Surgical loop delivery device

• US 6,152,936 A
• Filed: 02/02/1999
• Issued: 11/28/2000
• Est. Priority Date: 09/23/1996
• Status: Expired due to Term

• Current Assignee: WW7 LLC
• Original Assignee: ESD Medical, LLC
• Inventors: Christy, William J., Christy, James R., Williamson, Warren P. IV, Berky, Craig
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US09/241,394
• Time in Patent Office: 665 Days
• Field of Search: 606/139, 606/144, 606/181, 606/147, 606/167, 606/170, 606/140
• US Class Current: 606/148
• 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 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/303 with four or more legs

Abstract

A surgical loop delivery device is disclosed in parent disclosures Ser. No. 09/071,811 and U.S. Pat. No. 5,766,217. This device is improved to permit tissue targets larger than the device to be ligated while also maintaining a clear sight path between the surgeon and the target. The surgical loop is also stable during the procedure.

Claims

1. A device for ligating anatomical tissue comprising:

a main body having an outer dimension;

a suture loop holding means on said main body for holding a suture loop during a process of ligating an anatomical tissue target and including means for expanding said suture loop from one configuration having a first size to a second configuration having a second size which is larger than the outer dimension of said main body and further including cutting means for cutting a suture adjacent to said suture loop; and

suture loop tightening means connected to said suture loop holding means for tightening the suture loop into a garroting configuration about the anatomical tissue target.

2. The device defined in claim 1 wherein said second size is at least twice the size of said outer dimension.

3. The device defined in claim 2 wherein said cutting means further includes an elastic element connected to the suture, said elastic element changing length when the suture loop is associated with one size tissue target as opposed to another different size of tissue target.

4. The device defined in claim 1 wherein said suture loop holding means includes a sight line forming means between an operator and the tissue target for viewing the tissue target from proximal of said suture loop.

5. The device defined in claim 1 wherein said suture loop holding means includes means for moving said suture loop holding means to a location outside the outer dimension of said main body.

6. The device defined in claim 5 wherein said cutting means further includes a pulley around which said suture is wound.

7. The device defined in claim 5 wherein each loop engaging element includes a means for releasably holding the suture loop.

8. The device defined in claim 1 wherein said means for expanding said suture loop includes a plurality of fingers at least one of which includes a cam near one end thereof and a loop engaging element near another end thereof, and further including a living hinge.

9. The device defined in claim 8 wherein said cutting means includes a means for mounting said cutting element on a finger element.

10. The device defined in claim 8 further including a suture retaining tab adjacent to at least one finger.

11. The device defined in claim 1 wherein said suture loop holding means is a replaceable cartridge.

12. The device defined in claim 1 wherein said cutting means includes a body which is rotatably mounted on said main body, the suture being connected to said rotatably mounted body to be wound up on said rotatably body.

13. The device defined in claim 1 wherein said suture loop holding means includes castellations around which said suture loop is accommodated.

14. The device defined in claim 1 wherein said suture loop holding means includes break-away tabs around which said suture loop is accommodated.

15. The device defined in claim 1 further including a suture tail and wherein said suture loop includes a running element slidably connecting said suture loop to said tail, and said cutting means includes a means for accommodating said running element.

16. The device defined in claim 15 wherein said running element is a slip knot.

17. The device defined in claim 15 wherein said running element includes a body having a tortuous path defined therethrough through which said suture tail passes.

18. A device for ligating anatomical tissue comprising:

A) a main body;

B) an expanding member connected to said main body;

C) an actuating member on said main body;

D) ligature supporting structure of a first size mounted on said main body;

E) a length of pre-knotted suture material mounted on said ligature supporting structure and having a slip knot, a tail and a loop;

F) releasable suture mounting elements on said supporting structure;

G) a suture loop formed from said length of pre-knotted suture material and being releasably retained in at least one of said releasable suture mounting elements; and

H) a ligature supporting structure on said main body and having means for moving said ligature support structure from said first size to a second size when actuated by said expanding member with said second size being larger than said first size.

19. A device for ligating anatomical tissue comprising:

a main body having an outer dimension;

a suture loop managing means on said main body for holding and controlling a suture loop during a process of ligating an anatomical tissue target and including means for moving said suture loop between a first configuration having a first size and a second configuration having a second size with one of said first and second sizes being larger than the outer dimension of said main body and further including cutting means on said holding means for cutting a suture adjacent to said suture loop; and

suture loop tightening means on said suture loop managing means for tightening the suture loop into a garroting configuration about the anatomical tissue target.

20. The device defined in claim 19 wherein said suture loop encircles said main body when in one of said first and second configurations.

21. The device defined in claim 20 wherein said suture loop slidably rests on said main body when in one of said first and second configurations.

22. The device defined in claim 19 wherein said suture loop managing means includes a plurality of fingers each finger including an end attached to said main body and a section to which said suture loop is attached, said fingers having means connected thereto for moving the sections between said first and second configurations.

23. The device defined in claim 22 wherein the means for moving the fingers includes a cam lobe on each finger located to be engaged by a tissue grasper as the tissue grasper is being positioned to grasp the tissue target.

24. The device defined in claim 22 wherein the means for moving said fingers includes a ring slidably mounted on said main body and elements connecting said ring to said fingers.

25. The device defined in claim 19 wherein said suture loop tightening means includes means for controlling tension on said suture loop.

26. The device defined in claim 25 wherein the means for controlling tension on said suture loop includes a tension coupler having a drive bar connected thereto at one end and a suture drive bar connected thereto at a second end and a spring-like element connecting the first and second ends together.

27. The device defined in claim 26 further including a suture ail and wherein said suture tail is fixed at one end thereof and said suture drive bar engages said suture tail.

28. The device defined in claim 27 wherein the means for controlling tension on said suture loop further includes means on one of said first and second ends abuttingly engaging the other of said first and second ends when a pre-set amount of tension has been established on said suture loop.

29. A method for ligating anatomical tissue comprising:

providing a body;

providing a suture loop on the body, the suture loop including a tail;

providing a suture loop manager on said body;

providing a tissue manipulator connected to the body;

moving the loop manager and the tissue manipulator relative to each other and encircling the suture loop about tissue to be ligated;

tightening the suture loop around the tissue to be ligated; and

cutting the tail from the tightened suture loop.

30. The method defined in claim 29 further including a step of enlarging the suture loop to a size larger than the outer dimension of the body.

31. The method defined in claim 30 further including a step of using the tissue manipulator to enlarge the suture loop.

32. The method defined in claim 29 further including a step of establishing a pre-set amount of tension on the suture loop before cutting the tail from the tightened suture loop.

33. The method defined in claim 29 further including a step of establishing a sight line between an operator and the tissue.

34. The method defined in claim 29 further including a step of releasing the suture loop from the loop manager during the step of tightening the suture loop.

35. The method defined in claim 29 further including a step of controlling the tail while the loop manager is being moved.