Abstract: A medical device is disclosed for joining a first tubular organ (1), such as a blood vessel, to a second tubular organ (2), such as a blood vessel. The kit includes an external tubular scaffold (4) with a removable scaffold handle (7, 18, 19) and a clip (3). In use, the clip (3) and the external tubular scaffold (4) remain outside of the tubular organs (1, 2) being joined. The clip (3) embraces a first longitudinal tubular section (6) of the external tubular scaffold (4) thereby holding together a longitudinal segment of an intima of the first tubular organ (1) and a longitudinal segment of an intima of the second tubular organ (2).

Abstract: An insert 30 comprises a rod 32 having a proximal end 34 and a distal end 36. The insert 30 also comprises a tool 38 which is demountably coupled to the distal end 36. Proximal end 34 is formed with a ball 40 which is configured to seat and engage in a socket of a handle 12 of a laparoscopic instrument 10. The rod 32 fits within a sheath 14 of the laparoscopic instrument 10. The distal end 36 of the rod 32 is provided with an attachment head 42 to facilitate the attachment of the tool 38. A linkage mechanism 44 in the attachment head 42 converts the linear motion of the insert 30 (and in particular rod 32) relative to the outer sheath 14 to a pivotal motion.

Abstract: An engaging element for engaging tissue is described. The engaging element may include a first member including at least one tissue engaging portion and a second member including at least one tissue engaging portion. The second member may be pivotally connected to the first member. The engaging element includes a locking mechanism operatively associated with the first and second member. The locking mechanism may be configured to inhibit the relative motion of the first and said second member. An engaging system for engaging tissue is described. The engaging system may include an engaging element for engaging tissue, a first member having at least one tissue engaging portion, and/or a second member including at least one tissue engaging portion. A method for engaging tissue is described. The method may include positioning an engaging element relative to an engaging element delivery device and/or to a portion of tissue.

Abstract: A surgical clip includes a pair of opposed arms joined at one end by an integrally formed flexible hinge and a hinge lock. A male locking pin near the free end of one arm is configured to penetrate tissue when the male locking pin is urged towards a mating female aperture near the end of the opposite arm. The clamping side of an arm may include a protruding feature, such as a wedge shape elongated ridge, while the clamping side of the opposite arm includes a corresponding trough or aperture that receives the protruding feature. Clamping surfaces may include non-slip protrusions, such as ribs, ridges, cones or pins. An applicator holding feature, such as a boss, near the hinge prevents the clip from yawing and becoming askew during application.

Abstract: A surgical clip comprising a curved backbone having a lower side, a plurality of arms coupled to the curved backbone and extending therefrom in the same direction, each arm having a facing side, and an interior surface comprising the lower side of the curved backbone and the facing sides of the plurality of arms. A method of installing a surgical clip comprising fastening body tissue with surgical staples to form a stapled edge, and fastening the surgical clip across the stapled edge to inhibit the development of openings along the stapled edge. A tool for installing a surgical clip, the tool comprising a clip delivery end to carry and position the surgical clip, and an actuator to cause the surgical clip to engage and secure the stapled edge of body tissue.

Abstract: An apparatus comprises a surgical instrument having a cutter and a stapler. The cutter is operable to sever a portion of tissue. The apparatus further comprises a plurality of staples where the stapler is operable to introduce the plurality of staples into tissue to form a staple line. The apparatus further comprises a reinforcement clip. The reinforcement clip is operable to be in selective communication with the staple line. The reinforcement clip comprises a crown, a leg portion, and a teeth portion. In some versions, the leg portion has a width operable to cover the area defined by the staple line. In some versions, the teeth portion is configured to anchor into tissue.

Abstract: A wound closure device includes an elongated body with proximal and distal ends having a plurality of through-holes along the length and defining a longitudinal axis with a plurality of surface features extending away from the axis. The proximal end is configured and dimensioned to pass through body tissue and thereafter be selectively passed through at least one of the plurality of through-holes such that at least one of the surface features also passes through the through-hole thereby forming a locked closed loop to secure body tissue held therein.

Abstract: A surgical clip includes a pair of opposed arms joined at one end by an integrally formed flexible hinge and a hinge lock. A male head element near the free end of one arm is configured to spread tissue when the male head element is urged towards a head mating element near the end of the opposite arm. The clamping side of an arm may include a protruding feature, such as a wedge shape elongated ridge, while the clamping side of the opposite arm includes a corresponding trough or aperture that receives the protruding feature. Clamping surfaces may include non-slip protrusions, such as ribs, ridges, cones or pins. An applicator holding feature, such as a boss, near the hinge prevents the clip from yawing and becoming askew during application.

