Apparatus and method for laparaoscopic ligation
First Claim
1. A ligation device for tying a suture around a selected bodily vessel or duct, in combination with a suture having a tag end and a standing part with a loop formed therein, the device comprising:
- an elongate hollow tube extending axially between a proximal portion and a distal end;
first means, attached to the elongate hollow tube near its distal end, for isolating and engaging a selected vessel or duct, and for releasably holding the tag end of the suture;
second means, disposed within the elongate hollow tube for axial movement therein between a first axial position and a second axial position, for holding the loop formed in the standing part of the suture when in the first axial position and releasing the loop when in the second axial position;
first actuation means for selectively moving the second means from the first position to the second position;
third means, disposed within the second means for axial movement therein between a first axial position and a second axial position, for grasping the tag end of the suture directly from the first means when in the second axial position and when the tag end is held by the first means, and for pulling the tag end around the selected vessel or duct and toward the proximal portion of the tube as the third means moves to its first axial position; and
second actuation means for selectively moving the third means between its first and second axial positions;
whereby the movement of the third means from its second position to its first position carries the tag end of the suture into the second means and within the loop held on the second means, and whereby the movement of the second means from its first position to its second position releases the loop onto the tag end of the suture to form a knot in the suture that is tightened around the vessel or duct by the further movement of the third means toward its first position.
2 Assignments
0 Petitions
Accused Products
Abstract
A laparoscopic ligation device comprises an elongate hollow tube, having an open distal end. An arcuate finger, attached to the tube, has a tip that is distally spaced from the distal end of the tube. The finger includes structure adjacent its tip that releasably holds the tag end of a length of suture. A hollow mandrel is disposed within the tube, for movement between extended and withdrawn positions. The mandrel has an open distal end, carrying a plurality of loops formed in the standing part of the suture, that extends distally from the open end of the tube in the extended position. A rod having a hook at its distal end is disposed within the mandrel for movement between extended and withdrawn positions. In use, the finger is manipulated to engage a vessel or duct. The rod is moved to its extended position so that its hook snags the suture tag end from the finger tip. The rod is then moved toward its withdrawn position, carrying the tag end to form a ligature loop around the vessel or duct, and then into the distal end of the mandrel, and through the loops thereon. The mandrel is moved to its withdrawn position, thereby dropping the loops onto the tag end to form a loose knot that is tightened by the continued movement of the rod to its withdrawn position to constrict the ligature loop around the duct or vessel. The knot is then cut away from the rest of the suture.
376 Citations
41 Claims
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1. A ligation device for tying a suture around a selected bodily vessel or duct, in combination with a suture having a tag end and a standing part with a loop formed therein, the device comprising:
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an elongate hollow tube extending axially between a proximal portion and a distal end; first means, attached to the elongate hollow tube near its distal end, for isolating and engaging a selected vessel or duct, and for releasably holding the tag end of the suture; second means, disposed within the elongate hollow tube for axial movement therein between a first axial position and a second axial position, for holding the loop formed in the standing part of the suture when in the first axial position and releasing the loop when in the second axial position; first actuation means for selectively moving the second means from the first position to the second position; third means, disposed within the second means for axial movement therein between a first axial position and a second axial position, for grasping the tag end of the suture directly from the first means when in the second axial position and when the tag end is held by the first means, and for pulling the tag end around the selected vessel or duct and toward the proximal portion of the tube as the third means moves to its first axial position; and second actuation means for selectively moving the third means between its first and second axial positions; whereby the movement of the third means from its second position to its first position carries the tag end of the suture into the second means and within the loop held on the second means, and whereby the movement of the second means from its first position to its second position releases the loop onto the tag end of the suture to form a knot in the suture that is tightened around the vessel or duct by the further movement of the third means toward its first position. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A ligation device for tying a suture around a selected bodily vessel or duct, in combination with a suture having a tag end and a standing part with a first loop formed therein, the device comprising:
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first means for isolating and engaging a selected vessel or duct, and for releasably holding the tag end of the suture; second means, axially movable with respect to the first means between an extended and a withdrawn position, for holding the first loop formed in the standing part of the suture when in the extended position and releasing the first loop when in the withdrawn position; first actuation means, operatively connecting the first means and the second means, for selectively moving the second means from the extended position to the withdrawn position; third means, disposed within the second means and axially movable with respect to the second means between a withdrawn and an extended position, for grasping the tag end of the suture directly from the first means when in the extended position and when the tag end is held by the first means, and for pulling the tag end around the selected vessel or duct to form a second loop around the selected vessel or duct; and second actuation means for selectively moving the third means between its withdrawn and extended positions; whereby the movement of the third means from its extended position to its withdrawn position carries the tag end of the suture through the first loop, whereby the movement of the second means from its extended position to its withdrawn position releases the first loop onto the tag end of the suture to form a knot in the suture, and whereby the second loop is constricted around the selected vessel or duct as the knot is tightened by the further movement of the third means from its extended position to its withdrawn position. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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27. A laparoscopic ligation device for tying a suture around a selected bodily vessel or duct, the suture having a standing part and a tag end, the device comprising:
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an elongate, hollow, tubular member having a distal end and a proximal portion; an arcuate finger attached to the elongate, hollow, tubular member near its distal end, and having a tip spaced distally from the distal end of the elongate, hollow, tubular member; means adjacent the tip of the finger for releasably holding the tag end of the suture; an elongate, hollow mandrel axially disposed within the tubular member, the mandrel having a proximal end and an open distal end configured for carrying a plurality of loops formed in the standing part of the suture; first actuation means for selectively moving the mandrel between a first position in which the distal end of the mandrel extends distally from the distal end of the elongate, hollow, tubular member, and a second position in which the distal end of the mandrel is withdrawn into the elongate, hollow, tubular member; suture-grasping means, axially disposed within the mandrel for movement between a first axial position and a second axial position, for removing the tag end of the suture from the tip of the finger when in the second position, and for pulling the tag end of the suture around the selected vessel or duct and toward the proximal end of the mandrel as the suture-grasping means moves to its first position; second actuation means for selectively moving the suture-grasping means between its first and second positions; and biasing means, operative on the second actuation means, for biasing the suture-grasping means toward its first position; whereby the movement of the suture-grasping means from its second position to its first position carries the tag end of the suture into the open distal end of the mandrel and through the suture loops carried on the mandrel, and whereby the movement of the mandrel from its first position to its second position releases the loops onto the tag end of the suture to form a knot in the suture that is tightened around the vessel or duct by the further movement of the suture-grasping means toward its first position. - View Dependent Claims (28, 29, 30, 31, 32, 33, 34, 35, 36)
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37. A laparoscopic ligation device for tying a suture around a selected bodily vessel or duct through a single surgical passage into a patient'"'"'s body, in combination with a suture having a tag end and a standing part, the device comprising:
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first means, insertable into the passage to the vicinity of the vessel or duct, for (a) isolating and engaging the selected vessel or duct, and (b) releasably holding the tag end of the suture; second means, disposed within the first means and insertable into the passage together with the first means, for selectively grasping the tag end directly from the first means while the tag end is held by the first means, and for knotting the tag end with the standing part to form a ligature loop around the vessel or duct; and third means, operatively connected to the second means and remote from the first means so as to be located outside the body when the first and second means are inserted into the passage, for actuating the second means to remove the tag end from the first means and to knot the tag end with the standing part.
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38. A method of ligating a bodily vessel or duct, comprising the steps of:
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(1) providing an elongate, hollow mandrel having an open distal end and a proximal end, and providing engagement means spaced distally from the distal end for isolating and engaging a vessel or duct; (2) providing a length of suture having a standing part and a tag end; (3) forming a plurality of loops in the standing part of the length of suture around the distal end of the mandrel, and removably securing the tag end of the suture to the engagement means; (4) isolating and engaging the vessel or duct with the engagement means; (5) removing the tag end of the suture from the engagement means and drawing it around the vessel or duct, toward the distal end of the mandrel, thereby forming a ligature loop around the vessel or duct; (6) drawing the tag end of the suture into the open distal end of the mandrel, thereby passing the tag end through the loops formed on the mandrel; (7) dropping the mandrel-formed loops over the tag end of the suture to form a loose knot; and (8) drawing the tag end of the suture toward the proximal end of the mandrel to tighten the knot, while thereby closing the ligature loop around the vessel or duct until the vessel or duct is completely ligated. - View Dependent Claims (39, 40, 41)
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Specification