Methods of endoscopic tubal ligation
First Claim
1. A method of endoscopic tubal ligation comprising the steps ofintroducing a distal end of an instrument assembly at an internal operative site in a patient'"'"'s body through a small size port providing communication with the internal operative site from externally thereof with a proximal end of the instrument assembly disposed externally of the operative site;
- visualizing the internal operative site with an endoscope from externally of the internal operative site;
grasping an anatomical tubular structure at the internal operative site with a grasping member of the instrument assembly disposed at the distal end;
manipulating the grasping member from externally of the internal operative site to draw the anatomical tubular structure into a loop formation through a contractible ligature loop of filamentous ligature material of the instrument assembly disposed externally of the distal end;
contracting the ligature loop around the loop formation of the anatomical tubular structure, from externally of the internal operative sites to form a ligature while the anatomical tubular structure remains grasped by the grasping member;
cutting a segment of the loop formation proximally of the ligature with a cutting member carried by the grasping member;
capturing the cut segment within the cutting member; and
withdrawing the grasping member from the patient'"'"'s body to retrieve the cut segment externally of the patient'"'"'s body.
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Abstract
A method of endoscopic tubal ligation includes the steps of introducing a distal end of an instrument assembly at an internal operative site through a small size port, visualizing the internal operative site with an endoscope from externally of the internal operative site, grasping an anatomical tubular structure at the internal operative site with a grasping member of the instrument assembly and drawing the anatomical tubular structure into a loop formation and contracting a ligature loop of filamentous ligature material of the instrument assembly around the loop formation to form a ligature without withdrawing the instrument assembly from the internal operative site.
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Citations
26 Claims
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1. A method of endoscopic tubal ligation comprising the steps of
introducing a distal end of an instrument assembly at an internal operative site in a patient'"'"'s body through a small size port providing communication with the internal operative site from externally thereof with a proximal end of the instrument assembly disposed externally of the operative site; -
visualizing the internal operative site with an endoscope from externally of the internal operative site; grasping an anatomical tubular structure at the internal operative site with a grasping member of the instrument assembly disposed at the distal end; manipulating the grasping member from externally of the internal operative site to draw the anatomical tubular structure into a loop formation through a contractible ligature loop of filamentous ligature material of the instrument assembly disposed externally of the distal end; contracting the ligature loop around the loop formation of the anatomical tubular structure, from externally of the internal operative sites to form a ligature while the anatomical tubular structure remains grasped by the grasping member; cutting a segment of the loop formation proximally of the ligature with a cutting member carried by the grasping member; capturing the cut segment within the cutting member; and withdrawing the grasping member from the patient'"'"'s body to retrieve the cut segment externally of the patient'"'"'s body.
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2. A method of endoscopic tubal ligation comprising the steps of
introducing a distal end of an instrument assembly at an internal operative site in a patient'"'"'s body through a small size port providing communication with the internal operative site from externally thereof with a proximal end of the instrument assembly disposed externally of the operative site, said step of introducing including introducing a distal end of an endoscope at the internal operative site through the same port as the instrument assembly; -
visualizing the internal operative site with the endoscope from externally of the internal operative site; grasping an anatomical tubular structure at the internal operative site with a grasping member of the instrument assembly disposed at the distal end; manipulating the grasping member from externally of the internal operative site to draw the anatomical tubular structure into a loop formation through a contractible ligature loop of filamentous ligature material of the instrument assembly disposed externally of the distal end; and contracting the ligature loop around the loop formation of the anatomical tubular structure, from externally of the internal operative site, to form a ligature without withdrawing the instrument assembly from the internal operative site.
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3. A method of endoscopic tubal ligation comprising the steps of
introducing a distal end of an instrument assembly at an internal operative site in a patient'"'"'s body through a small size port providing communication with the internal operative site from externally thereof with a proximal end of the instrument assembly disposed externally of the operative site; -
visualizing the internal operative site with an endoscope from externally of the internal operative site; grasping an anatomical tubular structure at the internal operative site with a grasping member of the instrument assembly disposed at the distal end, said step of grasping including grasping the anatomical tubular structure between a pair of grasping members disposed at the distal end of the instrument assembly; manipulating the grasping members from externally of the internal operative site to draw the anatomical tubular structure into a loop formation through a contractible ligature loop of filamentous ligature material of the instrument assembly disposed externally of the distal end; and contracting the ligature loop around the loop formation of the anatomical tubular structure, from externally of the internal operative site, to form a ligature without withdrawing the instrument assembly from the internal operative site. - View Dependent Claims (4, 5, 6, 7, 8)
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9. A method of endoscopic tubal ligation comprising the steps of
introducing a distal end of an endoscope, a distal end of a grasping instrument and a distal end of a ligating instrument at an internal operative site in a patient'"'"'s body through a single, small size port providing communication with the internal operative site from externally thereof with a proximal end of the endoscope, a proximal end of the grasping instrument and a proximal end of the ligating instrument disposed externally of the internal operative site; -
visualizing the internal operative site, from externally thereof, with the endoscope; grasping an anatomical tubular structure at the internal operative site with a grasping member at the distal end of the grasping instrument; drawing the anatomical tubular structure into a loop formation; positioning a contractible ligature loop of filamentous ligature material carried by the ligating instrument and disposed externally of the distal end of the ligating instrument around the loop formation; and contracting the ligature loop, from the proximal end of the ligating instrument, around the loop formation to form a ligature. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17)
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18. A method of endoscopic tubal ligation comprising the steps of
introducing an endoscope through a small size port in the abdominal cavity wall to position a distal end of the endoscope in the abdominal cavity and a proximal end of the endoscope externally of the abdominal cavity to provide visualization of the abdominal cavity from externally thereof; -
introducing a ligating instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a contractible ligature loop of filamentous ligature material of the ligating instrument in the abdominal cavity and a proximal end of the ligating instrument externally of the abdominal cavity; introducing a grasping instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a distal end of the grasping instrument to grasp a Fallopian tube in the abdominal cavity and a proximal end of the grasping instrument externally of the abdominal cavity; drawing the Fallopian tube into a loop formation through the ligature loop with the grasping instrument from externally of the abdominal cavity; contracting the ligature loop around the loop formation with the ligating instrument from externally of the abdominal cavity to form a ligature; cutting a segment of the loop formation proximally of the ligature with a cutting member of the grasping instrument; retrieving the cut segment externally of the patient'"'"'s body; repeating said drawing, said contracting, said cutting and said retrieving steps on the other Fallopian tube; and performing an examination on the cut segments to confirm that the cut segments were taken from the Fallopian tubes.