Abstract: A clip assembly includes a first clip comprising two opposing contact surfaces connected by a U-shaped hinge, where each of the two opposing contact surfaces has protruding flanges with teeth for engaging a surface inserted between the flanges. The clip assembly further includes a second clip comprising two opposing contact surfaces connected by a U-shaped hinge, wherein each of the two opposing contact surfaces has protruding flanges with teeth for engaging a surface inserted between the flanges. The clip assembly also includes a wire connected to the first clip at one end of the wire and to the second clip at another end of the wire.

Abstract: Thermosetting polymeric compositions, such as polyurethane compositions, and related methods are provided. The invention relates to coating and polymer compositions and related methods derived from a biodegradable natural polysaccharide compound such as chitosan, pectin, heparin, and combinations thereof reacted to a cyclic oxide compound, such as an oxetane, oxolane or oxepane compound. The compositions and methods of the present invention exhibit self-repairing properties upon exposure to ultraviolet (UV) light. The compositions and methods of the present invention can be used in many coating applications, such as the transportation, packaging, fashion, and biomedical industries.

Abstract: A remotely adjustable remotely power gastric band system may include a control device, an implant electronic device, and an implantable gastric band. The control device may telemetrically power and communicate with the implant electronic device, which may be used for adjusting the diameter of the implantable gastric band. The implant electronic device may store the gastric band adjustment history records of a patient and regulate the power received from the control device. To improve transmission efficiency, the implant electronic device may adopt a double modulation scheme for communicating with the control device. Furthermore, the implant electronic device may detect and resolve motor blockage issues related to the implantable gastric band.

Abstract: A medical instrument tool or end effector constructed of a fixed jaw having a distal grasping end and a proximal body end; a movable jaw having a distal grasping end and a proximal body end; a slide member controlled from a tool actuator, adapted for linear translation and supported between the jaws; at least one link that inter-couples between the slide member and the movable jaw; and a pivot member mounted at the fixed jaw and for engagement with a slot in the body end of the movable jaw.

Abstract: Implant delivery systems are disclosed. In general overview, an exemplary system includes any number of the following: a delivery device, a sling assembly, guide members, and connectors that interconnect the above. Embodiments of all the above components and their combinations are disclosed. Methods of using the above system in suprapubic, prepubic, transvaginal, trans-obturator and other approaches are also disclosed.

Abstract: Apparatus and methods are described including an implantable device shaped to define (a) at least two artery-contact regions, the artery-contact regions comprising struts that are configured to stretch an arterial wall by applying pressure to the arterial wall, and (b) at least two crimping regions that comprise locking mechanisms configured to prevent the crimping regions from becoming crimped due to pressure from the wall of the artery on the artery-contact regions. The crimping regions are configured to be crimped during insertion of the device, via a catheter, by the locking mechanisms being unlocked during insertion of the device. Other embodiments are also described.

Abstract: The present invention provides methods and modalities that can modify wave reflection in the vascular system in order to create constructive interactions between existing wave dynamics and new reflective waves for the purpose of lowering the workload on the heart and increasing cardiac output, providing a viable option for the prevention and treatment of many heart conditions and diseases.

Abstract: An introducer sheath assembly is provided that is capable of securely fastening a sheath tube to a patient's limb so as to keep it from being displaced after insertion into an incision. The introducer sheath assembly has an introducer sheath including a sheath tube to be inserted into the incision made on the patient's limb and a sheath hub attached to the proximal end of the sheath tube. In one form, the introducer sheath assembly has a belt, which is connected to the sheath hub and wound around the limb, and a fastening member to fasten the belt wound around the limb.

Abstract: An aneurysm clip includes a compression spring having a compression axis, a first end, and a second end. A first force receiving surface is coupled to the first end of the spring, and a second force receiving surface is coupled to the second end of the spring. A first arm coupled to the first force receiving surface is approximately parallel to the spring's compression axis. A second arm coupled to the second force receiving surface is approximately parallel to the spring's compression axis. A first clamping leg coupled to the first arm extends approximately perpendicular therefrom, and a second clamping leg coupled to the second arm extends approximately perpendicular therefrom. The first and second clamping legs oppose one another and are biased into contact with one another by the spring.

