AU2014262200B2 - Apparatus and method for effecting at least one anatomical structure - Google Patents

Abstract

Abstract Exemplary embodiments of apparatus and method for effecting at least one anatomical structure of a body can be provided. For example, at least one first arrangement can be provided which is structured to be at least partially inserted into the body and including an opening. In addition, at least one second arrangement can be provided which configured to increase and/or decrease a size of the opening by a motion thereof in a first direction. Further, at least one third arrangement can be provided which can be coupled to the second arrangement(s), and configured to move at least in a second direction which is at least approximately parallel to the second direction. In particular, when the anatomical structure(s) is/are provided or inserted in the opening and is pressed on by the second arrangement(s), a first motion of the second arrangement(s) toward the anatomical structure(s) in the first direction is reduced and/or terminated while a second motion of the third arrangement(s) in the second direction either (i) remains at least approximately the same, and/or (ii) is reduced to a lesser extent than that of the first motion.

Description

APPARATUS AND METHOD FOR EFFECTING AT LEAST ONE ANATOMICAL STRUCTURE FIELD OF THE DISCLOSURE [0001] The present disclosure relates to an apparatus and method for effecting at least one 5 anatomical structure, and more particularly to exemplary embodiments of the apparatus and method to effectuate a surgical treatment of tissue masses located inside the human body, e.g., in the hollow internal organs such as the colon. The exemplary apparatus and methods can be suitable for, e.g., a treatment of hemorrhoids, as well as other conditions. The exemplary apparatus and method can be implemented to, e.g., compress a hemorrhoid or/and reduce its 0 blood supply with a clamping instrument, while preventing a cutting of the hemorrhoid or its blood vessels with such exemplary instrument. CROSS REFERENCE [0002] This application claims priority to U.S. Provisional Application Serial No. 61/328,005 filed April 26, 2010. 5 [0002a] The present application is a divisional application of Australian Application No. 2011248672, which is incorporated in its entirety herein by reference. BACKGROUND INFORMATION [0003] There are a variety of abnormal conditions in the body which can be related to the wall(s) of hollow organs. Colonic polyps and tumors, endothelial vascular lesions, diverticuli, 20 symptomatic internal hemorrhoids are some of the examples of these abnormal conditions. A treatment to such abnormal conditions from inside a hollow organ cavity or a lumen (so-called intra-luminal or endolumenal approach) may be beneficial to the patient since a surgical access trauma is reduced or eliminated. [0004] One common condition that can be easily treated with the endoluminal approach is a 25 symptomatic internal hemorrhoids condition. Internal hemorrhoids are conventionally treated using a variety of interventional and non-interventional endoluminal methods. An immediate proximity of intemal hemorrhoids to the external orifice allows for a relatively easy access thereto. Several technologies for treating the internal hemorrhoids are currently available, but are a complex and/or frequently have less than acceptable clinical outcomes and/or high costs associated therewith. 5 [005] Hemorrhoidal disease is a very common condition that can occurs in more than half of the population by the age of 50. Currently, over 10 million people suffer symptoms from hemorrhoids in the United States, and one million new cases of symptomatic hemorrhoids are diagnosed annually. Approximately "1020 percent of such cases may need a surgical removal of the hemorrhoid which is associated with significant postoperative 0 morbidity and high cost to the individuals and society. [6606] The term "hemorrhoid" is generally used to recfr to the disturbing perianal symptoms related to vascular complexes in the lower rectum and anus This is usually associated with enlargement of this naturally occurring vascular tissue, which is responsible for its subsequent prolapsing, thrombosis, itching; buying, etc. Repetitive straining 5 due to constipation appears to be a leading factor in forming and progressing of hemorrhoids. The chances of having symptomatic hemorrhoids increase with age, pregnancy, obesity sedinentary life, heavy lifting and genetic predisposition, [0071 Various treatments can be tailored to the type and severity of the specific hemorrhoids A pharmacological treatmentwhich is aimed at the reguladon of defecation 20 and symptomatic relict may he less beneficial as likely having only a temporary and frequently :ncomplete effect Current interventional, non-excisional, therapies are designed to obliterate blood supply to part of or to the entire hemorrhoid (e~g., rubber band ligation, infrared coagulation, injection sclerotherapy, ultrasound guided hemorrhoidal artery ligation.

