Ligating apparatus

• US 5,797,928 A
• Filed: 12/29/1995
• Issued: 08/25/1998
• Est. Priority Date: 01/20/1995
• Status: Expired due to Term

• Current Assignee: Olympus Optical Corporation Limited (Olympus Corporation)
• Original Assignee: Olympus Optical Corporation Limited (Olympus Corporation)
• Inventors: Kogasaka, Takahiro
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/581,181
• Time in Patent Office: 970 Days
• Field of Search: 606/144, 606/148, 606/139
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/12009 Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
• CPC Class Codes: A61B 2017/047 having at least one proximally pointing needle located at the distal end of the instrument, e.g. for suturing trocar puncture wounds starting from inside the body J-shaped suture needles A61B2017/0608
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0477 with pre-tied 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

Abstract

A ligating apparatus comprising a ligature applying device having at a distal end a ligature holding section for holding a ligature; a ligature holding device movable relative to the ligature applying device, the ligature holding device having a through hole through which the ligature-applying device is to be moved, ligature holding mechanism for holding one end of the ligature, and a ligature retaining section for retaining the ligature; ligature winding mechanism for winding the ligature around the ligature applying device or the ligature holding device, thereby to form at least one loop to be tightened into a knot; loop releasing mechanism for releasing the loop from the ligature applying device or the ligature holding device when the ligature applying device is pulled into the through hole of the ligature holding device; and loop tightening mechanism for tightening the loop released from the ligature applying device or the ligature holding device, when the ligature applying device and the ligature holding device are moved relative to each other.

Claims

1. A ligating apparatus comprising:

a ligature applying body having a distal end with a ligature holding section thereat for holding one end of a ligature;

a ligature holder movable relative to the ligature applying body, said ligature holder including;

a through hole through which the ligature-applying body is to be moved,

ligature holding means for holding at least one part of the ligature to the ligature holder, and

a ligature retaining section for retaining the ligature and through which the through bore extends;

ligature winding means for holding the ligature in a wound relation around the ligature applying body or the ligature holder, thereby to form at least one loop to be tightened to form a knot;

loop releasing means for releasing said at least one loop from the ligature applying body or the ligature holder when the ligature applying body is pulled into the through hole of the ligature holder; and

loop tightening means as part of the ligature holding section of the ligature applying body for tightening said at least one loop released from the ligature applying body or the ligature holder, when the ligature applying body and the ligature holder are moved relative to each other.

2. The apparatus according to claim 1, wherein said ligature winding means is a ligature holding member which is removably connected to said ligature holder, which has an outer surface for holding said at least one loop, and from which said at least one loop is to be transferred onto said ligature applying body.

3. The apparatus according to claim 1, wherein said loop releasing means has a surface which is located at a distal end of said through hole and on which said at least one loop abuts until said at least one loop is released from the ligature applying body as said ligature holding section holding said one end of the ligature is pulled into said ligature holder.

4. The apparatus according to claim 1, wherein said ligature applying body passes through said ligature holder and is capable of moving back and forth.

5. The apparatus according to claim 1, wherein said ligature winding means includes a helical groove made in an outer surface of said ligature retaining section and is capable of retaining said at least one loop.

6. The apparatus according to claim 5, wherein said loop releasing means has rotating means for rotating said ligature retaining section, thereby to release said at least one loop first from said helical groove and ultimately from said ligature retaining section.

7. The apparatus according to claim 6, wherein said rotating means has a pin provided on one of said ligature applying body and said ligature holder, and a cam groove formed in the other of said ligature applying body and said ligature holder, for guiding said pin to rotate said ligature retaining section as said ligature applying body is pulled into said ligature holder.

8. The apparatus according to claim 7, further comprising operation means for moving said ligature holder back and forth with respect to the ligature applying body, thereby to move said pin along said cam groove.

