Surgery – Instruments – Suture – ligature – elastic band or clip applier
Reexamination Certificate
1999-08-23
2001-02-06
Jackson, Gary (Department: 3731)
Surgery
Instruments
Suture, ligature, elastic band or clip applier
C606S148000
Reexamination Certificate
active
06183484
ABSTRACT:
FIELD OF THE INVENTION
This invention generally relates to a suture technology for ligating tissues at a small area within a human body to be used in performing endoscopic surgery, and more particularly, to a suture ligating device for sending a knot of a suture formed outside the human body to an intended location in the human body to ligate the tissues therein.
BACKGROUND OF THE INVENTION
Recently, surgery using an endoscope (endoscopic surgery) is getting more widely performed. While the conventional surgery methods need to largely dissect the abdomen or chest of a human body for cutting, suturing or ligating the tissues to be treated, an endoscopic surgery only needs to cut a hole of a minimum size in the abdomen or other regions. Due to the smallness of the cut, early recovery of the patient is possible.
Endoscopic surgery is performed as follows. First, a trocar having a reverse stop valve is inserted into the hole cut in an abdomen. A gas is charged therethrough into the abdominal cavity to create a space at the surgery region. Thereafter, surgery is performed by inserting scalpels, forceps and the like in the abdominal cavity through the hollow space of the trocar. In order to monitor the surgery, another hole is created in the abdomen to insert another trocar to provide a monitoring camera therein for monitoring the operation of the surgery.
Since the space of the abdominal cavity is limited, surgeons must insert slender devices in a narrow space by monitoring the display to perform the surgery appropriately. Depending on the circumstances, surgeons must suture the tissue of the dissected portion or ligate a number of blood vessels.
The above suturing procedure is performed as follows. A guide device for guiding a needle having a suture, formed for example in a forceps shape, such as a guide device disclosed in Japanese Laid Open Patent Publication No. 9-56719, is inserted through the space in the trocar. Then, the tissues to be sutured are grasped and pierced by the needle having a suture. Thereafter, both ends of the piercing suture is pulled back outside the human body through the space of the trocar. Subsequently, a tie or knot (hereinafter referred to as a “knot”) of the suture is formed outside the human body. This knot is then sent back to the place where the tissues are ligated by using a suture sending device called a “knot pusher”, an example of which is disclosed in Japanese Laid Open Patent Publication No. 5-317321. Then, the tissues are ligated at that place. By repeating this operation more than two times, a ligation which will not get loose, such as called a “surgeon's knot”, can be achieved.
However, at the time the knot is sent to the inner cavity with use of the knot pusher through the space of the trocar, the movement of the knot pusher is hindered by the reverse stop valves as well as the narrow space of the tube of the trocar, hitting many spots inside the trocar. Owing to this problem, the knot of the suture is sometimes separated from the knot pusher. If the knot has already passed the trocar and is reached the space of the abdominal cavity, it is still possible to recapture the knot by the knot pusher through monitoring the knot by the camera display. However, such an operation for recapturing the knot takes a long time. If the knot is separated from the knot pusher inside the trocar, it is extremely difficult to recapture the knot. Thus, the knot pressing operating has to start over again, taking a much longer time.
In addition, as described above, since the number of the knots to be tied for each tissue ligating is at least two, possibility of occurrence of the above trouble exists at least two times at one place. This results in a heavy burden to surgeons as well as patient. Further, the knot ligated by the first operation sometimes becomes loose before the second knot is sent thereto, resulting in the failure of sufficiently joining the tissues.
SUMMARY OF THE INVENTION
Therefore, it is an object of the present invention to provide a suture ligating device which can reliably send a knot or knots of the suture tied outside the human body to the tissues to be ligated inside the human body without causing a separation of the knot from the device.
It is another object of the present invention to provide a suture ligating device which can transfer two knots at the same time to the tissues to be ligated inside the human body and tighten the knots.
It is a further object of the present invention to provide a suture ligating device which can smoothly transfer one or more knots formed outside of the human body to the tissues to be ligated inside the human body without causing friction between the suture and the ligating device.
It is a further object of the present invention to provide a suture ligating device which can securely transfer one or more knots to the tissues to be ligated by forming a closed space in which at least one knot is confined.
It is a further object of the present invention to provide a suture ligating device which can easily tighten the knots for the tissues to be ligated by widening a top end portion of the suture ligating device.
The above object of the present invention is achieved by providing a suture ligating device which includes a manipulation portion, a first and second rod members for making a relative movement to each other by an operation of the manipulation portion, first and second top end members provided at the top ends of the first and second rod members, and a third top end member connected to the second rod member for entering in a space provided between the first and second top end members in accordance with the relative movement of the first and second rod members, wherein the first and second top end members are provided with concaves opening in the top end direction, each of the concaves is separated from, each other by a predetermined distance, and the third top end member enters into a position located at the top end side over a bottom of the concaves of the first and second top end members.
The first and second rod members of the above device are provided in parallel and the relative movement of these members are made in the longitudinal direction of these slender members. At the time the third top end member enters into the space between the first and second top end members, the top end of the protrusions forming the concavity of the first and second top end members may protrude beyond the third top end member so that the second concavity is formed by the third top end member and the protrusions of the first and second top end members.
In a further aspect of the present invention, the third top end member may be provided with a projection at its top end side such that the projection and a protrusion of the first and second top end member protruding beyond the third top end member may form the second concavity. Further, the top end face of the third top end member may be formed in a concave shape so that the knot of the suture placed in the second concavity is prevented from directly contacting with the top end face of the third top end member. Further, a part of the first and the second top end members may be integrally connected by a connecting member.
In a further aspect of the present invention, the suture ligating device is structured so that all of first, second and third top end members perform open and close movement in response to an operation of a manipulation portion of the suture ligating device. The suture ligating device includes a manipulation portion, first and second slender members for making a relative movement to each other by manipulating the manipulation portion, first and second top end members provided at the top end of the first and second slender members, and a third top end member connected with the second slender member and moving between the first and second top end members in accordance with the relative movement of the first and second slender member, wherein the first and second top end members are provided with concavities opening in the top end direction, the fi
Matsumoto Takayuki
Matsutani Kanji
Jackson Gary
Mani, Inc.
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