etc.). These treatments have modest, inconsistent clinical success with a frequent recurrence rate, [0008] Rubber band ligation is one popular treatment methods of hemorrhoids, In the rubber band ligation, some hemorrhoidal tissue is pulled into the lgator, and a rubber band is 5 placed around the base of the pulled tissue, This causes a strangulation of the blood supply to a portion of the internal hemorrhoid and. its overlying rectal mucosAi. An ischemic necrosis and autoainputation of the hemorrhoid can generally follow in a few days, leaving an open rectal wound, which heals over several days-. Severe and possibly debilitating postoperative pain is rare, but significant anal discomfort and tenesmus (a painfully urgent but ineffectual 0 sensation or amp to defecate) are quent. Recurrences after the rubber band ligation are also frequent. In addition, since such treatment leaves the patient with anopen wound in the anus for several days, the rubber band ligation may be rendered unsuitable for [[IV-positive patients, and may require a demanding preparation for patients with bleeding disorders. I{i09] Sclerotherapy is another method for treatment of small internal hemorrhoids. 5 A sclerosing agent is injected via needle into and around the internal hemorrhoid The rates of complications and recurrence of selerotherapy can be high, 10010" -An ultrasound guided hemorrhoidal artery ligation involves manual suturing of the rectal tissues ontaning the henorrhoial artery. The artery can be located by ultrasound radiation with an appropriate ultrasound arrangement A resultin g regression of 20 the corresponding internal hemorrhoid would be expected. Since the suture-ligation can be performed above the internal hemorrhoid in the pain-insensitive zone, the procedure should be painless. However, such technique is demanding, and is highy dependent on the operator's experience and dexterity. inexperience or lack of skill of the operator is responsible f both "missing the hemorrhoida!artery and inadIertent rectal and vascular -3injuries. Hemorthoidal artery injuries with resulting severe bleeding, rectal wall hinry, etc. have been reported and the recurrences are frequent. [0011] The treatment of internal hemorrhoids with infrared coagulation can involve a blind heat coagulation of the branches of superior hemorrhoidal artery. Theoretic ally, when 5 the branches of superior hemorrhoidal artery are successful targeted it can cause a subsequent regression of the corresponding inteNahemorrhoid Howeversince the exact location of the artery is not known, there is no guarantee that the infrared coagulation pulses reach the vessels and hence have any effect on hemorrhoids. Multiple treatments in a time span of several months are currently recommended by the distributor and treating doctors, OI The proper application of the infrared probe can be difficult with larger hemorrhoids due to obscurity of the interfhe between the probe and mucosa. Recurrences and ineffective treatment can be frequent. 100121 Traditional surgical excision of hemorrhoids can be an effective but often a debilitating form of treatment. The hemorThoidal tissue can he removed in longitudinal 5 (parallel to main rectal axis) direction. Surgical exsion of hemorrhoids may require the use of an anesthesia, and can cause a severe postoperative pain to the patient for several weeks along with a significantlss of work time therefore. Such technique is also dependent on the technical skill of the operator, 00131 Another procedure, iueI a Procedure for Prolapse and Hemorrhoids (PPH) can 20 be used which involves circumferential excision of the rectal mucosa and submucosal layer proximal to the internal hemorrhoids using a circular stapler. As a result, a superior hemorrhoidal blood supply can be interrupted, while the hemorrhoidal tissue itself is left to ischemicailly regress Since the excision is performed above the dentate line, a decreased postoperative pain and faster recovery (when compared to traditional hemorrhoidcctomy) -. 4- -5 would likely occur. The internal hemorrhoids can consequently shrink within four to six weeks after such procedure. This PPH technique requires the implementation by highly skilled operators, as well as a significant learning curve, a general or regional anesthesia, and an expensive instrumental set-up. In addition, the use of PPH creates 5 a substantial circumferential rectal trauma, which is likely excessive in the majority of cases when only 1 or 2 hemorrhoids are enlarged. A substantial circumferential injury of the anal canal and subsequent scarring can cause a rectal stricture (narrowing), which is debilitating and difficult to treat in patients. Serious complications during and after PPH have been previously reported. 10 [0014] Thus, there are several less invasive procedures than conventional surgery methods for the treatment of symptomatic internal hemorrhoids. However, such methods do not have the desired combination of simplicity, effectiveness and being substantially painless, minimally invasive, and inexpensive. [0015] Accordingly, there is a need to provide device and method which overcome at 15 least some of the deficiencies with the previous devices and methods. [001 5a] Any discussion of the prior art throughout the specification should in no way be considered as an admission that such prior art is widely known or forms part of common general knowledge in the field. SUMMARY OF EXEMPLARY EMBODIMENTS OF THE DISCLOSURE 20 [001 5b] According to a first aspect, the present invention provides a device for treatment of hemorrhoids comprising: a first part having a hollow portion including a tapered insertion tip, a first handle grip, and a first clamping surface; a second part having a second handle grip, the second part being movable in 25 relation to the first part; a third part defining a second clamping surface; and a spring coupling the second part to the third part to facilitate movement of the second part independently of the third part; wherein the first and second clamping surfaces define a window, the second 30 clamping surface being movable toward the first clamping surface to reduce a size of the window.