Abstract: A gutclamper includes two hard rod-like bodies having flexible belts on one ends, a joint at which the rod-like bodies are joined, and at least one through hole made in one of the belts. The gut tract is clipped by using the two hard rod-like bodies and the joint as a pivot. By clipping the gut tract by side surfaces of the rod-like bodies, it can be clipped while the width of the gut is pressed and widened, so that the gut is prevented from being excessively clamped and torn. In addition, the two rod-like bodies are made different in length from each other, a through hole is made in the belt connected to the shorter rod-like body, and the tip end of the longer rod-like body is fit into the through hole and locked, so that reliable clipping is realized without an excessive burden being placed on an operator.

Abstract: This system is a computer-based system for simulating an effect of a specific surgical treatment based on three-dimensional data of a shape of a target vascular site of a subject, comprising: a surgical treatment receiving unit, by a computer, for displaying the three-dimensional data of a shape of a target vascular site on a computer display screen, and receiving a specification of a lesion on display and a selection of a surgical treatment for the lesion, a modification method storage unit, by a computer, for pre-storing selectable surgical treatments and methods for modifying the three-dimensional data for respective surgical treatments in memory, and a modified three-dimensional data output unit, by a computer, for reading out a modification method from the modification method storage unit according to the selection of a surgical treatment, modifying the three-dimensional data related to the specification of the lesion by the selected method, and outputting the modified three-dimensional data.

Abstract: In some embodiments, an apparatus, for reducing or stopping flow through a tubular structure of a patient, includes an elongate member arranged to form a frame having a distal and proximal opening and configured to be positioned within a lumen of the tubular structure. The frame includes a proximal, distal, and middle portion. The distal portion is tapered such that an outer cross sectional dimension (OCSD) of the distal opening is less than an OCSD of the middle portion. The frame is configured to be inverted such that the distal portion moves within and toward the middle portion for removing the frame from within the lumen. The apparatus also comprises a flow reducing member coupled to the frame such that when the frame is positioned within the lumen, the flow reducing member substantially reduces or totally obstructs flow of at least one of emboli and fluid flowing through the lumen.

Abstract: The instant disclosure is directed to devices and methods for deploying a biased occlusion clamp. In addition, the present disclosure includes devices and methods for deploying a biased occlusion clamp using robotics. Moreover, the present disclosure includes devices and methods for reducing the force necessary to open an occlusion clamp without permanently compromising the clamping force of the clamp itself.

Abstract: Apparatus and methods for treating a hollow anatomical structure comprises an implant sized for insertion into a hollow anatomical structure. The implant comprises a plurality of loose, bulked fibers. The fibers are formed from one or more bioabsorbable materials. Upon implantation, the apparatus causes a partial occlusion of the hollow anatomical structure, followed by a complete or substantially complete occlusion.

Abstract: An apparatus for treating a hollow anatomical structure comprises an implant comprising a plurality of bioabsorbable fibers. The implant has a compressed state in which the implant can fit within a cylindrical tube having an inside diameter of 8 French or less. The implant is expandable from the compressed state to an expanded state in which the implant has sufficient size to span the inside diameter of a cylindrical tube having an inside diameter of 12 French or greater.

Abstract: A method for endoscopic treatment that performs treatment on a subject under an endoscope includes irradiating the subject with white light, performing predetermined treatment on a living tissue of the subject after irradiation with the white light, and switching from irradiation with the white light to irradiation of the subject with narrow band light having a predetermined peak wavelength according to a condition of bleeding from the living tissue in the predetermined treatment.

Abstract: The invention relates to a compressive system for reducing edge bleeding in classical hysterotomy in cases of placenta praevia, said system comprising: a compressive device formed by two compressive bars and bracketing members; and a clamp for applying the compressive device, said clamp comprising two handles, two jaws, a rotation nut, two protuberances and a threaded adjustment nut. The clamp allows the opening of the compressive bars. The device is applied to the edges of the hysterotomy and, subsequently, the clamp is withdrawn.

Abstract: An aortic cross clamp includes an elongated handle and a clamp head. The clamp head has opposing jaws having open and closed positions. At least one of the jaws is pivotally mounted to a jaw actuator so as to be pivotal relative to the opposing jaw and about an axis distanced from the opposing jaw. A locking mechanism is provided for locking the jaws in the closed position. A jaw drive mechanism is operable through the elongated handle for moving the jaws between the open and closed positions. A method of clamping the aorta is also disclosed.

