Endoscopic ligation
Inventors
Ewers, Richard C. • Earley, Christopher James • Bandy, Barton P. • Chen, Eugene G. • Fauser, Haio
Assignees
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Publication Number
US-10433850-B2
Publication Date
2019-10-08
Expiration Date
Abstract
A ligature delivery device includes a control member, an elongated shaft, and an end effector attached to the distal end of the elongated shaft. An activation mechanism provides an user-operable connection between the control member and the end effector. In several embodiments, the end effector includes a reverse grasping mechanism. Several embodiments of ligature devices are adapted to be deployed endoscopically and/or translumenally using the reverse-grasping delivery device.
Core Innovation
The invention relates to endoscopic/translumenal ligature delivery using a ligature device configured for deployment of ligating clips or other ligature constructs. The described delivery concept supports an approach from a distal side, including tissue capture by retracting the end effector so that the ligature construct is carried to the target tissue. A reverse-grasping end effector is used that rotates proximally to form a hook, enabling positioning and capture from the distal side.
The ligature device architecture includes a handle, an elongated shaft with a flexible sleeve, and a proximal actuation mechanism that drives an end effector using a drive rod or drive wire. The end effector includes fixed and movable arm members, with structures such as a pivot pin and jaw or clamp geometry that cooperate to retract and engage tissue. The control member and reverse grasping mechanism are configured to improve visualization during translumenal/endoscopic operation and to enable deployment of ligating clips or other ligature constructs.
Multiple ligature embodiments are described, including a finger snare ligature device with an expandable loop and interlocking features, and a ribbon/loop cinch-style ligature device with a closure sleeve. In the ribbon/loop cinch concept, a ribbon/loop assembly is slidably positioned within a closure sleeve and moves between a first position and a second position, with the loop uncompressed in the first position and compressed in the second position as a distal end of the ribbon moves substantially perpendicularly through the loop. The document also describes ligature variants employing one-way cinching and stored-energy mechanisms using torsion or elastic arm elements for deployment.
Claims Coverage
The partial claims provided include two independent claims. Across the independent claims, the inventive coverage centers on a closure sleeve with a slidably movable ribbon/loop assembly that transitions between an extended uncompressed state and a retracted compressed state, including movement of a distal ribbon end substantially perpendicularly through the loop; one independent claim further specifies a size relationship between ribbon length and loop length when compressed and straightened, with the ribbon length greater than the loop length.
Closure sleeve with slidable ribbon/loop assembly that compresses the loop
A ligature device comprising a closure sleeve and a ribbon/loop assembly slidably positioned within the closure sleeve, where the ribbon/loop assembly is movable from a first position wherein the ribbon/loop assembly is extended out of the closure sleeve, the loop is uncompressed, and the ribbon is spaced apart from the loop, to a second position wherein the ribbon/loop assembly is retracted into the closure sleeve, the loop is compressed.
Perpendicular distal ribbon passage through the loop during retraction
A ligature device wherein, in the second position, a distal end of the ribbon is moved substantially perpendicularly through the loop.
Hook-shaped ribbon with loop formed in a plane
A ligature device wherein the ribbon/loop assembly includes a loop formed in a plane, and a hook-shaped ribbon.
Ribbon length greater than compressed-and-straightened loop length
A ligature device having a ribbon with a length L1 and the loop having a length L2 when compressed and straightened, wherein L1 is greater than L2.
Together, the independent claims define a closure sleeve with a slidably movable ribbon/loop assembly that compresses an expandable or uncompressed loop upon retraction, including substantially perpendicular movement of a distal ribbon end through the loop. One independent claim additionally requires a quantitative size relationship where ribbon length (L1) is greater than loop length (L2) when compressed and straightened, and specifies a hook-shaped ribbon with the loop formed in a plane.
Stated Advantages
Not explicitly described in patent.
Documented Applications
Not explicitly described in patent.
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