- 5a [001 5c] Unless the context clearly requires otherwise, throughout the description and the claims, the words "comprise", "comprising", and the like are to be construed in an inclusive sense as opposed to an exclusive or exhaustive sense; that is to say, in the sense of "including, but not limited to". 5 [0016] At least some of the objects of the present invention is to provide exemplary devices and methods to overcome at least some of the deficiencies indicated herein above. For example, the exemplary embodiment of method and device may be provided which can be useful in the treatment of hemorrhoids and/or associated tissues, and can facilitate a less traumatic experience than the conventional methods and 10 devices for the treatment of hemorrhoids. The exemplary device and method can also be utilized for treatment of other pathologies in locations remote from body openings.

[07 With one exemplary embodiment of method and device of the present disclosure, it is possible to efectuate an approximately constant tissue compression by a Clamp arrangement which is at least partially independent of the clamp-actuating force applied by a user to the associated handle of the exemplary device, 5 [018] According to one ex emplary embodiment ofhe present disclosure, a surgical instrment can be provide which comprises an insertable arrangement having a window, and a closure member movably connected to the insertable arrangement for alterately covering and uncovering the window, and applying pressure to or clamp any material provided within the window. The insertable arrangement can have a first (e g, clamping) surfhe along an 0 edge of the window, and the closure member can have a second (eg, clamping) surface situated opposite to the first surface to be able to selectively cover and uncover the window so as to apply a force to or clamp any tissue or object provided within the window. The exemplary instrument also includes a tissue effecting component coupled to the insertable arrangement and/or the closure member for acting on tissues gripped or clamped between the 5 first surface and the second surface. The exemplary instruments also has an further arrangement which is configured to propel the second surface toward the first surface so as to apply pressure to or clamp any object or tissue provided in the window, and also to prevent further pressure or clamping to be applied to the object or tissue if the pressure and/or Clamping thereon exceeds a particular amount of pressure; 20 10019i According to a particular exemplary embodiment of the present disclosure, the closure member can have a first component which includes the second clamping surface and a second component which is connected to a first handle grip. The first and second components can slide in relation to each other, and are connected to one another via a proximal spring. -6- [0*201 In accordance with another embodiment of the present disclosure, the device has at least two springs A first spring is affixed to a second handle grip at one end and to the closure member at another end thereof at their fixation points: A second spring is affixed to the first component of the closure member at one end, and to the second component of the 5 closure member at another end thereof at their respective fixation points. F~or example, according to one exemplary embodiment of the present disclosure, the springs can stretch between the fixation points during the window closure when the grip handles are moved toward one another The f spring provides an ability to effectuate an approximately constant tissue compression function, and avoid an unwanted excessive compression of the tissue 01 Each of the springs (e.g., the first spring) ca fEacilitate a retum of the closure member to its non-deployed (open) position so as to maintain the window open for another insertion of the tissue or object therein. 02In an exemplary operation, when a squeezing free is applied to the handle. e g.. for the purpose of compressing the tissue between the first and second surfaces, a first 5 handle grip (distal in relation to an. insertion tip of the exemplary device) moves towards a second handle grip (proximal in relation to the insertion tip of the device). In one exemplary embodiment the closure member moves towards the insertion tip of the device, and the second (e.g, clamping) surface of the closure member moves towards the clamping surface of the insertible arrangement As the closure mentber moves forward toward the first surface 20 of the insertible arrangement, the first and second springs are pulled in a general direction of the window and are stretched. [00221 The first spring facilitates gliding of the closure member during the closure and helps return the closure member to its non-deployed (open) position after the handle is released.