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19. A method of endoscopic tubal ligation comprising the steps of
introducing an endoscope through a small size port in the abdominal cavity wall to position a distal end of the endoscope in the abdominal cavity and a proximal end of the endoscope externally of the abdominal cavity to provide visualization of the abdominal cavity from externally thereof; -
introducing a ligating instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a contractible ligature loop of filamentous ligature material of the ligating instrument in the abdominal cavity and a proximal end of the ligating instrument externally of the abdominal cavity; introducing a grasping instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a distal end of the grasping instrument to grasp a Fallopian tube in the abdominal cavity and a proximal end of the grasping instrument externally of the abdominal cavity; drawing the Fallopian tube into a loop formation through the ligature loop with the grasping instrument from externally of the abdominal cavity; contracting the ligature loop around the loop formation with the ligating instrument from externally of the abdominal cavity to form a ligature; cutting a segment of the loop formation proximally of the ligature with a cutting member introduced in the abdominal cavity through a small size port; repeating said drawing, said contracting and said cutting steps on the other Fallopian tube; withdrawing the cut segments from the patient'"'"'s body; and examining the cut segments to confirm that the cut segments were taken from the Fallopian tubes. - View Dependent Claims (20, 21, 22, 23)
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24. A method of endoscopic tubal ligation comprising the steps of
introducing an endoscope through a small size port in the abdominal cavity wall to position a distal end of the endoscope in the abdominal cavity and a proximal end of the endoscope externally of the abdominal cavity to provide visualization of the abdominal cavity from externally thereof; -
introducing a ligating instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a contractible ligature loop of filamentous ligature material of the ligating instrument in the abdominal cavity and a proximal end of the ligating instrument externally of the abdominal cavity; introducing a grasping instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a distal end of the grasping instrument to grasp a Fallopian tube in the abdominal cavity and a proximal end of the grasping instrument externally of the abdominal cavity, said steps of introducing including introducing each of the endoscope, the ligating instrument and the grasping instrument through a different small size port; drawing the Fallopian tube into a loop formation through the ligature loop with the grasping instrument from externally of the abdominal cavity; contracting the ligature loop around the loop formation with the ligating instrument from externally of the abdominal cavity to form a ligature; and repeating said drawing and contracting steps on the other Fallopian tube.
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25. A method of endoscopic tubal ligation comprising the steps of
introducing an endoscope through a small size port in the abdominal cavity wall to position a distal end of the endoscope in the abdominal cavity and a proximal end of the endoscope externally of the abdominal cavity to provide visualization of the abdominal cavity from externally thereof; -
introducing a ligating instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a contractible ligature loop of filamentous ligature material of the ligating instrument in the abdominal cavity and a proximal end of the ligating instrument externally of the abdominal cavity; introducing a grasping instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a distal end of the grasping instrument to grasp a Fallopian tube in the abdominal cavity and a proximal end of the grasping instrument externally of the abdominal cavity, said steps of introducing including introducing the endoscope and the grasping instrument through a first small size port and introducing the ligating instrument through a second small size port; drawing the Fallopian tube into a loop formation through the ligature loop with the grasping instrument from externally of the abdominal cavity; contracting the ligature loop around the loop formation with the ligating instrument from externally of the abdominal cavity to form a ligature; and repeating said drawing and contracting steps on the other Fallopian tube.
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26. A method of endoscopic tubal ligation comprising the steps of
introducing an endoscope through a small size port in the abdominal cavity wall to position a distal end of the endoscope in the abdominal cavity and a proximal end of the endoscope eternally of the abdominal cavity to provide visualization of the abdominal cavity from externally thereof; -
introducing a ligating instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a contractible ligature loop of filamentous ligature material of the ligating instrument in the abdominal cavity and a proximal end of the ligating instrument externally of the abdominal cavity; introducing a grasping instrument in the abdominal cavity through a small size port in the abdominal cavity wall to position a distal end of the grasping instrument to grasp a Fallopian tube in the abdominal cavity and a proximal end of the grasping instrument eternally of the abdominal cavity, said steps of introducing including introducing the endoscope and the ligating instrument through a first small size port and introducing the grasping instrument through a second small size port; drawing the Fallopian tube into a loop formation through the ligature loop with the grasping instrument from externally of the abdominal cavity; contracting the ligature loop around the loop formation with the ligating instrument from externally of the abdominal cavity to form a ligature; and repeating said drawing and contracting steps on the other Fallopian tube.
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Specification