Medical instrument for setting tissue clips

1. A proctological instrument comprising:

an instrument handle to which at its proximal end a bending-resistant tubular shaft is mounted at the distal end of which a cap is fixed or formed to which a tissue clip adapted to be withdrawn from the cap by means of a releasing or withdrawing means is attached in a preferably spring-elastic manner, wherein the tubular shaft is offset at its distal end portion in an area directly ahead of the cap and/or the cap itself is offset at a predetermined fixed angle so that the withdrawing direction for the clip defined by the cap is aligned at the angle with respect to the tubular shaft axis, wherein the releasing or withdrawing means at least comprises a pulling/pushing element which extends along the tubular shaft within at least one function channel being fixed at the outer surface of the tubular shaft and which releasing or withdrawing means further has an operating lever which is provided at the instrument handle and which is coupled with the pulling/pushing element at the proximal end thereof, further wherein:

the bending-resistant tubular shaft is pre-bent in an S-shape at its distal end portion,

the pulling/pushing element is coupled at its distal end to a withdrawing ring which is shiftably supported on the outer surface of the cap,

two function channels are provided being arranged diametrical to each other with respect to the tubular shaft at its outside surface, and

the pulling/pushing element is formed as cables which are shiftably supported within the function channels to apply forces onto the withdrawing ring in an axially symmetrical manner.

2. The proctological instrument according to claim 1 , wherein the releasing or withdrawing device includes at least one pull and/or push element extending along the tubular shaft in a respective function channel fixed at the outside of the tubular shaft and being coupled at its proximal end to an operating lever of the instrument handle and at its distal end to a slip ring which is guided so as to be axially movable on the cap.

3. The proctological instrument according to claim 1 , wherein the cap at its outside includes a longitudinally extending tab forming a groove-shaped gap between itself and the outer cap wall into which gap the clip is inserted.

4. The proctological instrument according to claim 3 , wherein the pull and/or push element is a thread which is guided at its distal end across the groove-shaped gap and is fixed at the tab in order to be entrained by the same when the clip is slipped on and which is mounted at its proximal end to an operating lever of the instrument handle in order to be pulled upon operation of the lever, whereby the thread portion inside the gap shrinks and thus withdraws the clip to the front.

5. The proctological instrument according to claim 1 , wherein the instrument handle has a grip portion which is hinged to the instrument handle such that its angular position is adjustable with respect to the tubular shaft.

6. A tissue clip for a proctological instrument especially according to claim 1 , further comprising upper and lower jaws which are elastically connected via two hinge portions while forming a closed ring, each of the hinge portions in the ring plane being in the form of a pitch circle bulge, wherein the hinge portions are bent in each transition area to the jaws by approximately 160° to 180° perpendicularly to the ring plane.

7. The tissue clip according to claim 6 , wherein the bulges are aligned radially inwardly or outwardly in the bent state of the hinge portions.

8. The tissue clip according to claim 6 , wherein the jaws are bent perpendicularly to the ring plane in a direction opposed to the bending direction of the hinge portions so as to obtain a bulge.

9. The tissue clip according to claim 7 , wherein the jaws are bent perpendicularly to the ring plane in a direction opposed to the bending direction of the hinge portions so as to obtain a bulge.