DE102009019062A1 - Applicator for use as circular clip seam device in surgical clip utilized during minimally-invasive and microscopic surgery to close e.g. skin of patient, has applicator tube provided with bend at distal end and exhibiting circular arc form - Google Patents

Abstract

The applicator (1) has an oblong applicator-tube (2), where a gripping section (5) is provided at a proximal end (3) of the applicator tube. An oblong slider (6) is inserted into the applicator tube. A bend (7) is provided at a distal end (4) of the applicator tube. The applicator tube exhibits the form of a circular arc with a central angle which is in the range of 45- 90 degree. The radius of curvature of the distal bend is in the range of 2-5 mm. The length of the tube is in the range of 10-20 cm. Independent claims are also included for the following: (1) a surgical clip wire and applicator assembly comprising a superelastic alloy-made wire (2) a method for attaching a clip seam.

Description

The The present application relates to a surgical staple and an applicator for a surgical staple.

The Surgical hand suture is tedious and time consuming. Therefore have long been using techniques in surgery, the one To replace hand seam. For example, so-called clips used, for example, closed with vessels can be. Furthermore come staplers used with single clamps to close the Skin, but also in the simultaneous insertion of numerous staples used to occlude large hollow organs such as the intestine, stomach, etc. become. Also at anastomosis, that is at connection large hollow organs, such Klammernahtgeräte come for use.

These Staplers have opposite the hand seam among other things the advantage that the brackets are not completely close and therefore that blood vessels, which are captured by the bracket, not necessarily be closed by the clamp. In contrast it comes at surgical handstitch especially in the area of intestinal seam often for closing blood vessels and then to necrosis in the area of the anastomosis, because parts of the tissue be cut off from the blood supply. It therefore exists today Agreed that in the intestinal suture but also in suture of bronchi and large vessels the staple seam is superior to the hand seam.

in the Area of minimally invasive and microscopic surgery comes It is important that the devices for applying single stitching or rows of sutures have the smallest possible diameter. A minimization of the diameters is only possible to a certain extent, because the braces themselves are not a certain size below, but also the demanding and elaborate mechanics of the staplers, each individual staple leg need to provide an anvil fit, on which this deformed leaves a further miniaturization not too.

WO 96/03925 and DE 69 531 746 T2 describe an applicator for attaching spiral fasteners to body tissue. However, due to the shape of the spiral fasteners, this applicator is difficult to miniaturize.

Furthermore, from the WO 95/08296 a suture needle of shape memory material is known for endoscopic surgery, which bends in place due to its shape memory properties. However, this is a needle for the hand seam, which is removed after application.

It is therefore an object of the present invention, an improved surgical clip as well as an applicator for such To provide a surgical clip that is simple miniaturize. This task comes with the features of the independent claims. In the dependent claims are preferred embodiments described.

The The present invention provides an applicator for a surgical clip with an elongated applicator tube with a proximal and a distal end, a handle portion at the proximal end of the applicator tube and an elongate slider ready to be inserted into the applicator tube with the applicator tube at its distal end has a curvature.

Of the Invention is based on the principle that the surgical clip in the form of an elongated, substantially straight wire in the applicator tube of the applicator are introduced can and only when leaving the applicator from the wire one For example, a key ring-shaped bracket or Seam is formed. This can be done for example by that it is a soft wire passing through the applicator tube is advanced, at the end of which he bends through you the applicator tube the applicator in curved Form leaves. The wire is sharpened at its tip or cut, he will invade the tissue, essentially take circular path and then again leak out so that a substantially completely closed, partially overlapping ring arises.

alternative or in addition, the forming of the clip can also be achieved come about that it is the wire to a shape memory alloy with embossed clip shape, which at lower Temperature is stretched into the applicator where it loads its stretched form can not leave. As soon as she gets out of the top though of the applicator, it must be due to the shape memory their body temperature corresponding bracket shape, for example to resume an annular curvature. This embodiment also allows other than annular designs of the brackets. For example, these surgical staples can also be clip-shaped, that is two branches of the brackets lie close together. Furthermore, they can, for example also be provided with hooks to prevent slipping.

