A comparison of holding strength of various surgical clips

Due to advances in clip design, new types of surgical ligation clips are available that may reduce clip failure and improve function, especially for 5-mm clip appliers. We tested a preformed spring clip based on a 5-mm applier against other commonly used clips from 5- and 10-mm multiloading clip appliers. Five different clips were compared using a digital force gauge to test perpendicular pulloff force after application to tubing of varying thickness and compliance. The average pull-off force for commonly used 5-mm and 10-mm clip appliers was 0.29 +/- 0.06 and 0.35 +/- 0.05 kg, respectively. Average pull-off force for the new preformed spring clip was 0.53 +/- 0.07 kg (p <0.0001). The new clip technology has significantly higher pull-off force than other currently used clips. This may be particularly beneficial in procedures requiring 5-mm clip appliers, which are known to place clips with lower holding force.