A medical instrument including a first joint including a first member and a second member, the first member configured to be repositionable with respect to the second member in a first degree of freedom, a second joint operatively coupled to the first joint, the second joint including a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a second degree of freedom, a pair of repositionable jaws operatively coupled to the first joint and the second joint, an open-ended occlusion clip detachably mounted to the pair of repositionable jaws, and a controller operatively coupled to the first joint, the second joint, and the pair of repositionable jaws, the controller including a control with a line operatively coupled to the first and second jaws in at least a gun tackle pulley configuration.