Hydraulically actuated multiband ligator

Surgery – Instruments – Suture – ligature – elastic band or clip applier

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Details

606139, A61B 1704

Patent

active

060995351

DESCRIPTION:

BRIEF SUMMARY
BACKGROUND OF THE INVENTION

1. Field of the Invention
This invention generally relates to ligating instruments and more particularly to instruments for dispensing a plurality of ligating bands to one or more internal sites within a patient's body in a single ligation procedure, without removing the instrument between successive ligating band placements.
2. Brief Description of Related Art
The treatment of various types of lesions including internal hemorrhoids and varices by ligation within the alimentary canal in order to stop bleeding is well known. The object of ligation is to position an elastic cord, or ligating band, at the lesion to stop circulation through tissue and allow the tissue to necrose whereupon the body sloughs off the necrotic or dead tissue.
Surgical ligation has also been employed in female and male sterilization procedures. In the case of tubal ligation in female patients, ligating rings or bands are placed on a folded-over loop portion of each Fallopian tube, blocking the path from uterus to ovaries, and thereby preventing fertilization of an ovum. In the case of male sterilization, a ligating band may similarly be placed on a folded-over loop portion of the vas deferens, thus preventing passage of spermatozoa from the testes.
The following United States Letters Patent disclose various embodiments of ligating instruments that are useful for dispensing a ligating band at a designated site within a patient: 3,760,810 to Van Hoorn; 4,257,419 to Goltner, et al.; and 4,735,194 to Stiegmann. Each of the foregoing instruments dispenses a single ligating band or a single set of ligating bands at a single location. None suggests dispensing ligating bands at discrete locations. The Van Hoorn patent does disclose the possibility of depositing plural ligating bands; however, Van Hoorn seems only to suggest dispensing plural ligating bands at a single site in a single operation. The apparatus disclosed in the Van Hoorn, Goltner or Stiegmann patents apparently would have to rely on an operator's sense of touch in order to displace the inner tube by an incremental distance corresponding to the thickness of a stretched ligating band to deposit a plurality of bands at different sites. That would be very difficult to accomplish. Thus, when it is desired to deposit ligating bands at different sites, the common practice has been to withdraw the entire instrument from the patient and load a new ligating band onto the inner tube. Loading ligating bands on an instrument requires special tools and could be time consuming particularly if the special tooling must be retrieved to install each ligating band individually while the instrument is withdrawn. Each of these instruments requires some structure, such as special stoppers or overtubes, for preventing the premature dispensing of the ligating band. Consequently, none of these instruments was readily adapted for dispensing ligating bands at different sites without withdrawing the instrument after each individual site is ligated.
Aimed at solving the aforementioned problems, the following United States Letters Patent disclose various embodiments of ligating instruments which are designed to deposit or place a plurality of ligating bands at one or more internal sites within a patient without the necessity of withdrawing the ligating instrument to reload successive ligating bands: 3,985,138 to Jarvik; 4,226,239 to Polk et al.; 3,870,048 to Yoon; 5,207,690 to Rohrabacher et al.; and 5,269,789 to Chin.
U.S. Pat. No. 3,985,138 to Jarvik discloses a ligature gun for placing a plurality of preformed suture loops which are tightened around bleeders after emplacement. The successive preformed suture loops are advanced to the dispensing end of the ligature gun by rotation of a threaded rod onto which the loops have been preloaded. The Jarvik ligature gun comprises large number of mechanical parts and is relatively complex in design and operation.
U.S. Pat. No. 3,870,048 to Yoon discloses the use of elastic bands or rings in tubal ligation. The Yoon device is construc

REFERENCES:
patent: 5318544 (1994-06-01), Drypen et al.
patent: 5423834 (1995-06-01), Ahmed
patent: 5507797 (1996-04-01), Suzuki et al.

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