9. The apparatus according to claim 6, wherein said rotating means comprises a driving gear and a driven gear provided on said ligature retaining section and set in mesh with said driving gear, and rotates said ligature retaining section by transmitting a rotation of said driving gear to said driven gear.

10. The apparatus according to claim 6, further comprising rotation inhibiting means for inhibiting said at least one loop retained in said helical groove from rotating.

11. The apparatus according to claim 10, wherein said rotating means moves forward said at least one loop along said helical groove while said rotating inhibiting means is inhibiting said at least one loop retained in said helical groove from rotating.

12. The apparatus according to claim 11, wherein said ligature holding means is moved forward along said helical groove, together with said at least one loop.

13. The apparatus according to claim 12, further comprising means for preventing said ligature holding means from slipping from said helical groove while said ligature holding means is moving along said helical groove.

14. The apparatus according to claim 6, further comprising a protective cover protecting said ligature holder.

15. The apparatus according to claim 14, wherein said protective cover has a notch, and that portion of said at least one loop which remains on said ligature holder can be seen through the notch.

16. The apparatus according to claim 14, wherein said protective cover is made of transparent material, and that portion of said at least one loop which remains on said ligature holder can be seen through said protective cover.

17. The apparatus according to claim 1, wherein said ligature applying body and said ligature holder are removably connected to each other.

18. The apparatus according to claim 1, wherein said ligature holder comprises a hollow cylindrical cartridge and a sheath removably connected to the cartridge, said cartridge having said ligature holding means and said ligature retaining section.

19. The apparatus according to claim 1, wherein a needle is connected to the other end of the ligature.

20. The apparatus according to claim 1, wherein said ligature applying body passes through said ligature holder and is sealed therefrom in airtight fashion.

21. The apparatus according to claim 1, wherein said ligature holding means is a ligature guiding hole made in said ligature holder having a diameter larger than a diameter of the ligature and smaller than an outer diameter of a tag formed on the ligature.

22. The apparatus according to claim 1, wherein said ligature holding means fastens the ligature to said ligature holder.

23. The apparatus according to claim 1, wherein said ligature holder has ligature catching means for preliminarily holding the other end of the ligature.

24. The apparatus according to claim 23, wherein the other end of the ligature held by the ligature catching means hangs almost vertically from the ligature holder toward an axis of said ligature holder.

25. The apparatus according to claim 24, wherein said ligature catching means is spaced apart from the axis of said ligature holder by a predetermined distance.

26. The apparatus according to claim 1, wherein said ligature holder has a knot holding groove located at a distal end of said through hole, for holding a knot formed by tightening said at least one loop.

27. The apparatus according to claim 1, wherein said loop releasing means has a loop releasing member, each for releasing loops of the ligature, one by one.

28. The apparatus according to claim 27, wherein said loop releasing means comprises a helical groove made in an outer surface of said ligature retaining section, for retaining the loops of the ligature, and rotating means for rotating said ligature retaining section, thereby to release the loops of the ligature from said helical groove and ultimately from said ligature retaining section.

29. The apparatus according to claim 1, wherein said ligature winding means has loop retaining means for retaining a plurality of loops of the ligature one by one on said ligature applying body or said ligature holder.

30. The apparatus according to claim 29, wherein said loop retaining means includes a helical groove made in an outer surface of said ligature retaining section, for retaining said plurality of loops.

31. The apparatus according to claim 29, wherein said loop retaining means comprises a plurality of walls provided on said ligature holder, for separating said plurality of loops from one another.

32. The apparatus according to claim 1, wherein said ligature applying body extends from a distal end of said ligature holder for a distance longer than a length of that portion of the ligature which form said at least one loop.

33. The apparatus according to claim 1, wherein said ligature holder has a blade for cutting the ligature.

34. The apparatus according to claim 1, wherein said loop tightening means includes a projection of said ligature applying body protruding from said ligature holder.

35. The apparatus according to claim 1, wherein said ligature holding means winds a plurality of loops of the ligature around said ligature applying body or said ligature holder, said loops being connected one to another.

