Endoscopic ligating instrument

• US 5,462,559 A
• Filed: 06/14/1994
• Issued: 10/31/1995
• Est. Priority Date: 02/23/1993
• Status: Expired due to Term

• Current Assignee: Dabegran Technologies Incorporated
• Original Assignee: Munir Ahmed
• Inventors: Ahmed, Munir
• Primary Examiner(s): Graysay, Tamara L.
• Assistant Examiner(s): Schmidt, Jeffrey A.
• Application Number:
  US08/260,380
• Time in Patent Office: 504 Days
• Field of Search: 606/135, 606/139, 606/140, 606/141, 606/165
• US Class Current: 606/140
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/00973 pedal-operated
• CPC Class Codes: A61B 2017/12018 Elastic band ligators
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system

Abstract

An endoscopic instrument for ligating multiple lesions within a hollow body organ. A flexible endoscope 10 is provided with channels 16-21 for accomodating means for illumination, viewing and application of suction and is also provided with a hollow tubular member 101 affixed to the insertion end of the endoscope. A plurality of cords 103 are laid over the tube 101 to extend longitudinally thereon and be folded over the distal end of the tube. The cords 103 are connected to one another at a common point by a connector 106 inside the tube 101. A plurality of elastic rings 50 are mounted on the tube 101 in stretched condition and overlaying the cords 103. The segment of each cord 103 between each pair of adjacent rings 50 is in slack condition and of a length which equals or exceeds the distance of the tube'"'"'s distal end to the furthest ring of the pair. By a trip cord 105 threaded through a working channel 19 of the endoscope and connected to the cords 103, a pull can be exerted thereon to simultaneously retract the cords 103 and dislodge each of the rings in controlled stepped sequence in a procedure wherein only one elastic ring at a time moves over the tube in the process of its dislodgement to ligate a lesion which has been suctioned part way into the tube 101.

Claims

1. A flexible endoscopic instrument for ligating a multiplicity of lesions within a hollow body organ, such as the alimentary tract, said instrument comprising:

(a) a flexible fiber optic endoscope having a forward insertion end and a rearward end, said endoscope including means for illumination and viewing through said endoscope, means for providing a suction force at said insertion end, and a working channel;

(b) a tubular member having a forward distal end, a rearward end and a longitudinal axis, said rearward end having means for providing attachment to the insertion end of the endoscope;

(c) a plurality of string-like cords of flexible substantially inelastic material, each said cord being folded over the distal end of the tubular member with a first portion of each said cord overlaying a part of the exterior of said tubular member and a second portion thereof being disposed internally of said tubular member, said cords being oriented in angular spacing about the longitudinal axis of said tubular member;

(d) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member in coaxial relation thereto and each of said rings being in overlying contacting relation to all of said plurality of cords, said rings being spaced from one another in the longitudinal direction of the tubular member at successively greater different distances from the distal end of the tubular member; and

(e) means for imparting relative sliding motion between said cords and said tubular member to dislodge each of the elastic rings in controlled sequence during a single insertion of the endoscope into the body organ whereby each of the elastic rings can be dislodged from the endoscope and placed in ligating relation to a lesion when lesion tissue is drawn into the tubular member by said suction means with each ring being applied to a different one of multiple lesions present in the body organ, said means for imparting relative sliding motion comprising a flexible line element threaded through the working channel of the endoscope and connecting at one end to said cords disposed within said tubular member and exiting the endoscope at the rearward end thereof whereby a pulling force may be exerted on the other end of the line element to cause sliding movement of the cords over said tubular member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

2. A flexible endoscopic instrument for ligating a multiplicity of lesions within a hollow body organ, such as the alimentary tract, said instrument comprising:

(a) a flexible fiber optic endoscope having a forward insertion end and a rearward end, said endoscope including means for illumination and viewing through said endoscope, means for providing a suction force at said insertion end, and a working channel;

(b) a tubular member having a forward distal end, a rearward end and a longitudinal axis, said rearward end having means for providing attachment to the insertion end of the endoscope;

(c) a plurality of string-like cords of flexible substantially inelastic material, each said cord being folded over the distal end of the tubular member with a first portion of each said cord overlaying a part of the exterior of said tubular member and a second portion thereof being disposed internally of said tubular member, said cords being oriented in angular spacing about the longitudinal axis of said tubular member;