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f023] The second proximal spring provides the constant tissue compression fuction during closure and facilitates returning of the closure member to its nowdeployed (closed) posiion after the handle is released. [0024] When the closure member is actuated by squeezing the handle of the device 5 and hence the second handle grip and. the associated second component of the dosure member move forward, the second proximal spring (which is connected between first and second components of the close member r)pulls and moves forward the first component of the closure member, If the closure member doesn't meet an obstacle in the window, for example, a protruding tissue, the opposing surfaces of the closure mmber meet without 0 substantially stretching the spring. The device's parts are dimensioned so that when handle grips meet, the opposing clunpig surices touch each other and the window closes, 10251 If the closure member meets an obstacle in the window, for example, a protrding tissue, a first component of the closure member carryingg an opposing clamping surface) stops, while the second component of the closure member continues its forward 5 movement and slides over the first component of the closure member. As a result, the second proximal spring stretches and additional (after the first component of the closure member is stopped by the tissue) squeezing force of the handle by an operator translates into forward movement of the second component of the closure member and. stretching of the second proximal spring Consequently, only constant compression to the tissue is delivered as 20 designed by the strength of the second proxinal spring and the compressing tissue prperties, regardless of the additional force used by an operator. 100261 When handle is released, the distal spring pulls back on the second component of the closure meamer and its associated second handle grip and brings it back to its non deployed (open) position.