Abstract: A pusher-occlusive coil delivery assembly 10 that is advanced through a microcatheter 40 to the desired vascular site within a patient. The delivery assembly 10 includes a pushwire 12 which interlocks with the occlusive coil 11 which can be manipulated to detach the occlusive coil 11. When the assembly 10 is positioned at the site, the pushwire 12 is advanced to allow the interlock joint 14, 15 to move out of the delivery sleeve 13 to uncouple the pushwire 12 and the occlusive coil 11.

Abstract: Apparatus includes Flexible Sheath extending from a proximal end which extends into living body; Capsule extending from a proximal to a distal end and having an opening formed in a proximal end thereof; Clip Assembly provided in Capsule and configured to be operably movable between a closed configuration in which first and second arms of Clip Assembly are drawn toward one another and an expanded configuration in which the first and second arms are separated from one another to receive target tissue therebetween; Bushing extending between a proximal end coupled to Sheath and a distal end releasably coupled to Capsule via a tab on the distal end of Bushing engaging the opening of Capsule; and Control Member a distal end of which is releasably coupled to Clip Assembly to transmit to Clip Assembly forces applied thereto to move Clip Assembly between the insertion and expanded configurations.

Abstract: The invention relates to a perivascular ring having an inner diameter adjustable by inflation/deflation and adapted to be implanted and closed about a vessel for controlling the inner diameter of said vessel and thus the flow and/or pressure of a fluid flowing in said vessel. The ring of the invention is capable of regulating blood flow to the liver, in particular after an hepatectomy or hepatic transplant, and to substantially improve the survival chances of the patient. The ring according the invention has an adjustable inner diameter (?i) for implantation and locking about a vessel.

Abstract: The present disclosure provides an elastomeric material for the delivery of an ophthalmic agent to the eye of a subject and methods of using such material.

Abstract: An implantable aneurysm clip including a first arm and an opposed second arm. The first and second arms having corresponding opposed first and second clamping surfaces facing each other, and the first and second arms are movable relative to each other. The first and second clamping surfaces are shiftable between a first, preselected, open resting position in which the first and second clamping surfaces are separated by a first distance and a second open position wherein the first and second clamping surfaces are separated by a second distance. The second distance is greater than the first distance and the first and second clamping surfaces are biased toward the first position by a biasing force.

Abstract: Apparatus and methods for delivering a surgical clip to a patient during a minimally invasive surgical procedure are disclosed herein. An exemplary apparatus for isolating an atrial appendage of a patient includes a surgical clip that locks onto the atrial appendage of the patient, and a surgical clip applicator that releasably engages the surgical clip. The surgical clip can include a top portion and a bottom portion. The surgical clip applicator can include a first flexible flap and a second flexible flap. The first and second flexible flaps can be sufficiently rigid to prevent the surgical clip from falling off of the surgical clip applicator when the surgical clip is engaged to the surgical applicator and the surgical clip applicator is in a relaxed state, and sufficiently flexible to facilitate separation of the surgical clip from the surgical clip applicator when the surgical clip is locked onto the atrial appendage.

Abstract: Methods and devices are provided for closing a puncture wound. In one exemplary embodiment, a puncture closure device is provided having an elongate tubular body that is disposable through a puncture in tissue and that includes proximal and distal portions. The proximal portion can be adapted to expand to form proximal wings upon rotation of the elongate tubular body, preferably in a first direction. The distal portion can be adapted to expand to form distal wings upon rotation of the elongate tubular body, preferably in a second, opposite direction. The proximal and distal portions can also be adapted to be moved toward one another as they expand upon rotation. As a result, the proximal and distal wings can engage tissue therebetween.

Abstract: A vascular closure device includes a frame to which there is fitted a plurality of anchor elements, spaced radially around the frame. The closure device includes a radial compression feature, which may be a memorised shape of the frame or non-sprung condition of the frame, having a small radius. The closure device is deployed in a vessel such that the anchor elements are embedded into the vessel wall. The radial compression feature causes the frame to compress radially, as a result of which the anchor elements will pull the vessel wall inwardly, thereby closing the vessel.

Abstract: An aortic cross clamp includes an elongated handle and a clamp head. The clamp head has opposing jaws having open and closed positions. At least one of the jaws is pivotally mounted to a jaw actuator so as to be pivotal relative to the opposing jaw and about an axis distanced from the opposing jaw. A locking mechanism is provided for locking the jaws in the closed position. A jaw drive mechanism is operable through the elongated handle for moving the jaws between the open and closed positions. A method of clamping the aorta is also disclosed.

