NUM> exceeds a predetermined threshold value, forcing the second protrusion <NUM> proximally past the projection <NUM> of the bushing <NUM> while also causing the curved portions <NUM> of the deployment arms <NUM> to slide proximally over projection <NUM>, as shown in <FIG>. As the curved portions <NUM> move proximally over the projection <NUM>, the deployment arms <NUM> are deflected radially outward so that the engaging features <NUM> of the deployment arms <NUM> are moved out of engagement with the openings <NUM> of the capsule <NUM> and the second protrusion <NUM> is moved proximally past the proximal end <NUM> of the projection <NUM>.

As shown in <FIG>, the second protrusion <NUM> engages the proximal end <NUM> of the projection so that the coupler <NUM> remains engaged to the bushing <NUM> while being disengaged from the capsule <NUM>. The user continues to exert proximal force on the control member <NUM> until the yoke <NUM> breaks, fails or otherwise separates, releasing the clip <NUM>, from the control member <NUM>. Thus, the applicator <NUM>, with the coupler <NUM> coupled thereto, may be removed from the body <NUM>, leaving just the clip <NUM> in place clipping the target tissue. The entire applicator <NUM>, including the control member <NUM>, the coupler <NUM> and the proximal portion <NUM> of the yoke <NUM> may then be withdrawn proximally from the body leaving the clip <NUM> clipped over the target tissue. If so desired, a new clip <NUM> may be loaded onto the applicator <NUM>, in the same manner as described above, so that the system <NUM> may then be used to clip a second portion of tissue. This process may be repeated using the same applicator <NUM> as many times as needed or desired.

Claim 1:
A clipping system (<NUM>) for treating tissue, comprising:
a clip (<NUM>) including a pair of clip arms (<NUM>), each of the clip arms extending from a proximal end to a distal end, proximal ends of the clip arms slidably received within a channel of a capsule (<NUM>) to be moved between an open configuration and a closed configuration, a proximal end of the capsule including a pair of openings (<NUM>) extending through a wall thereof; and
a coupler (<NUM>) mounted over the proximal end of the capsule via a pair of deployment arms (<NUM>) including engaging features extending laterally inward from an interior surface thereof to engage the pair of openings of the capsule, the coupler including retention arms (<NUM>), configured to engage a corresponding portion of an applicator,
characterized in that the deployment arms are configured so that, when the coupler is drawn proximally against the applicator with a pre-determined force, the deployment arms slide proximally past the corresponding portion of the applicator to deflect the deployment arms out of engagement with the capsule so that the coupler is separable from the capsule.