36. A ligating apparatus comprising:

a single ligature forming groups of loops, each group comprising a plurality of loops which are to be tightened to form knots;

ligature holding means for holding at least one part of the ligature and the groups of loops, thereby holding said ligature; and

loop releasing means for releasing the loops of said groups, one by one, from the ligature holding means while retaining the ligature extending from a released loop by the ligature holding means, whereby a first loop is released and tightened before a second loop is released from the ligature holding means.

37. The apparatus according to claim 36, wherein said ligature holding means has a ligature applying body passing through said groups of loops and having at a distal end a ligature holding section for holding a free end of the ligature.

38. The apparatus according to claim 37, wherein said ligature holding means has a tubular body which has ligature fastening means for fastening at least one part of the ligature, and said ligature applying body passes through said tubular body and is capable of projecting from and receding into a distal end of said tubular body, for holding the groups of loops.

39. The apparatus according to claim 38, wherein said loop releasing means has separating means provided on said tubular body, for separating the loops on said ligature applying body, from one another, and for releasing the loops, one by one, while cooperating with said ligature applying body moving forward or backward with respect to said tubular body.

40. The apparatus according to claim 37, wherein said ligature holding means has a tubular ligature holder for holding the groups of loops, the tubular ligature holder having a ligature holding section for holding at least one part of the ligature, and said ligature applying body passes through said ligature holder and is capable of projecting from and receding into a distal end of said ligature holder.

41. The apparatus according to claim 40, wherein said loop releasing means releases the loops held on said ligature holder one by one when said ligature applying body is pulled in to said ligature holder.

42. The apparatus according to claim 40, wherein ligature holding section winds the loops around said ligature holder.

50. A ligating apparatus according to claim 37, further comprising tightening means for tightening the knots.

43. A ligating apparatus comprising:

a single ligature forming groups of loops, each group comprising a plurality of loops which are to be tightened to form knots;

ligature holding means for holding at least one part of the ligature and the groups of loops, thereby holding said ligature; and

loop holding means for holding the loops of said groups on the ligature holding means, such that the loops are releasable from the ligature holding means one by one, said loop holding means retaining non-released loops on the ligature holding means, and retaining the ligature extending from a released loop on the ligature holding means, whereby a first loop is released and tightened before a second loop is released from the ligature holding means.

44. The apparatus according to claim 43, wherein said ligature holding means comprises a tubular body which has a ligature holding section for holding at least one part of the ligature, and a ligature applying body which passes through said tubular body, which is capable of projecting from and receding into a distal end of said tubular body, for holding the groups of loops and which has at a distal end a ligature holding section for holding a free end of the ligature.

45. The apparatus according to claim 43, wherein said ligature holding means has a tubular ligature holder for holding the group of loops, the tubular ligature holding having a ligature holding section for holding at least one part of the ligature, and said loop holding means comprises a helical groove made in an outer surface of said ligature holder, for retaining the loops.

46. The apparatus according to claim 43, further comprising loop releasing means for releasing the loops, one by one, from said ligature holding means.

47. The apparatus according to claim 43, wherein said ligature holding section winds the loops around said ligature holder.

48. A ligating apparatus comprising:

a single ligature forming groups of loops, each group comprising a plurality of loops which are to be tightened to form a plurality of continuous knots;

ligature holding means for holding the groups of loops of the ligature, thereby holding said ligature; and

loop releasing means for releasing the loops of each group, one by one, from the ligature holding means; and

loop tightening means for pulling a free end of said ligature through a loop released from said loop holding means, and then tightening said released loop prior to releasing another said loop.

49. A ligating apparatus comprising:

a ligature forming groups of loops, each group comprising a plurality of loops which are to be tightened to form a plurality of continuous knots;

ligature holding means for holding the groups of loops of the ligature, thereby holding said ligature; and

loop holding means for holding the loops of each group, so as to be releasable one by one, from the ligature holding means.