Case studies

High-quality, low-cost, disposable surgical tools

Femcare-Nikomed’s Filshie Clip is the leading method of female surgical sterilisation. TTP worked with the Femcare-Nikomed team to develop the Sterishot II applicator, the leading method of deploying the implant.

  • Client


The Filshie Clip is the most reliable method of surgical sterilisation, and the new applicator had to be cheap to manufacture but make no compromise regarding reliability.


Sterishot II gives reliable performance every time and is easy to manufacture, achieving zero defects by design within the cost constraints. It also provides good ergonomics – comfortable handling, easy manipulation and low muscle effort during use.


Femcare-Nikomed’s product was well-received by surgeons and has become the preferred method of application for the Filshie Clip.

High-quality, low-cost, disposable surgical tools


Single-use tools and kits reduce logistics and sterilisation overheads, lower the risk of patient infection, improve reliability and help to increase reimbursement transparency.

Single-use tools must, of course, also be manufacturable at much lower cost than reusable products, and achieving low cost was an important motivation for the development of the new applicator.

Laparoscopic surgery is a complex, ergonomically-demanding activity. Therefore, the applicator also had to provide comfortable body positioning, low operating forces, easy manipulation and a simple user interface. To achieve all of this, our human factors team researched the setting and created a model surgery to select and refine the applicator ergonomics.

The Filshie Clip is the most reliable method of surgical sterilisation available and the applicator could not compromise this reliability. The mechanism had to close the clip accurately every time without breaking or jamming. Using mathematical models to predict reliability in the light of manufacturing tolerances, we were able to achieve zero-defect performance by design.


Concept selection is pivotal to both the cost and reliability of a product. Therefore, we constructed cost and reliability models at the concept phase, allowing us to select the cheapest concept, confident that it would still perform as required.

The combination of technical performance, ergonomic design and low cost achieved meant that Sterishot II was well received by surgeons and continues to be the preferred applicator for the Filshie Clip.

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