Apparatus for ligating/suturing living tissues and system for resecting/suturing living tissues

• US 20030236535A1
• Filed: 05/06/2003
• Published: 12/25/2003
• Est. Priority Date: 05/08/2002
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Olympus Optical Corporation Limited (Olympus Corporation), Pankaj Jay Pasricha
• Inventors: Onuki, Yoshio, Pasricha, Pankaj Jay, Miyamoto, Satoshi, Kawashima, Koichi
• Granted Patent: US 8,105,342 B2
• Time in Patent Office: Days
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0474 Knot pushers
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/061 : hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185
• CPC Class Codes: A61B 2017/2905 : flexible

Abstract

In the case where the living tissues in the patient'"'"'s body is resected as well, it is possible to suture the resected portion immediately without replacement with another treatment device after resection. Thus, prevention of bleeding from the resected portion or earlier repair of an ulcer that occurs with the resected portion can be carried out for the patent lowly invasively and easily.

Claims

1. An apparatus used in combination with an endoscope, to perform at least one of ligation and suture of a living tissue of a body cavity, the apparatus comprising:

a chamber having at least one side opening;

a suction system configured to draw the tissue of the body cavity into the chamber via the side opening;

at least one ligating member configured to be put through the suctioned tissue;

at least one puncture member having a sharp-pointed end and configured to put the ligating member through the suctioned tissue; and

a holding member provided movably on the ligating member and configured to hold the tissue in at least either one of ligated state or sutured state by the ligating member.

2. The apparatus according to claim 1, wherein the puncture member has an internal cavity and is movable on the side opening from a first position, which is located on a proximal end side of the side opening, to a second position, which is located on a distal end side of the side opening.

3. The apparatus according to claim 1, wherein the chamber is a sheath having an internal cavity through which the endoscope can be inserted.

4. The apparatus according to claim 1, wherein the chamber is a cylindrical member detachably attached to a distal end of the endoscope.

5. The apparatus according to claim 1, wherein at least a portion of the chamber, which includes a vicinity of the side opening, is transparent.

6. The apparatus according to claim 1, wherein the suction system includes:

means for measuring a pressure inside the chamber;

means for displaying the pressure measured; and

control means for arbitrarily controlling the pressure inside the chamber.

7. The apparatus according to claim 1, wherein the ligating member further comprises:

a main body made of a wire rod having a biocompatibility;

a larger-diameter portion provided in at least an end of the wire rod and having a cross sectional area larger than that of the wire rod,

the larger-diameter portion being detachably fit into the distal end of the puncture member, and the holding member is movable on the main body of the ligating member.

8. The apparatus according to claim 1, wherein the apparatus comprises two of the puncture members, which are disposed in the chamber to be in parallel to each other with a certain interval therebetween.

9. The apparatus according to claim 1, further comprising a ligation manipulating device configured to move the holding member towards the distal end of the ligating member.

10. The apparatus according to claim 6, wherein the suction system is connected to the chamber via a suction port provided in the chamber.

11. The apparatus according to claim 8, wherein the ligating member further comprises:

a main body made of a wire rod having a biocompatibility;

larger-diameter portions provided at both ends of the wire rod and having a cross sectional area larger than that of the wire rod,

the two larger-diameter portions being detachably fit into the distal ends of the puncture members, respectively and the holding member is movable on the main body of the ligating member.

12. The apparatus according to claim 9, further comprising a cutting member configured to a part of the ligating member.

13. The apparatus according to claim 11, wherein the holding member is a cylindrical member made of an elastic material.

14. The apparatus according to claim 11, wherein the ligating member includes the larger-diameter portion and the main body, which can be separated from each other,

the larger-diameter portion has two side holes;

the main body is movably put through the two side holes, and

the holding member is made of an knot that is formed by knotting the main body itself.

15. The apparatus according to claim 11, wherein the holding member further comprises a first cylindrical member and a second cylindrical member,

the first cylindrical member can fit into an internal cavity of the second cylindrical member, and

the main body is inserted between the first cylindrical member and the second cylindrical member.

16. The apparatus according to claim 11, wherein the holding member is formed of a flexible thin member having two holes,

the larger-diameter portion is located further from the holding member on the distal end side,

the main body is put through the holes such as to form a loop portion on the proximal end side of the holding member.

17. The apparatus according to claim 11, wherein the holding member includes a first holding member and a second holding member,

the first holding member is made of a flexible thin member, and the first holding member is located further from the second holding member on the distal end side.

18. The apparatus according to claim 12, wherein the cutting member is provided for the holding member.

19. The apparatus according to claim 15, wherein the first cylindrical member includes a cutting member,

the main body is sandwiched and fixed while the first cylindrical member fitting into the internal cavity of the second cylindrical member, and

the cutting member cuts the main body which is located on a further proximal end side than a portion where the main body is sandwiched and fixed.

20. The apparatus according to claim 1, further comprising a tissue resecting device for resecting a tissue of a body cavity, and the apparatus is used to perform at least one of ligation and suture of the tissue which has been resected with the tissue resecting device.

21. The apparatus according to claim 20, further comprising an injection device configured to inject a fluid into an arbitrary portion in a depth direction of the tissue.