To ensure that the wire after leaving the applicator the desired Has the distal end of the applicator tube of the applicator according to the invention preferably in the form of a circular arc with a center angle which is between 30 ° and 180 °, preferably between 45 ° and 90 °. Preferably, the radius of curvature of the distal curvature of the applicator tube is between 1 mm and 10 mm, more preferably between 2 mm and 5 mm.

The Applicator tube preferably has a length between 5 cm and 50 cm, more preferably between 10 cm and 20 cm. At At its proximal end, the applicator tube preferably has a funnel-shaped expansion on which the insertion the surgical clip and / or the elongated slider simplified into the applicator tube. The inner diameter the applicator tube is preferably between 0.1 mm and 1.0 mm, more preferably between 0.2 mm and 0.5 mm. The outer diameter of the applicator tube is preferably between 0.4 mm and 3.0 mm, more preferably between 0.5 mm and 1.0 mm.

According to one preferred embodiment of the invention Applicator has the interior of the applicator tube Cross-sectional profile, which differs from a circle. In particular, an elliptical, triangular, rectangular, square or polygonal cross-sectional profile is preferred. Combined with a surgical staple which has a corresponding rotationally stable Has cross-sectional profile, so can be a targeted Position the tip of the sewing wire and fold it away prevent the clamp from perforating the tissue.

According to one Another preferred embodiment, the applicator two or more tubes and sliders on. Is preferred then further provided means by which the two or more slides simultaneously and / or successively operable are. It is particularly preferred if several Appliaktor tubes are arranged in a linear or circular arrangement. In this way, several surgical clips can be along attach to a linear or circular seam line.

It is specifically provided, several applicator tubes so circular that the applicator as use circular stapler. For a circular array of applicator tubes it is further preferred that the distal curvature of the Applicator tubes substantially tangential to the circular shape is curved.

A preferred embodiment of the invention Applicator also has an abutment, the shaping of the Surgical staple supported from the surgical wire. Such an abutment is particularly advantageous in use of the applicator as a circular stapler for use.

The The present invention further relates to an applicator as above described in combination with a surgical wire. The surgical wire has at least one pointed end, wherein the wire in a stretched Form in the applicator or the applicator tube can be introduced is and only when leaving the applicator and penetrating the to be fixed and / or stapled or sewn Tissue takes the form of a surgical clip.

According to one preferred embodiment, the wire consists of a soft wire material when leaving the applicator through Deflection is shaped into a ring. Alternatively, the wire exists from a shape memory alloy, at body temperature the pre-embossed staple form automatically assumes. For example, nickel-titanium alloys (Nitinol) or other shape memory alloys. Also the use of a wire made of a superelastic alloy, resulting from a ring shape when inserted into the applicator in a stretched form and after leaving the applicator immediately resumes the ring shape is provided.

According to one Another preferred embodiment of the combination surgical staple (surgical staple) and applicator is the ring-shaped structure of the clip not circular, but consists of two branches, which are at a predetermined Bend point against each other and have holding elements. It is further preferred that the wire does not have a round cross-sectional profile, but a rectangular, triangular, trapezoidal or otherwise irregular cross-sectional profile, preferably according to the inner cross section of the applicator tube. The diameter of the surgical staple is preferably between 0.05 mm and 1.0 mm, more preferably between 0.1 mm and 0.4 mm and is especially on the inside diameter matched to the applicator tube.

According to a further preferred embodiment, two or more wires for forming staples are arranged behind one another in the applicator according to the invention, which can be released one after the other from the applicator. In this case, the slide can be preferably advanced in stages for applying the staples, with each stage a clamp is released. The stepwise advancement of the slide is preferably carried out either by a ratchet construction or by a thread large he slope, which has a detent position per revolution, so that each time a rotation from one Rasstellung to the next one clip is released.

