This clip applier has application in many types of surgical procedures to occlude vessels and other tubular structures and for vagotomy, sympathectomy and radiographic markings. The Premium Surgiclip II clip applier consists of a body with attached handles and an applier shaft with an integrated cartridge containing 20 or 30 titanium clips. The Premium Surgiclip II clip applier has a selectable ratchet function. The ratchet ON position provides instrument control of the closing sequence. The clip cannot be released from the jaw until the device is fully cycled. Once completed, the handles will return to their original position and a new clip will be automatically fed into the jaw. In the ratchet OFF position, the closing sequence is fully manual. Relaxation of pressure on the device handles at any time in the closing sequence will result in the clip releasing from the jaw. This feature allows physicians to vary the degree of clip closure, depending on clinical need. Once completed, the handles will return to their original position and a new clip will be automatically fed into the jaw.