Endoscopic ligating apparatus

• US 6,685,713 B1
• Filed: 11/21/2000
• Issued: 02/03/2004
• Est. Priority Date: 02/22/1993
• Status: Expired due to Term

• Current Assignee: Dabegran Technologies Incorporated
• Original Assignee: Dabegran Technologies Incorporated
• Inventors: Ahmed, Munir
• Primary Examiner(s): Bui, Vy Q.
• Application Number:
  US09/718,136
• Time in Patent Office: 1,169 Days
• Field of Search: 606/139, 606/140, 606/135, 606/141, 606/165, 606/144, 606/148, 606/106, 606/110, 606/111, 606/112, 606/113
• 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 ligating apparatus is provided that can be used to dispense multiple ligating bands or rings about several lesions. In one embodiment, a barrel supporting a plurality of bands stretched around its circumference is removably engaged to the insertion end of an endoscope. A trip wire extends through a working channel of the endoscope and includes a plurality of strands extending from the distal end of the barrel and wrapped around the end of the barrel. The ligating bands are situated over the strands, while the strands are provided with beads disposed adjacent the bands. As tension is applied to the trip wire by way of an activating mechanism, the strands retract within the barrel so that the beads draw the ligating bands successively to the end of the barrel.

Claims

1. A flexible endoscopic instrument for multiple ligation, said instrument comprising:

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

(b) a hollow support member having a forward distal end and a rearward portion, said rearward portion being connectable to the insertion portion of the endoscope;

(c) at least two string-like cords of flexible substantially inelastic material, each of said cords having a first portion overlaying a part of the exterior of said support member and a second portion disposed internally of said support member; and

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

wherein a pulling force may be exerted on each of said cords to cause movement of each of said cords relative to said support member to dislodge one or more of said rings in controlled sequence from said support member, each of said cords being arranged in slack condition between each pair of adjacent elastic rings.

2. The apparatus of claim 1, further comprising a flexible line element extending into the working channel of the endoscope and connecting to each of said cords for transmitting pulling force to each said cord.

3. A method, comprising:

providing a ligation apparatus including (1) a hollow support member having a forward distal end and a rearward portion, (2) at least two string-like cords of flexible substantially inelastic material, each of said cords having a first portion overlaying a part of the exterior of said support member and a second portion disposed internally of said support member, and (3) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member and each of said rings being in overlying contacting relation to each of said cords, each of said cords being arranged in slack condition between each pair of adjacent elastic rings;

connecting said rearward portion of said support member to the forward insertion end of an endoscope;

inserting said insertion end into a body organ and adjacent tissue to be ligated;

drawing said tissue within said support member; and

exerting a pulling force on each of said cords, wherein said pulling force dislodges one of said band from said support member to ligate said tissue.

4. The method of claim 3, further comprising:

moving said insertion end to a position adjacent a second tissue to be ligated;

drawing said second tissue within said tubular member; and

exerting a pulling force on each of said cords, wherein said pulling force dislodges another of said bands from said tubular member such that it ligates said second tissue.

5. A flexible endoscopic instrument for multiple ligation, said instrument comprising:

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

(b) a hollow support member having a forward distal end and a rearward portion, said rearward portion being connectable to the insertion portion of the endoscope;

(c) at least two string-like cords of flexible substantially inelastic material, each of said cords having a first portion overlaying a part of the exterior of said support member and a second portion disposed internally of said support member; and

(d) a plurality of elastic ligating rings removably mounted in stretched condition on said support member and each of said rings being in contacting relation to each of said cords, said rings being spaced from one another along said support member at successively greater different distances from said distal end of said support member;

wherein a pulling force may be exerted on each of said cords to cause movement of each of said cords relative to said support member to dislodge one or more of said rings in controlled sequence from said support member, each of said cords being arranged in slack condition between each pair of adjacent elastic rings.

6. The apparatus of claim 5, further comprising a flexible line element extending into the working channel of the endoscope and connecting to each of said cords for transmitting pulling force to each of said cords.

7. A flexible endoscopic instrument for multiple ligation, said instrument comprising:

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

(b) a hollow support member having a forward distal end and a rearward portion, said rearward portion being connectable to the insertion portion of the endoscope;

(c) at least one string-like cord of flexible substantially inelastic material, each said cord having a first portion overlaying a part of the exterior of said support member and a second portion disposed internally of said support member; and

(d) a plurality of elastic ligating rings removably mounted in stretched condition on said support member and each of said rings being in overlying contacting relation to each said cord, said rings being spaced from one another along said support member at successively greater different distances from said distal end of said support member;

wherein a pulling force may be exerted on each said cord to cause movement of each said cord relative to said support member to dislodge one or more of said rings in controlled sequence from said support member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

8. The apparatus of claim 7, further comprising a flexible line element extending into the working channel of the endoscope and connecting to each said cord for transmitting pulling force to each said cord.

9. A method, comprising:

providing a ligation apparatus including (1) a hollow support member having a forward distal end and a rearward portion, (2) at least one string-like cord of flexible substantially inelastic material, each said cord having a first portion overlaying a part of the exterior of said support member and a second portion disposed internally of said support member, and (3) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member and each of said rings being in overlying contacting relation to each said cord, each said cord being arranged in slack condition between each pair of adjacent elastic rings;

connecting said rearward portion of said support member to the forward insertion end of an endoscope;

inserting said insertion end into a body organ and adjacent tissue to be ligated;

drawing said tissue within said support member; and

exerting a pulling force on each said cord, wherein said pulling force dislodges one of said bands from said support member to ligate said tissue.

10. The method of claim 9, further comprising:

moving said insertion end to a position adjacent a second tissue to be ligated;

drawing said second tissue within said tubular member; and

exerting a pulling force on each said cord, wherein said pulling force dislodges another of said bands from said tubular member such that it ligates said second tissue.

11. A flexible endoscopic instrument for multiple ligation, said instrument comprising:

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

(b) a hollow support member having a forward distal end and a rearward portion, said rearward portion being connectable to the insertion portion of the endoscope;

(c) at least one string-like cord of flexible substantially inelastic material, each said cord having a first portion overlaying a part of the exterior of said support member and a second portion disposed internally of said support member; and

(d) a plurality of elastic ligating rings removably mounted in stretched condition on said support member and each of said rings being in contacting relation to each said cord, said rings being spaced from one another along said support member at successively greater different distances from said distal end of said support member;

wherein a pulling force may be exerted on each said cord to cause movement of each said cord relative to said support member to dislodge one or more of said rings in controlled sequence from said support member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

12. The apparatus of claim 11, further comprising a flexible line element extending into the working channel of the endoscope and connecting to each said cord for transmitting pulling force to each said cord.