1. Field of the Invention
The present invention relates to a treatment system for living tissues, which is designed for use in combination with an endoscope and another type of an instrument to perform an endoscopic treatment such as suture and ligation on the living tissues in the body.
2. Description of the Related Art
U.S. Patent Application Publication No. 2003/0236535A1 (hereinafter referred to as “publication”) discloses a ligation apparatus for use in endoscopic treatment, i.e., the apparatus that a surgeon uses to suture or ligate the living tissues in the body while observing the tissues through an endoscope. The apparatus disclosed in the publication enables the surgeon to suture or ligate the tissues by passing the ligature attached to a holding member, through the tissues. To release the tissues from the sutured or ligated state, the surgeon cuts the ligature, or grasps and removes the holding member from the tissues. The tissues may not be sutured or ligated at desired parts. In this case, the surgeon cuts the ligature to release the tissues from the sutured or ligated state. To cut the ligature the surgeon uses, for example, surgical scissors, while observing the tissues through an endoscope. Otherwise, the surgeon may grasp the holding member with a grasping forceps or the like and then remove the holding member from the tissues, while observing the tissues through the endoscope.
According to an aspect of this invention, there is provided a medical treatment device includes a ligating member, a stopper and a ligation releasing member. The ligating member has a distal end portion and a proximal end portion, that ligates biological tissue. The stopper is provided to be movable forward or backward with respect to the ligating member, and stoppable by friction on the ligating member to maintain the biological tissue in a ligated state by the ligating member. The ligation releasing member is provided on the ligating member to release the ligation state between the ligating member and the stopper by moving the ligating member to the distal end side with respect to the stopper.
Advantages of the invention will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. Advantages of the invention may be realized and obtained by means of the instrumentalities and combinations particularly pointed out hereinafter.
The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate embodiments of the invention, and together with the general description given above and the detailed description of the embodiments given below, serve to explain the principles of the invention.
Preferred embodiments of the invention will be described, with reference to the accompanying drawings.
First, the first embodiment will be described with reference to FIGS. 1 to 7.
The treatment system 10 for living tissues, shown in
As
The ligature 22 is provided in the form of a loop. Therefore, its two end portions pass through the silicone tube 26. The silicone tube 26 is held, by virtue of a frictional force, on any desired part of the ligature 22. The tube 26 can be moved when a force greater than a prescribed value is applied along the ligature 22. Thus, the silicone tube 26 performs the function of a stopper that holds the ligature 22 at a desired position with respect to the tissue that is to be treated.
The flexible wire 30 is connected to the ligature 22, at a position close to the distal end of the ligature 22 and deviated from the axis X of the lumen into which the ligature 22 should be inserted. One flexible wire is used in this embodiment. Nonetheless, two, three or more flexible wires may be connected to the ligature 22. It is desirable to connect one or two flexible wires to the ligature 22. If too many flexible wires are connected to the ligature 22, they may entangle while the ligation apparatus 12 remains in the body. The flexible wire 30 may be replaced by a member of a different shape, such as a band.
The flexible wire 30 can be made of any material that is flexible and strong enough to withstand a pulling force applied to release the tissue from a ligated state. It may be made of the same material as suture thread, e.g., drawn polyamide synthetic fiber, polypropylene, polyethyleneterephthalate, polytetrafluoroethylene. Alternatively, it may be made of bioabsorbable material such as polyglycolic acid. The wire may be either a monofilament one or a twisted thread. The flexible wire 30 is colored not similar to the living tissues, not white, red or yellow, and different in color from the ligature 22. Hence, the surgeon can well distinguish the wire 30 when he or she sees it through the endoscope.
As
How this embodiment is operated will be explained. Note that the embodiment is endoscopically operated, though the operation may not be explained without referring to the endoscope used. Here, it will be described how the embodiment is manipulated to ligate the tissue 60 to be treated and to release the tissue 60 from the ligated state. First, it will be described how to ligate the tissue 60.
As shown in
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It will be explained how the tissue 60 is released from the ligated state.
As
As is illustrated in
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The embodiment described above is advantageous in the following respects.