Abstract: An occluder (7) for sealing body orifices (6, 6a) of the human or animal body is illustrated and described, in particular an occluder (7) for percutaneous transcatheter sealing of atrium septum defects of the human or animal heart (1). According to the invention it is provided that the occluder (7) or parts of the occluder (7) form an electric oscillating resonance circuit, whereby at least one conductive loop forming the inductivity of the oscillating resonance circuit is provided and the occluder (7) or parts of the occluder (7) are formed by the conductive loop.

Abstract: An apparatus for deployment of a hemostatic clip comprises a handle assembly, a shaft connected to a distal portion thereof and a clip assembly releasably coupled to a distal portion of the shaft. The clip assembly includes clip arms and a capsule cooperating with the clip arms to provide a first user feedback indicating a decision configuration of the clip assembly. In addition, the apparatus includes a control wire including a ball connector, the control wire extending from the handle assembly and coupled to the clip assembly by the ball connector to maintain the clip assembly coupled to the shaft, wherein the ball connector is detachable from the clip assembly to provide a second user feedback indicating separation of the clip assembly from the shaft.

Abstract: The present invention relates to a hermetic occlusion surgical clamp for the female cervix to be used in case of placenta previa, including compression jaws with a spring (5.1) and semi-conical sections (5.2) and at the end of each jaw a machined semi-cylinder (5.3), and a pull-down cylinder with a machining that generated two arms (6.2) with a hole that is joined by a pin (5.4) that connects the jaws to the pull-down cylinder. The pull-down cylinder also includes a thread (6.4). which allows you to screw on a screw (6.5) to open or close the jaws. Finally, the surgical clamp also includes a shell which is a hollow cylinder along its longitudinal axis, which covers semi-conical sections (5.2) of the jaws to leave a thread length (6.4) free that allows placement of the screw (6.5).

Abstract: Devices, systems and methods related to endoscopic surgery, particularly related to robotic surgical operations, provide a tissue stabilizer for endoscopically stabilizing a target tissue within a patient's body. For stabilizing a beating heart during a closed-chest coronary artery bypass grafting procedure, a stabilizer is inserted through an endoscopic cannula and provides sufficient surface area to contact the heart and effectively stabilize the target tissue area. The stabilizer can straddle a blood vessel, such as a coronary artery, which is targeted for an anastomosis. Vessel occlusion fasteners may occlude the target blood vessel prior to the anastomosis procedure.

Abstract: A surgical instrument for at least partially occlusion of the uterus blood vessels during a cesarean section comprising two jaws movable relative to each other to at least partially occlude the uterus blood vessels, latching mechanism to retain the jaws the in the working position over needed period of time and release the jaws when the need for occlusion is over, a disposable tubular cover on the end member of each jaw, said end member of a jaw is connected with the other member of the jaw with an angle 25-45 degrees, preferred angle is 30-45 degrees, said cover has an inner cavity open from one end for receiving and retaining the jaw, the thickness of the side of the cover to be engaged with the blood vessels is 3-15 mm, preferably, 8-12 mm, the width of said cover is 10-30 mm, the length of said cover is 50-60 mm, and said cover made of gauze or fabric.

Abstract: The invention relates to a medical clip carrier device for retention and/or mounting of at least one medical clip, in particular a ligature clip, comprising at least one clip receptacle in which a clip is retainable in a mounted position, and a securing device with at least one securing member for detachably securing a clip in the at least one clip receptacle. The clip receptacle comprises an insertion opening for insertion of a clip into the clip receptacle and removal of the clip therefrom. The at least one securing member is constructed in the form of a retaining projection which protrudes at least partially into the insertion opening.

Abstract: Medical device used to cause hemostasis of blood vessels using a clip arrangement delivered to a target region through an endoscope. Method for using the device to cause hemostasis of a blood vessel through an endoscope. Medical device including a reversibly closeable clip, a locking arrangement, a control wire, a sheath, and a handle with an actuating trigger. Through the endoscope, hemostatic clipping device that is fully reversible and lockable. Hemostatic clip that reversibly targets and clips bleeding ulcers.