According to one preferred embodiment of the combination of surgical Clamp and applicator are several applicator tubes with Wires arranged on a circle. Here are the applicator tubes with respect to their preferably asymmetric inner cross section (rotation-stable profile) aligned such that the output the brackets or the arrangement of the applied clips substantially tangential or at a small angle to the circle and scaly overlapping takes place.

The The present invention further relates to a surgical clip from a wire of shape memory material with a proximal one and a distal end, the distal end having a tip. Optionally, the proximal end also has a tip. Prefers is the form imprinted on the bracket, that the clamp forms a closed curve and the proximal and distal end of the bracket are substantially in contact and / or to cross each other. It is particularly preferred that the clip stamped shape is substantially circular. The clip may alternatively or optionally be made of a super-elastic Material exist. It is further preferred that the wire of the surgical Clamp has a cross-sectional profile that extends from a circle differs, in particular an elliptical, triangular, rectangular, square or polygonal cross-sectional profile.

The The present invention further relates to a method of attachment a staple with the aid of an inventive Applicator, wherein in the applicator tube a surgical Wire is introduced. According to the method of the invention The applicator is placed in the body of a patient and the distal end of the applicator tube with respect to a tissue to be fixed and / or positioned to be sutured. Then the slider of the applicator is actuated, wherein the surgical wire is expelled from the tube and is brought into the form of a clamp for fixation and / or suitable for sewing the fabric. After all the applicator is removed from the patient's body away.

following preferred embodiments of the invention are based on the figures described in more detail. Show it:

1a a side view of an applicator according to the invention;

1b a cross-sectional view of the applicator 1a ;

2a a detailed view of the distal applicator tip in cross section;

2 B a side view of the detail 2a after partial application of the surgical clip;

3a a side view of a surgical clip according to the invention in an elongated form;

3b a side view of the surgical clip of the invention 3a in ring form;

4a a side view of the applicator according to the invention together with a piece of tissue before the introduction of a surgical clip;

4b the applicator of 4a when applying the surgical clip;

4c a detailed view of the 4b ;

5a a side view of the distal tip of an applicator according to the invention and a surgical clip according to the invention during the application process;

5b a side view as in 5a with the surgical staple almost completely expelled from the applicator;

5c a side view of a surgical clip according to the invention in the form that it takes after application;

6 a perspective view of the proximal end of an applicator according to the invention;

7 a cross section through the proximal end of the applicator according to the invention 6 ;

8th a perspective view of the proximal end of another embodiment of the applicator according to the invention;

9a a cross-section through the distal end of another preferred embodiment of the applicator according to the invention during the application of a surgical clip in a tissue piece;

9b a cross section through the distal End of a further preferred embodiment of the applicator according to the invention during the application of a surgical clip in a tissue piece;

9c a cross-sectional view of the distal end of the applicator from the 9a and 9b when inserting a surgical staple into the piece of tissue;

10 a perspective view of the distal end of the applicator 9 ;

11 a detailed perspective view of 10 ; and

12 various cross sections, which may have the surgical clips according to the invention.

1a shows a preferred embodiment of the applicator according to the invention 1 in side view. The applicator 1 has an elongated applicator tube 2 with a proximal end 3 and a distal end 4 on. At the proximal end 3 the applicator tube 2 is a handle section 5 intended. At its distal end 4 points the applicator tube 2 a curvature 7 or a curved section 7 on. The applicator tube 2 is hollow and suitable for having an elongated slider in it 6 can be introduced or introduced. Preferably, the elongate slider 6 a handle at its proximal end 15 on, with the help of the slider 6 into the applicator tube 2 introduce or can be introduced.