To release the tissue 60 from the ligated state, the flexible wire 30 is held with the grasping forceps 48. It is easier for the surgeon to hold the flexible wire 30 than to hold the ligature 22 directly, while observing the tissue through the endoscope 50. This prevents any damage to the tissue 60. Further, the surgeon would not fail to hold the flexible wire 30 with the grasping forceps 48, because the flexible wire 30 has a loop 31 at the distal end.
Once the flexible wire 30 has been held with the grasping forceps 48, the ligature 22 can be removed from the tissue 60 and pulled from the silicone tube 26, in whichever direction the flexible wire 30 is pulled.
The second embodiment of the invention will be described, with reference to
As can be seen from
When the apparatus 12a is used, it performs the same operation as the first embodiment and can achieve the same result as the first embodiment. In addition, the flexible wire 30 can be easily held with, for example, a grasping forceps 48, because the flexible wire 30 has a looped part 32. Thanks to the looped part 32, the grasping forceps 48 can hold the flexible wire 30 at two parts. Hence, the flexible wire 30 can be pulled by using the grasping forceps 48, with a greater force than when the forceps 48 holds the wire 30 at only one part (see
The third embodiment will be described, with reference to
As can be seen from
A distal pledget 54 is arranged near the distal end of the looped ligature 22 and positioned symmetrical with respect to the axis X of the lumen of the silicone tube 26 (see
A proximal pledget 56 is provided between the distal pledget 54 and the silicone tube 26 and located near the silicone tube 26. The proximal pledget 56 has a hole made in the center part. Two parts of the looped ligature 22 pass through this hole. Hence, the tissue 60 can be ligated, while being held between the distal pledget 54 and the proximal pledget 56.
When the apparatus 12b is used, it performs the same operation as the first embodiment and can achieve the same result as the first embodiment. In addition, the flexible wire 30 can be prevented from contacting the tissue 60 when the tissue 60 is ligated, because the distal pledget 54 contacts the tissue 60 at a large area. Thus, the flexible wire 30 can be easily grasped with the grasping forceps 48 in order to remove the ligature 22 from the tissue 60 that has been ligated by using the ligation apparatus 12b.
Once the tissue 60 has been ligated, the distal pledget 54 contacts the tissue 60 at a large area. This reliably prevents the ligature 22 from being embedded in the tissue 22. Further, the proximal pledget 56 contacts the tissue 60 at a large area once the tissue 60 has been ligated. This also reliably prevents the ligature 22 from being embedded in the tissue 22.
The fourth embodiment will be described, with reference to
As can be understood from
When this apparatus 12c is used, it performs the same operation as the third embodiment and can achieve the same result as the third embodiment. In addition, the flexible wire 30 can be easily held with, for example, a grasping forceps 48, because the flexible wire 30 has a looped part 32. Thanks to the looped part 32, the grasping forceps 48 can hold the flexible wire 30 at two parts. Hence, the flexible wire 30 can be pulled by using the grasping forceps 48, with a greater force than when the forceps 48 holds the wire 30 at only one part (see
Moreover, that part of the flexible wire 30, which is connected to the distal pledget 54, would not interfere with the distal pledget 54 when the tissue 60 is ligated. The tissue 60 can therefore be ligated more reliably.
The fifth embodiment will be described, with reference to
As can be seen from
When this apparatus 12d is used, it performs the same operation as the fourth embodiment and can achieve the same result as the fourth embodiment. In addition, the flexible wire 30 is so shaped not to occupy much space, when the apparatus 12d is endoscopically left in a body cavity. This prevents the flexible wire 30 from entangling with the food being swallowed, the endoscope 50 being removed, or the grasping forceps 48 being removed.
The sixth embodiment will be described, with reference to FIGS. 12 to 14. The embodiment is a modification of the first embodiment. The components identical to those of the first embodiment are designated at the same reference numerals and will not be described in detail.
As can be seen from
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A ligature 22 passes through the ligature-guiding lumen 72. The ligature-guiding lumen 72 has an inside diameter large, allowing the ligature 22 to slide smoothly.
