Surgery – Instruments – Suture – ligature – elastic band or clip applier
Reexamination Certificate
2001-04-26
2004-06-29
Calvert, John J. (Department: 3765)
Surgery
Instruments
Suture, ligature, elastic band or clip applier
Reexamination Certificate
active
06755844
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to a ligator used to knot a ligature in a body in a medical care, i.e., surgery, especially endoscopic surgery.
2. Description of the Related Art
A technique to make an incision portion smaller in surgery is regarded as important in order to accelerate the course of convalescence after an operation and make an operative wound left in a body smaller. Recently, endoscopic surgery permitting to make an incision portion excessively smaller has widely been put into practical use.
In such endoscopic surgery, there is required an operation to carry out ligation of tissue or a blood vessel in a body with the use of a ligature or to knot the ligature after suture to fix the sutured portion by an operator through a minor opening of an incision of the body. A medical appliance called a “ligator” has conventionally been used to achieve such an operation of knotting the ligature in the body from outside thereof. Japanese Provisional Publication No. HEI 05-317321 discloses one of examples of such a conventional ligator, which is illustrated in
FIGS. 21 and 22
.
FIG. 21
is a schematic descriptive view of the conventional ligator and
FIG. 22
is a cross-sectional view of essential elements of the conventional ligator.
The conventional ligator
100
as shown in
FIGS. 21 and 22
comprises a handle
101
having a prescribed length, a recess portion
102
formed on the front end of the handle
101
, a guide passage
103
provided so as to communicate with the recess portion
102
and extend beyond the bottom of the recess portion
102
between the opposite portions thereof toward the front end of the handle
101
.
Description will be given below of a ligation operation using the conventional ligator
100
. A ligature
50
is previously put around a target part in a body, which is to be subject to a ligation operation (i.e., tissue in the body, a blood vessel, or the like) (hereinafter referred to as the “target regation part in the body”) and the opposite ends of the ligature
50
are pulled out of the body with the use of another medical appliance. An operator crosses the opposite ends of the ligature
50
to make a half hitch
51
outside the body. Opposite portions of the ligature
50
extending from the half hitch
51
are put in the guide passage
103
in the vicinity of the recess portion
102
. The operator moves the ligator
100
forward while holding the opposite ends of the ligature
50
. As a result, the half hitch
51
shifts to move together with the front end of the ligator
100
, while the ligature
50
smoothly slips in the guide passage
103
without occurrence of contact of the half hitch
51
with the recess portion
102
of the ligator
100
. The ligator
100
is inserted into the body in such a state to move the half hitch
51
toward the target regation part in the body. After the half hitch
51
finally moves to the above-mentioned target part in the body, the opposite ends of the ligature
50
are pulled from outside the body to make a knot, while keeping the ligator
100
stationarily, thus providing a ligation condition for the target part in the body.
In the conventional endoscopic surgery, a port is used to be fixed to the surface of a body to facilitate insertion of a medical appliance such as the ligator into the body and removal of it from the body (see FIG.
1
). A closed-type port, which is used in the endoscopic surgery according to aeroperitoneum, has a built-in valve for preventing occurrence of a gas leakage. A ligature that is put around a target part in the body, which is to be subject to a ligation operation, and pulled out of the body, comes into contact with the valve, resulting in a bending state in the middle of the ligature. When the ligator
100
is inserted into such a port, the ligature may come off the guide passage
103
at one of the opposite portions between which the recess portion
102
is placed, due to the bending state of the ligature in the vicinity of the valve. This may cause the half hitch
51
to deviate from the recess portion
102
, deteriorating slidability of the ligature
50
and causing a problem. When the ligator
100
opens the valve and enters the port, a resistance force having a function of returning the valve to close it is applied to the ligator
100
. An operator cannot easily recognize that such a resistance force is generated due to deviation of the half hitch
51
of the ligature or returning action of the valve. This makes it unable to judge properly whether the operation be continued or not, causing the other problem.
In case where the operator continues to insert the ligator
100
without recognizing deviation of the half hitch
51
of the ligature
50
, the ligature
50
may be broken or an excessively large force may be applied to the target regation part in the body, around which the ligature
50
has been put, thus causing damage. When the ligature
50
comes off the front end of the ligator
100
within the port, it is very difficult to put again the ligature
50
on the front end thereof due to impossibility of visual inspection of the inside of the port.
The conventional ligator
100
has a non-uniform thickness. There exists a relatively large gap between the port into which the maximum thickness portion of the ligator
100
can be inserted and the ligator
100
has actually been inserted into the port. This may cause an aeroperitoneum gas to leak out during operation, thus making it impossible to ensure a proper field of vision through an endoscope, resulting in interruption of operation.
SUMMARY OF THE INVENTION
An object of the present invention, which was made to solve the above-described problems, is therefore to provide a ligator, which prevents a ligature from coming off the front end of the ligator, has a shape of the front end thereof, by which the ligature can easily be put on the front end of the ligator even when it comes off, permits to shift surely a half hitch of the ligature toward a target part, which is to be subject to a ligation operation, and permits an operator to carry out the ligation operation so as to improve remarkably an operation efficiency, thus reducing a burden of both the operator and a person to be operated.
In order to attain the aforementioned object, a ligator of the present invention comprises a ligation member formed of a bar-shaped body having a constant thickness in a region extending by at least a prescribed length from one end of said ligation member; a front hole formed on one end surface of said ligation member, said front hole having a prescribed shape and a prescribed depth in a longitudinal direction of said ligation member; and a pair of side holes formed on opposite positions at one end portion of said ligation member so as to be substantially at right angles to said front hole, said front hole being located between said opposite positions, and said side hole communicating with said front hole, opposite ends of a ligature to be knotted passing through said front hole and said side hole. In the feature of the present invention, the bar-shaped ligation member is provided on its front end with the front hole and the side holes. An operator passes the opposite ends extending from a half hitch of a ligature through the front hole and the side holes so that the half hitch is placed within the front hole. The operator carries out a ligation operation while holding the opposite ends of the ligature. When the ligator is inserted into a body, the side holes urge the ligature to shift the half hitch of the ligature into the body, while keeping the half hitch within the front hole of the ligator. When the ligator is pulled out of the body, the ligature comes into contact with the ligation member within the front hole and the side holes to hold securely the ligature. It is therefore possible to pass the ligator through a port to carry out the ligation operation without causing deviation of the half hitch and slip-off of the ligature. In addition, the half hitch of the ligature shifts
Calvert John J.
Hoey Alissa L.
Kananen, Esq. Ronald P.
Rader & Fishman & Grauer, PLLC
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