Endoscopic apparatus with integrated variceal ligation device

• US 20060259041A1
• Filed: 05/13/2005
• Published: 11/16/2006
• Est. Priority Date: 05/13/2005
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Hoffman, David W., Rowland, Christopher
• Granted Patent: US 8,097,003 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/00103 designed for single use
• CPC Class Codes: A61B 1/012 characterised by internal passages or accessories therefor
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/12018 Elastic band ligators
• CPC Class Codes: A61B 2090/0803 Counting the number of times an instrument is used

Abstract

A variceal banding endoscope includes an elongated shaft having a distal end and a proximal end that is removably connected to a control unit. The endoscope includes a variceal banding apparatus fixedly attached to the distal end of the endoscope and capable of receiving a plurality of ligation bands. A trigger cable extends from the proximal end to the distal end of the shaft and is digitally actuated by an actuator in the control unit or handle of the scope in response to a user input device.

Claims

1. A variceal band ligation system comprising:

a variceal banding endoscope comprising;

an elongated shaft with a proximal end and a distal end;

a working channel extending from the proximal end to the distal end of the shaft;

a variceal banding apparatus fixedly coupled to the distal end of the shaft;

wherein the variceal banding apparatus comprises a hood on which a plurality of ligation bands are disposed and a trigger cable for individually deploying the plurality of ligation bands; and

a control unit functionally connected to the variceal banding endoscope, the control unit comprising an actuator capable of actuating the trigger cable; and

a user input device in communication with the control unit wherein the actuator selectively tensions the trigger cable in the variceal banding apparatus in response to one or more commands from the user input device.

2. The system of claim 1, wherein the variceal banding endoscope is a single-use endoscope.

3. The system of claim 1, wherein the trigger cable is disposed in a separate lumen from the working channel.

4. The system of claim 1, wherein the system further comprises a position tracking system for mapping reference coordinates of a varix.

5. The system of claim 4, wherein the position tracking system includes an electromagnetic sensor element in the endoscope.

6. The system of claim 1, wherein the hood is adapted to receive at least five ligation bands.

7. The system of claim 1, wherein the system further comprises software provisions for tracking the number of ligation bands contained on the hood of the variceal banding endoscope.

8. The system of claim 7, wherein the software provisions track input commands from the user input device.

9. The system of claim 8, wherein the system further comprises a display device adapted to display signals received from the control unit.

10. The system of claim 9, wherein the display device displays the number of ligation bands remaining on the hood of the variceal banding endoscope.

11. An endoscope, comprising:

an elongated shaft with a proximal end and a distal end;

a working channel extending from the proximal end to the distal end of the shaft;

an imaging system at or adjacent the distal end of the shaft; and

a variceal banding apparatus fixedly coupled to the distal end of the shaft;

wherein the variceal banding apparatus comprises a hood adapted to receive a plurality of ligation bands thereon and means for individually deploying each of the plurality of ligation bands.

12. The endoscope of claim 11, wherein the endoscope is a single-use endoscope.

13. The endoscope of claim 11, wherein the hood projects distally from the distal end of the shaft.

14. The endoscope of claim 13, wherein the hood is transparent.

15. The endoscope of claim 13, wherein the outer diameter of the hood is substantially the same as the outer diameter of the distal end of the shaft.

16. The endoscope of claim 13, wherein the outer diameter of the hood is smaller than the outer diameter of the distal end of the shaft.

17. The endoscope of claim 11, wherein the hood is adapted to receive from two to five ligation bands.

18. The endoscope of claim 11, wherein the hood is adapted to receive more than five ligation bands.

19. The endoscope of claim 11, wherein the means for individually deploying each of the plurality of ligation bands includes a trigger cable that extends from the proximal end of the shaft to the hood.

20. The endoscope of claim 19, wherein the trigger cable extends through a lumen extending from the proximal end to the distal end of the shaft.

21. The endoscope of claim 19, wherein the proximal end of the distal shaft is removably connected to a control unit, and wherein the trigger cable is digitally actuated by an actuator in the control unit in response to a user input device.

22. The endoscope of claim 19, wherein the endoscope includes a manual handle, and wherein the trigger cable is acutated by an actuator located in the handle.

23. The endoscope of claim 11, wherein the hood further comprises a sensor element for sensing the presence of each of the plurality of ligation bands received thereon.

24. The endoscope of claim 11, wherein the hood further comprises a position sensor element for tracking the position of the endoscope in a patient.

25. A kit for variceal ligation, said kit comprising:

i) a single-use variceal banding endoscope comprising an elongated shaft with a proximal end and a distal end;

a working channel extending from the proximal end to the distal end of the shaft;

an imaging system at or adjacent the distal end of the shaft; and

a variceal banding apparatus fixedly coupled to the distal end of the shaft;

wherein the variceal banding apparatus comprises a hood adapted to receive a plurality of ligation bands thereon; and

means for individually deploying each of the plurality of ligation bands;

ii) a plurality of ligation bands; and

iii) written indicia describing a method of loading the plurality of ligation bands onto the hood prior to clinical use of the variceal banding endoscope.

26. The kit of claim 25, wherein the variceal banding endoscope and the plurality of ligation bands are packaged into a removable sterile wrapper.

27. The kit of claim 25, the kit further comprising a computer readable media having software provisions for tracking the number of ligation bands remaining on the hood during clinical use.

28. All embodiments of the system as shown and described.

29. A method of variceal band ligation comprising

i) connecting a variceal banding endoscope to a control unit;

ii) inserting a variceal banding endoscope having a plurality of ligation bands into a patient;

iii) observing a varix in need of ligation;

iv) pulling the varix towards the distal end of the endoscope;

v) digitally actuating a ligation band from the variceal ligation endoscope; and

vi) repeating steps iii-v for additional varices in need of ligation; and

vii) removing the variceal banding endoscope from the patient.

30. The method of claim 29, further comprising disconnecting the variceal banding endoscope from the control unit and disposing of the variceal banding endoscope.