In 1b is the applicator 1 of the 1a to see in cross section. In this view, it can be seen that the applicator tube 2 at its proximal end 3 preferably a funnel-shaped widening 8th which serves to insert the elongate slider 6 into the applicator tube 2 to simplify. Furthermore, in 1b an elongated surgical clamp 10 (or a surgical wire 10 ), which is located within the applicator tube 2 located at its distal end. A detail view of the distal end 4 the applicator tube 2 is in 2a to see. Accordingly, the elongated surgical clip 10 a distal end 12 and a proximal end 11 on, being at the distal end 12 the surgical clamp 10 a tip is provided. Optionally, also the proximal end 11 the surgical clamp 10 have a peak.

Like from the 1b and 2a becomes clear, the surgical clip can 10 inside the applicator tube 2 with the help of the slider 6 towards the distal end 4 the applicator tube 2 to be moved. The distal end of the slider 6 is with the proximal end 11 the surgical clamp 10 in contact. Should the surgical clip 10 with the help of the slider 6 can be completely discharged from the applicator, the slider has 6 preferably a length substantially equal to the length of the applicator tube 2 equivalent.

The surgical clamp 10 is initially in the form of an elongated surgical wire piece with a tip 12a (see. 3a ) into the cavity of the applicator tube 2 brought in. Now the surgical clip 10 from the in 2a shown position by means of the slider 6 further advanced in the distal direction, it must be the curved section 7 of the distal end 4 run through. This becomes the surgical wire piece 10 the curvature of the curved section 7 impressed. Are the radius of curvature of the curved section 7 and the length of the surgical wire piece 10 properly matched, forms when passing through the curved section 7 an annular surgical clip 10 as in the 2 B and 3b shown at the distal end 12 and the proximal end 11 the surgical clamp 10 are in contact with each other or cross each other. In this way, a surgical staple is formed with relatively simple means from a surgical wire piece.

This can be used when fixing or sewing on tissue, as in the 4a to 4c is shown. In 4a is the applicator according to the invention 1 together with a piece of tissue 9 and a surgical device 13 to see. The surgical device 13 has an opening 14 on, with the help of a surgical clip 10 on the piece of tissue 9 should be fixed. Is starting from the position in 4a the surgical clamp 10 from the applicator tip as described, the distal tip is described 12 the surgical clamp 10 a circular arc path through the opening 14 the surgical device 13 through and pass through the tissue twice 9 , This is an annular clamp 10 (see. 4c ) formed the surgical device 13 on the piece of tissue 9 fixed.

With the aid of the applicator according to the invention, as just described, a conventional piece of stretched surgical wire can be formed into an annular surgical clip. It will be clear to those skilled in the art that for this purpose the material of the surgical clip must be sufficiently soft so that it passes through the curved section 7 undergoes a plastic deformation. This will ensure that the clip maintains its annular deformed structure even after exiting the applicator. This process of forming the clip can be optio facilitate or support the use of a shape memory material.

alternative can also just a wire of shape memory material in one elongated applicator are used, wherein on the Use of the curved tip of the applicator omitted can be and the applicator has a straight distal end. For this purpose, the surgical wire is made of a shape memory alloy, For example, a nickel-titanium alloy (Nitinol) produced. Shape memory alloys can conform to one given earlier shaping "remember". The shape conversion is based on the temperature-dependent Lattice transformation of two crystal structures, wherein between a High and a low-temperature phase is distinguished. Will the Alloy imprinted a certain shape, this can be added low temperature to be reshaped. Under the influence of a corresponding Temperature increase, the alloy then takes the again original, impressed form.

According to the invention the surgical wire with the usual for the treatment of shape memory materials Process a particular desired shape, namely the Shape of surgical clip, imprinted. At lower Temperature, the surgical clip is then stretched and stretched Mold is placed in the applicator, where it reaches its stretched shape do not change inside the applicator tube can. Once the stretched wire is out of the tip of the applicator is pushed out, the wire is under the influence of body temperature the pre-embossed shape, that is the clip shape, taking.

