Surgery – Instruments – Suture – ligature – elastic band or clip applier
Patent
1996-11-20
1997-10-28
Jackson, Gary
Surgery
Instruments
Suture, ligature, elastic band or clip applier
A61B 1700
Patent
active
056813287
DESCRIPTION:
BRIEF SUMMARY
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.
BACKGROUND OF THE INVENTION
The treatment of various types of lesions including internal hemorrhoids by ligation 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 U.S. Pat. Letters Nos. disclose various embodiments of ligating instruments: 3,760,810 to Van Hoorn; 4,257,419 to Goltner, et al.; and 4,735,194 to Stiegmann.
U.S. Pat. No. 3,760,810 to Van Hoorn discloses an instrument for facilitating the placement of a single ligating band or set of bands. The instrument includes, at its distal end, a ligating band dispenser comprising two rigid, concentric tubes. The tubes can slide with respect to each other under the control of a trigger mechanism at the proximal end of the instrument. A rigid endoscope having internal passages forming a suction path and a light path interconnect the trigger mechanism and dispenser. The inner tube can be loaded with a set of one or more elastic rings or ligating bands. A separate stopper bar attaches to the instrument to prevent premature dispensing. When the instrument is located proximate a lesion, a surgeon removes the stopper bar and applies vacuum to draw tissue into a hollow passage at the distal end of the instrument. Pulling on the trigger retracts the inner tube. A radial surface or shoulder on the outer tube engages the ligating band so it can not displace with the inner tube. As the inner tube is withdrawn from the ligating band, it collapses onto the tissue.
U.S. Pat. No. 4,257,419 to Goltner, et al. discloses a rigid endoscope that includes a ligating band dispenser with an inner tube that moves with respect to an outer tube to dispense a ligating band. This dispenser is oriented at right angles to the rigid endoscope and includes a structure for moving the inner tube of the dispenser in this configuration.
U.S. Pat. No. 4,735,194 to Stiegmann discloses a flexible endoscope ligating instrument in which a flexible endoscope structure includes a biopsy channel and a suction channel extending between the proximal and distal ends. A dispenser, like the dispenser structure shown in the Van Hoorn and Goltner patents, includes an inner tube that moves axially with respect to an outer tube at the distal end of the instrument. The outer tube connects to the distal end of the endoscope. An operating mechanism in the form of a pull wire with a weighted handle maintains tension on the inner tube so it does not displace axially outward while the instrument is being positioned. For some applications it is suggested that the endoscope structure be inserted through an overtube to prevent premature dispensing. Suction can be applied to draw tissue into a central aperture of the dispenser. Then a surgeon pulls the handle and retracts the inner tube axially past the distal end of the outer tube to force the ligating band off the instrument onto the tissue.
Each of the foregoing instruments dispenses a single ligating band or a single set of ligating bands at a single location. None of the patents suggests dispensing ligating bands at discrete locations. The Van Hoorn patent does
REFERENCES:
patent: 3760810 (1973-09-01), Van Hoorn
patent: 3985138 (1976-10-01), Jarvik
patent: 4226239 (1980-10-01), Polk et al.
patent: 4860746 (1989-08-01), Yoon
patent: 5203863 (1993-04-01), Bidoia
patent: 5207690 (1993-05-01), Rohrabacher et al.
patent: 5269789 (1993-12-01), Chin et al.
patent: 5320630 (1994-06-01), Ahmed
patent: 5356416 (1994-10-01), Chu et al.
Lamport Ronald B.
Watson Thomas E.
C.R. Bard Inc.
Jackson Gary
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