BACKGROUND: Clipping is an important technique for cerebral aneurysm surgery. Although clip mechanisms and features have been refined, little attention has been paid to clip appliers. Clip closure is traditionally achieved by opening the grip of the clip applier. We reconsidered this motion and identified an important drawback, namely that the standard applier holding power decreased at the moment of clip release, which could lead to unstable clip application.
OBJECTIVE: To develop a forceps to address this clip applier design flaw.
METHODS: The new clip applier has a non–cross-type fulcrum that is closed at the time of clip release, with an action similar to that of a bipolar forceps or scissors. Thus, a surgeon can steadily apply the clip from various angles.
RESULTS: We successfully used our clip applier to treat 103 aneurysms. Although training was required to ensure smooth applier use, no difficulties associated with applier use were noted.
CONCLUSION: This clip applier can improve clipping surgery safety because it offers additional stability during clip release.
From: A Reverse-Action Clip Applier for Aneurysm Surgery by Atsushi Sato et al.