With the aid of such a shape-memory material, not only can the formation of an annular clamp be supported as described above, but this embodiment also permits other designs of the clamp. For example, the surgical wire piece could have a shape as in FIG 5c to be impressed. In the 5a and 5b is shown as the distal end 12 the surgical clamp 10 emerges from the distal tip of the applicator and the shape memory material gradually takes on the pre-embossed shape of the surgical clip. Preferably, the shape impressed on the clamp is such that the proximal end 11 and the distal end 12 the bracket 10 are essentially in contact and / or cross each other. In this way it is ensured that the seam is self-contained and the clip can not slip out of the tissue.

Often, multiple surgical staples must be placed during surgery. Therefore, according to a preferred embodiment, two or more clips are arranged one behind the other in the applicator tube of an applicator according to the invention, which can be released one after the other from the applicator. For this purpose, the slide can preferably be advanced in stages, with each stage a clamp is released. 6 shows the proximal end of such a preferred embodiment in perspective view. The handle 15 of the slider 6 is in this embodiment, a thread of high pitch 16 with the handle section 5 the applicator tube 2 connected. Will the handle 15 with respect to the grip portion 5 turned, the slider moves 6 distally within the applicator tube 2 , Here is the slope of the thread 16 chosen such that exactly one clip is released per revolution, for example. Preferably, the thread has a locking position, which signals the end of a rotation to the user. A preferred solution for providing such a detent position is in 7 to see a cross-section through the proximal end of the embodiment 6 shows. After one complete turn, the rib hits 16a at the bolt 20 , whereby a certain resistance to further rotation is generated. However, if enough force is applied by the user, the rib can 16a and the bolt 20 glide past each other, so that another clip can be issued.

Alternatively, the stepwise deployment of a plurality of brackets may be accomplished by means of a ratchet construction, as in FIG 8th outlined. According to this embodiment, the handle moves 15 of the slider 6 along a ratchet 17 , With every click of the handle 15 into a stage of ratchet 17 In doing so, a surgical staple is dispensed from the applicator.

The distal end of a further preferred embodiment of the applicator according to the invention is in the 9a to 9c shown. In this embodiment, a plurality of applicator tubes 2 each with a slider 6 arranged in a circle (see also 10 ). The applicator 1 also has an abutment 18 which is also preferably circular and is curved inwardly on its surface facing the applicator tubes along the circumference, and preferably with the aid of a linkage 19 regarding the applicator tubes 2 can be moved. In 9a is the applicator according to the invention in a body cavity 9 arranged. This embodiment is suitable, inter alia, for a circular anastomosis. For example, as in 9b shown, two wall sections 9a and 9b a body cavity, such as the colon, between the applicator tubes 2 and the counter bearing 18 be introduced. By advancing the slides 6 in the applicator tubes 2 will each a surgical clamp 10 through the fabric of the two sections 9a and 9b encountered. In this embodiment, due to the curved surface of the anvil 18 the curvature of the surgical clamp 10 supported (cf. 9c ). In this way, when stuffing the brackets forms an annular structure that the two wall sections 9a and 9b the body cavity fixed together or sewn together. By an annular arrangement of many applicator tubes 2 , each one a surgical clip 10 can spend (cf. 10 ) can be so two circular wall sections 9a and 9b connect with a circular seam.

So far were called for the circular anastomosis circular Klammernahtapparate used, the two overlapping Insert rows of clips into the intestinal wall.

The Problem with these conventional devices is that have to press the clamps exactly against an anvil, which is so profiled that they can take their form. Accordingly, in the application of these devices is a high Precision guidance of the anvil required and very high forces are needed to get the big one Deform number of parentheses at the same time. Typically needed to trigger such a stapler Forces of the order of 800 N. If, however, a surgical inventive Bracket used are significantly lower firing forces necessary. This is especially true when the clip is not through Bending is shaped but through shape memory or superelastic properties itself forms. Also the high precision the anvil guidance is not necessary here, because the brackets largely find their own way.

