Endoscopic ligating instrument

• US 5,624,453 A
• Filed: 10/30/1995
• Issued: 04/29/1997
• Est. Priority Date: 02/23/1993
• Status: Expired due to Term

• Current Assignee: Dabegran Technologies Incorporated
• Original Assignee: Wilson-Cook Medical Incorporated (Cook Group Incorporated)
• Inventors: Ahmed, Munir
• Primary Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/550,531
• Time in Patent Office: 547 Days
• Field of Search: 606/139, 606/140, 606/141, 606/135, 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

A flexible endoscopic instrument is provided with a plurality of elastic ligating rings mounted on one tube of a pair of tubular members which are affixed in coaxial relation to the insertion end of an endoscope. The rings are adapted to be dislodged therefrom in sequence at selectively controlled times for treating multiple lesions during a single insertion of the endoscope into a body organ. The endoscope is equipped with illumination and viewing [means] apparatus to facilitate orientation of the instrument in the body organ, and longitudinally extending tubular passages comprising a channel through which objects may be passed and suction applied for drawing the lesion tissue into the tubular end of the endoscope to facilitate ligation of a lesion, and a working channel through which a flexible actuating cable is inserted. The cable is connected to one of the tubular members and serves to [as a means for] impart[ing] relative motion between the pair of tubular members to sequentially dislodge the elastic rings from the endoscope at controlled times. 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 innermost of the tubular members by a suction force applied through the suction channel and each of the rings can be applied to a different one of the multiple lesions in the body organ during a single insertion of the endoscope.

Claims

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

(a) 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 endoscopic instrument;

(b) 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;

(c) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member in coaxial relation thereto, 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, wherein each of the plurality of cords is wound around each of the plurality of ligating rings in a first direction and in a second, opposite direction.

2. The attachment of claim 1, wherein each of the plurality of cords is wound around each of the plurality of ligating rings in the first direction for a first cord length substantially equal to the distance between the distal end of tubular member and the ligating ring, and in the second, opposite direction for a second cord length substantially equal to the distance between the distal end of the tubular member and the ligating ring.

3. 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, 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, wherein each of the plurality of cords is wound around each of the plurality of ligating rings in a first direction and in a second, opposite direction; 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 rolling movement of the cords over said tubular member.

4. The flexible endoscopic instrument of claim 3, wherein each of the plurality of cords is wound around each of the plurality of ligating tings in the first direction for a first cord length substantially equal to the distance between the distal end of tubular member and the ligating ring, and in the second, opposite direction for a second cord length substantially equal to the distance between the distal end of the tubular member and the ligating ring.

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 endoscope having a forward insertion end and a rearward end, said endoscope including 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, 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, wherein each of the plurality of cords is wound around each of the plurality of ligating rings in a first direction and in a second, opposite direction; and

(e) an activating mechanism 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.

6. The flexible endoscopic instrument of claim 5, wherein each of the plurality of cords is wound around each of the plurality of ligating rings in the first direction for a first cord length substantially equal to the distance between the distal end of tubular member and the ligating ring, and in the second, opposite direction for a second cord length substantially equal to the distance between the distal end of the tubular member and the ligating ring.