A plug 76 has been pushed into the plug-receiving lumen 74. The plug-receiving lumen 74 has an inside diameter small than the diameter of the plug 76. Nonetheless, the plug 76 can be inserted into the plug-receiving lumen 74. To the proximal end of the plug 76 there is connected to a flexible wire 30 that has a looped part 32.
How the embodiment is operated will be explained. First, it will be described how the embodiment ligates tissue 60 to be treated. The ligation apparatus 12e shown in
As illustrated in
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It will be explained how the tissue 60 is released from the ligated state.
To release the tissue 60 from the ligated state, the endoscope 50 (see
The embodiment described above is advantageous in some respects. When this apparatus 12e is used, it performs the same operation as the first embodiment and can achieve the same result as the first embodiment. In addition, the looped part of the ligature 22 can easily expand because the ligature 22 smoothly moves in the ligature-guiding lumen 72. Because of this, it is easy to release the tissue 60 from the ligated state.
While the tissue 60 is being released from the ligated state, no tension is applied on the ligature 22 or the silicone tube 26. The ligature 22 can be removed from the tissue 60, not influencing the tissue 60 at all.
The seventh embodiment will be described, with reference to FIGS. 15 to 17. The embodiment is a modification of the first embodiment. The components identical to those of the first embodiment are designated at the same reference numerals and will not be described in detail.
As
As FIGS. 15 to 17 depict, the silicone tube 26b according to the embodiment has a slit 80 that extends at right angles to the axis X (see
How the embodiment is operated will be explained. To ligate the tissue 60 to be treated, it is operated in the same manner as the first embodiment. Therefore, it will be described how the embodiment is operated to release the tissue 60 from the ligated state.
To release the tissue 60 from the ligated state, the endoscope 50 is used, which has a channel 50a that can guide a grasping forceps 48. As shown in
When the flexible wire 30 is further pulled, the silicone tube 26b splits into two parts as illustrated in
The embodiment described above is advantageous in some respects. When the apparatus 12f is used, it performs the same operation as the first embodiment and can achieve the same result as the first embodiment. In addition, the silicone tube 26b can slits into two parts along the axis X of the lumen to release the tissue 60 from the ligated state, when the flexible wire 30 is held with the grasping forceps 48 and pulled toward its proximal end. Thus, the tissue 60 can easily be released from the ligated state. Even if the ligature 22 hardly slides on the silicone tube 26b and the friction between the ligature 22 and the tube 26b is high, the ligature 22 that was held by the silicone tube 26b can easily be removed from the tissue 60.
The eighth embodiment will be described, with reference to FIGS. 18 to 19. The embodiment is a modification of the first embodiment. The components identical to those of the first embodiment are designated at the same reference numerals and will not be described in detail.
As seen from
How the embodiment is operated will be explained. To ligate the tissue 60 to be treated, it is operated in the same manner as the first embodiment. Therefore, it will be described how the embodiment is operated to release the tissue 60 from the ligated state.
To release the tissue 60 from the ligated state, the endoscope 50 is used as shown in
The embodiment described above is advantageous in some respects. When the apparatus 12g is used, it performs the same operation as the first embodiment and can achieve the same result as the first embodiment. In addition, the silicone tubes 82, 84 and 86 can be removed, one by one, from the ligature 22, to release the tissue 60 from the ligated state. Hence, a small grasping force suffices to hold one silicone tube in the process of removing the tube from the ligature 22. The surgeon would not fail to hold each silicone tube with the grasping forceps 48 and can therefore easily release the tissue 60 from the ligated state.
After the tissue 60 has been ligated, one, two or three tubes that constitute the silicone tube 26c may be removed. Thus, the ligating force applied to the tissue 60 can be adjusted.
Additional advantages and modifications will readily occur to those skilled in the art. Therefore, the invention in its broader aspects is not limited td the specific details and representative embodiments shown and described herein. Accordingly, various modifications may be made without departing from the spirit or scope of the general inventive concept as defined by the appended claims and their equivalents.
This application claims the benefit of U.S. Provisional Application No. 60/572,968, filed May 20, 2004.
Number | Date | Country | |
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60572968 | May 2004 | US |