A detailed view of the embodiment of the applicator of 10 is in 11 to see. Preferably, this embodiment has between 20 and 50, more preferably between 30 and 40, applicator tubes 2 and associated slides 6 on. The diameter of the applicator is preferably between 5 mm and 50 mm, more preferably between 20 mm and 40 mm.

12 shows by way of example four preferred cross-sectional profiles for the surgical clip 10 or the applicator tube 2 , As already stated, in particular a rotationally stable cross-sectional profile is desirable, which deviates from a round cross-section. In this way, it is possible to precisely control in which direction the surgical wire should curve during the formation of the surgical clip. In particular from 10 It is clear that it is advantageous if the direction of curvature is clearly predetermined, so that the individual brackets 10 according to the figure substantially parallel to each other with a small angle with respect to the circle (their arrangement) arranging imbricated overlapping. If the direction of curvature of the individual staples were not predefined with the aid of the rotation-stable profile, each staple would curve in any direction.

Of the Applicator according to the invention or the inventive surgical staple can also be used to single-stitched manufacture. This is for example advantageous in the fixation of foreign matter in body tissue, such as surgical Nets to strengthen the abdominal wall, but also for example in the fixation of other implants, for example a port catheter on the body tissue. Alternatively, the invention can be used around a large number of single stitches simultaneously manufacture. This is how it can be, as described, for example for closing hollow organs or for restoring continuity use of hollow organs in the context of a so-called anastomosis. Both the applicator for attaching a single seam and the Applicator for the production of circular seams can be perfectly miniaturized. Furthermore allows the present invention, the sewing or suture clips with relatively low forces. In addition, you can when using a shape memory material also complicated Achieve clip shapes in a simple way.

The basic idea of the present invention is not to applications limited in surgery. Rather, both the applicator As well as the staple wire in other areas advantageous use Find. Accordingly, the present application discloses in general terms an applicator for a clip of staple with an elongated applicator tube with a proximal and a distal end, a handle portion at the proximal end of the Applicator tube and an elongate slider, which is insertable into the applicator tube, wherein the applicator tube has a curvature at its distal end having, with the help of which the staple wire the shape of the clip is imprinted. All in this application described preferred features may also be this general applicator exhibit. The invention further discloses an applicator as above described in combination with a staple wire. The staple wire has at least one pointed end, wherein the wire in a stretched Form in the applicator or the applicator tube can be introduced is and only when leaving the applicator and penetrating the to be fixed and / or to be clamped material the shape of a Bracket applies.

This applicator according to the invention or the applicator in combination with the clip is It is an advantage wherever things or materials are to be connected or fixed to one another under the boundary conditions, so that little space is available. Thus, for example, the applicator can be introduced through small holes in openings or cavities, where then staples can be applied to perform repairs such as.

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• WO 96/03925 [0005]
• - DE 69531746 T2 [0005]
• WO 95/08296 [0006]

Claims (29)