Abstract: Disclosed is a cannula including a first clamping portion, a second clamping portion and a force applying portion configured to apply at least two different clamping forces across the first clamping portion and the second clamping portion when the cannula is in a closed state. The first clamping portion includes a first gear, the second clamping portion includes a second gear, and the first gear and the second gear are in meshing engagement.

Abstract: A hemostasis assembly having a selectively expandable hemostasis member can be used with a medical device and in a method for delivering a closure element through tissue and into an opening formed in, or adjacent to, a wall of a blood vessel or other body lumen of any size while maintaining or improving hemostasis. The medical device and method of use utilizes such an expandable hemostasis member to maintain or improve hemostasis throughout a medical procedure for closing and/or sealing openings through tissues and/or blood vessels.

Abstract: A device for occluding a septal defect is provided. In general, the occluding device has a contracted state that allows the occluding device to be received within a delivery device for deployment to the site of the defect and an expanded state that is achieved when the occluding device is deployed from the delivery device. The occluding device has a proximal portion, which may be substantially circular, a distal portion, which may be substantially ovaloid, and a connecting portion extending between the two. The distal portion may define first and second outer parts at opposite ends of the major axis, which may be bent or curved. The configuration of the proximal and distal portions allow the occluding device to securely engage the septal wall and be kept in position at the septal defect without causing substantial interference with the functioning of adjacent heart structures.

Abstract: Apparatus for occluding a space between a first structure and a second structure, said apparatus comprising: an occluder, said occluder comprising a distal implant and a proximal implant, wherein: said distal implant comprises a body and a locking shaft mounted to said body, wherein said body of said distal implant comprises a plurality of legs which may assume (i) a diametrically-reduced configuration for disposition within the lumen of a tube, and (ii) a diametrically-expanded configuration for disposition against the first structure, and further wherein said locking shaft comprises a first locking element for selective connection to said proximal implant and a second locking element for selective connection to an inserter for deploying said occluder; and said proximal implant comprises a body having an opening, wherein said body of said proximal implant comprises a plurality of legs which may assume (i) a diametrically-reduced configuration for disposition within the lumen of a tube, and (ii) a diametr

Abstract: A cannula has a longitudinal base member having a first clamping end and a longitudinal arm member pivotally attached to the longitudinal base member and having a second clamping end, the cannula being in a closed position when the first and second clamping ends are brought together. A first clamp member is located at the first clamping end and has a first passage. A second clamp member is rotatably attached to the arm member at the second clamping end and has a second passage. The first and second passages form a combined passage when the clamp is in the closed position. The cannula may have a first locking member positioned on the arm member and a second locking member positioned on the base member. The first and second locking members interact with each other to lock the cannula in the closed position.

Abstract: A surgical clip for a clip applier to ligate vessels. The clip contains two opposing external and internal legs connected in parallel by two external apex and one internal apex to form a Y-shape configuration. As a vessel is ligated and compressed between the two external legs, the vessel attempting to expand from its compressed position, applies outwardly lateral forces to the external legs causing them to rotate outwardly. In response, the two opposing internal legs rotate in an opposing directions to the external legs rotations to maintain the position of the clip over the compressed tubular vessel.

Abstract: A bypass device for influencing blood pressure, including an implant with a volumetric chamber, having a connector or connecting means for connecting the volumetric chamber to a natural cardiovascular system, and having an adaptor or adaptation means, by which a change in volume of a volume of the volumetric chamber is enabled or effected upon a pressure change in the cardiovascular system or in the volumetric chamber. According to this invention, a change in volume in a lower pressure range between 50 mmHg and a pressure threshold value amounting to at least 100 mmHg amounts to at most 10 cm3, and in an upper pressure range between the pressure threshold value and 150 mmHg amounts to at least 10 cm3. With the device according to this invention, high blood pressure can be reduced in a carefully directed way.

Abstract: A surgical clip for occluding a vein, artery or other body passageway 2 comprises a base portion 3, a pair of resilient limbs 4a, 4b configured to extend generally laterally outwardly from the base portion and each having a free end disposed forward of the base portion, and a reaction portion 9a/b mounted to the base portion 3, the reaction portion defining a generally forwardly directed reaction surface 10 disposed between the base portion 3 and the free ends of the limbs 4a, 4b, the limbs (4a, 4b) being movable under a resilient restoring force from a first, open, condition, in which a gap is provided between the limbs and the reaction portion for receiving the body passageway into the clip, to a second, closed, condition, in which the limbs cooperate with the reaction portion to grip the body passageway to occlude the same.