(d) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member in coaxial relation thereto and in overlying relation to said cords, said rings being spaced from one another in the longitudinal direction of the tubular member and between at least one pair of adjacent elastic rings each of said cords having a slack segment of cord of a length which is at least equal to the distance between the distal end of the tubular member and the ring of said pair which is furthest from said distal end; and

(e) means for imparting relative sliding motion between said cords and said tubular member to dislodge each of the elastic rings in controlled sequence during a single insertion of the endoscope into the body organ whereby each of the elastic rings can be dislodged from the endoscope and placed in ligating relation to a lesion when lesion tissue is drawn into the tubular member by said suction means with each ring being applied to a different one of multiple lesions present in the body organ, said means for imparting relative sliding motion comprising a flexible line element threaded through the working channel of the endoscope and connecting at one end to said cords disposed within said tubular member and exiting the endoscope at the rearward end thereof whereby a pulling force may be exerted on the other end of the line element to cause sliding movement of the cords over said tubular member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

3. An endoscopic ligating instrument as set forth in claim 2 wherein each said cord on the portion thereof which overlies said rigid tubular member includes a series of shoulders at spaced intervals and against each of which a different one of said elastic rings is placed in abutting engagement and facing the distal end of said rigid tubular member and wherein each of said shoulders of a cord is in substantially co-planar relationship with a shoulder of each of the other cords.

4. An endoscopic ligating instrument as set forth in claim 2 wherein each said cord on the portion thereof which overlies said rigid tubular member includes a series of knots at spaced intervals and against each of which a different one of said elastic rings is placed in abutting engagement and facing the distal end of said rigid tubular member and wherein each of said knots of a cord is in substantially co-planar relationship with a knot of each of the other of said cords.

5. A flexible endoscopic instrument for ligating a multiplicity of lesions within a hollow body organ, such as the alimentary tract, said instrument comprising:

(a) a flexible fiber optic endoscope having a forward insertion end and a rearward end, said endoscope including means for illumination and viewing through said endoscope, means for providing a suction force at said insertion end, and a working channel;

(b) a tubular member having a forward distal end, a rearward end and a longitudinal axis, said rearward end having means for providing attachment to the insertion end of the endoscope;

(c) a plurality of string-like cords of flexible substantially inelastic material, each said cord being folded over the distal end of the tubular member with a first portion of each said cord overlaying a part of the exterior of said tubular member and a second portion thereof being disposed internally of said tubular member, said cords being oriented in angular spacing about the longitudinal axis of said tubular member;

(d) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member in coaxial relation thereto and in overlying relation to said cords, said rings being spaced from one another in the longitudinal direction of the tubular member at successively greater different distances from the distal end of the tubular member, such that the length of each cord between each pair of adjacent elastic rings is at least equal to the distance between the distal end of the tubular member and the furthest ring of said pair from said distal end; and

(e) means for imparting relative sliding motion between said cords and said tubular member to dislodge each of the elastic rings in controlled sequence during a single insertion of the endoscope into the body organ whereby each of the elastic rings can be dislodged from the endoscope and placed in ligating relation to a lesion when lesion tissue is drawn into the tubular member by said suction means with each ring being applied to a different one of multiple lesions present in the body organ, said means for imparting relative sliding motion comprising a flexible line element threaded through the working channel of the endoscope and connecting at one end to said cords disposed within said tubular member and exiting the endoscope at the rearward end thereof whereby a pulling force may be exerted on the other end of the line element to cause sliding movement of the cords over said tubular member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

6. An endoscopic ligating instrument as set forth in claim 5 wherein each said cord on the portion thereof which overlies said rigid tubular member includes a series of radially extending shoulders at spaced intervals and against each of which a different one of said elastic rings is placed in abutting engagement and facing the distal end of said rigid tubular member and wherein each of said shoulders of a cord is in substantially co-planar relationship with a shoulder of each of the other cords.

7. An endoscopic ligating instrument as set forth in claim 5 wherein each said cord on the portion thereof which overlies said rigid tubular member includes a series of knots at spaced intervals and against each of which a different one of said elastic rings is placed in abutting engagement and facing the distal end of said rigid tubular member and wherein each of said knots of a cord is in substantially co-planar relationship with a knot of each of the other of said cords.