Applicator ( 1 ) for a surgical staple ( 10 ) with at least one elongated applicator tube ( 2 ) with a proximal end ( 3 ) and a distal end ( 4 ), a handle portion ( 5 ) at the proximal end ( 3 ) of the applicator tube ( 2 ) and an elongate slider ( 6 ) inserted into the applicator tube ( 2 ) is insertable, wherein the applicator tube ( 2 ) at its distal end ( 4 ) a curvature ( 7 ) having. An applicator according to claim 1, wherein the distal end ( 4 ) of the applicator tube ( 2 ) has the shape of a circular arc with a center angle which is between 30 ° and 180 °, preferably between 45 ° and 90 °. An applicator according to claim 1 or 2, wherein the radius of curvature of the distal curve ( 7 ) is between 1 mm and 10 mm, preferably between 2 mm and 5 mm. Applicator according to one of the preceding claims, wherein the applicator tube ( 2 ) at its proximal end ( 3 ) a funnel-shaped expansion ( 8th ) having. Applicator according to one of the preceding claims, wherein the applicator tube ( 2 ) has a length between 5 cm and 50 cm, preferably between 10 cm and 20 cm. Applicator according to one of the preceding claims, wherein the interior of the applicator tube is a non-circular Cross-sectional profile, in particular an elliptical, triangular, rectangular, square or polygonal cross-sectional profile having. Applicator according to one of the preceding claims, wherein the applicator two or more applicator tubes ( 2 ) and slides ( 6 ) having. Applicator according to one of the preceding claims, wherein the applicator comprises means for simultaneously actuating the two or more slides ( 6 ) having. An applicator according to claim 7 or 8, wherein the plurality Applicator tubes in linear or circular Arrangement are arranged. The applicator of claim 9, wherein the plurality of applicator tubes are arranged in a circle and wherein the distal curvature (FIG. 7 ) is curved substantially tangentially to the circular shape. Applicator according to one of the preceding claims, further comprising an abutment ( 18 ). Applicator according to one of the preceding claims in combination with a surgical wire ( 10 ) with at least one pointed end ( 12 ), wherein the wire is introduced into the applicator in an elongated form and assumes the shape of a surgical clip only when leaving the applicator and penetrating the tissue to be clamped. Surgical staple and applicator according to claim 12, wherein the wire is made of a soft wire material, the When leaving the applicator is formed by deflection into a ring. Surgical staple and applicator according to claim 12, wherein the wire is made of a shape memory alloy, at body temperature, the pre-stamped staple shape automatically takes. Surgical staple and applicator according to claim 12, wherein the wire is made of a superelastic alloy, which can be brought from a ring shape into a stretched shape, after leaving the applicator but immediately resumes the ring shape. Surgical staple and applicator after one of claims 12 to 15, wherein the shape of the clip is not circular, but consists of two branches, which bend against each other at a predetermined point and holding elements exhibit. Surgical staple and applicator after one of claims 12 to 16, wherein the wire in cross section is not round, but preferably rectangular, triangular or trapezoidal. Surgical staple and applicator after one of claims 12 to 17, wherein in the applicator two or more staple wires are arranged one behind the other, the can be released one after the other from the applicator. Surgical staple and applicator according to claim 18, wherein the slider for ejecting the staple wires can be advanced gradually and with each step a bracket releases. The surgical stapling wire and applicator of claim 19, wherein the stepwise advancement of the pusher is achieved by a ratchet construction (US Pat. 17 ) or by a thread ( 16 ) large pitch, which has a detent position per revolution, so that with the rotation from one detent position to the next one each clamp is released. Surgical staple and applicator after one of claims 12 to 20, wherein the individual wires are arranged on a circle and by aligning the bend over a rotation-stable profile, the arrangement of the brackets in essence tangential and scaly overlapping takes place. Surgical staple ( 10 ) of shape memory material having a proximal and a distal end ( 11 . 12 ), with the distal end ( 12 ) has a tip. Surgical stapling wire according to claim 22, wherein the proximal end ( 11 ) has a tip. A surgical staple according to claim 22 or 23, wherein the clip wire impressed shape of the clip Such is that the proximal and distal end of the bracket are essentially in contact and / or cross each other. Surgical stapling wire according to any one of claims 22 to 24, wherein the clip wire impressed shape is substantially circular. Surgical stapling wire according to any one of claims 22 to 25, wherein the wire is made of a super-elastic material. Surgical stapling wire according to any one of claims 22 to 26, wherein the wire is a non-circular cross-sectional profile has, in particular an elliptical, triangular, rectangular, square or polygonal cross-sectional profile. Method for attaching a staple with help An applicator according to any one of claims 1 to 21, wherein a surgical wire is inserted into the applicator tube is, with the following steps: a) Introduction of the Applicator in the body of a patient and positioning of the distal end of the applicator tube with respect to tissue to be fixed and / or stitched; b) Press the slider, wherein the surgical wire in the form of a clamp is brought to fixation and / or sewing of the Tissue is suitable; and c) Remove the applicator the body. The method of claim 28 including a surgical Staple wire according to one of the claims 22 to 27.