[A027) s the second component of the closure member and its associated second handle grip is returning to its open position, the second component of the closure member pulls back on first component of the closure member and returns it to its non-deployed (open) position. As a result, the window is opened and the tissue is released $ I($28] In addition according to one exemplary embodinent of the present disclosure, it is possible to provide a device which can be an endoluninal inter-vention assenibly that includes an accessory system for the delivery and support (eg., optically and/or mechanically) of instrumentation to surgical sites remote from the body openings; 0-0291 In accordance with yet another exemplary embodiment of the present 0 disclosure, apparatus and method for effecting at least one anatomical structure of a body can be provided, For example, at least one first aurngement can be provided which is structured to be at least partially inserted into the body and includMig an opening. In addition at least one second amagement can be provided which configured to increase and/or decrease a size of the opening by a motion thereof in a first direction. Further, at least one third arrangement 5 can be provided which can be coupled to the second arrangementss, and. configured to move at least in a second direction which is at least approximately parallel to the second direction. In particular, when the anatomical struture(s) is/are provided or inserted in the opening and is pressed on by the second arrangements) a17rst motion of the second amagement(s) toward the anatomical structure(s) in the first direction is reduced and/or terminated while a 2O second motion of the third arrangement(s) in the second direction either (i) remains at least approximately the same, and/or (ii) is reduced. to a lesser extent than that of the first motion. 100301 1i addition, at least one fourth tension-setting arrangement can be provided which couples the first and second arrangements to one another, The fourth tension-setting arrangements) can include at least one sprng,ard when the anatomical structure is pressed ~9by the second anaagement(sXa tension of the at least one spring can be increased which causes the second arrangements) to at east reduce the first motion in the first direction while facilitating the second motion of the third arrangement(sy in the second direction to be unreduced or reduced less than the first motion. The spring(s) can generate a force on the 5 second arrangement(s) which can facilitate a gradual constant tissue compression. [0031 According to yet another exemplary embodfinent of the present disclosure, the second arrangement(s) can comprise a closure arrangement which is structured to be moved toward and away from a tip portion of the first arrangements) and can include a contacting surface which is contigured to increase and/or reduce the size. of the opening and contact the 0 anatomical structures) The first arrangement can includes a first handle structure, and the third arrangement(s) can include a second handle structure which is configured to move toward the first handle structure, In addition at least one fourth tension-setting arrangement can be provided which couples the first and second arrangements to one another and can include a constant force spring that I attached between the first handle structure and the 5 closure arrangement. [0321 According to still another exemphry emnbodinent, when the anatonial structure is pressed by the closure arrangement, a motion of the closure arrangement can be reduced or stopped.. an.d the third arrangement(s) can slide over the closure arrangement in the first direction, Further, when the anatomical structure is pressed by the second. 20 arrangementss, a tension of the spring is increased which likely causes the second arrangement(s)to at east reduce the first motion of the closure arrangement in the first direction and taciilate the third arrangement to slide over the closure arrangement. J03] In yet a further exemplary embodiments of the present disclosure, the first arangement(s) can include a first handle structure and an anascope structure non-releasably -10connected to one another. At least one further arrangement can also be provided 'which can include at least one further spring arrangement coupling the first and third arrangements to one another, 'Me first arrangements) can include at least one handle portion, and the second armngement(s) can comprise a closure arrangement which is structured to be moved toward 5 and awayfrom a tip portion of the first aringement The further spring arrangements) can be coupled to the handle portions) and the closure arrangement. The further spring arrngement(s) can fac ilitate a movement of the closure arrangement in a direction that is at least approximately opposite to the first direction. 10)341 According to yet a further exemplary embodiment of the present disclosure, 0 the second arrangements) can include therein or thereon at least one ciectrode provided at or near the contacting surface. The electrode can be powered by an electrical power soure Such electrode(s) can be at least partially embedded within the first arrangement(s), The electrode(s) can be coNfigured to radiate at least one area of the anatomical structures) when the anatomical struture is constricted in the opening by the second arrangementss. 5 Further, the second arrangements) can include therein or thereon at least one illumination arrangementwhich provides light to the anatomical structure(s) [00351 These and other objects, features and advantages of the exemplary enibodiment of the present disclosure will become apparent upon reading the following detailed description of the exemplary embodiments of the present disclosure, when taken InI 20 conjunction with the appended claims. ERIEF DESCRIP TON OF THE DRAWINGS 100361 Further objects, features and advantages of the present disclosure will become apparent fron the following detailed description taken in conjunction with the accompanying figures showing illustative enbiodiments of the present disclosure, in which ii 100371 Figl is a side crossvsetional vew of an exemplary embodiment of a device according to the present disclosure in an open position; P0038 Fig 2 is a rrossisectional view of the device of Fig. I in a closed position 10o391 Pig 3A is a left side cross-sectional view of a first part of the device of Figs 5 and 2; 60440j Fig, 3B is a right side cross-sectional view of the first part shown in Fig, 3A; 140411 Fig, 3 is a right side perspective view of the first part shown in Fig. 3A; 100421 Fig. 3D is a left side perspective view of the first part. shown in Fig. 3A; [0043} Fig. 4A is a right side view of a second part of the device of Fig, 1; 0 10044] Fig, 413 is a rear view of the second part shown in Fig, 4A; [00451 Fig, 4C is a right side view of the second part shown in Fig, 4A; [0P461 Fig 4D is a perspective view of the second part shown in Pig 4A; [0047] Fig, 5A is a side view of a third part of the device of Fig, 1; [00481 Fig, 53B is a top view of the third part shown in ig. 5A 15 049149 Fig, 5C is a right side perspective view of the third part shown in Fig SA; 100501 Fig. 5D is a left side perspective view of the third part shown in Fig. 5A; [41051] Pig 6A is a lateral side view of spring used in the device of Fig. 1; and 1410521 Fig, 6B is a front view of the spring illustrated in Fig. 6A, -12 - 053] 'Throughout the figures, the same reference numerals and characters, unless otherwise statedare used to denote like features, elements, components or portions of the i lustrated embodiments. Moreover, while the subject disclosure will now be described in detail with reference to the figures, it is done so in connection with the illustrative 5 embodiments. It is intended that changes and modifications can be made to the described exemplary embodimentswithout departing from the true scope and spirit of the subject disclosure as defned by the appended claims DETAILED DESCRIPTION OF EXEMPLARY EM*BO DIM ENTS [0-54] Figs 14C shows various components of an exemplary embodiment of a (1 device according to the present disclosure. As show in these drawings, the exemplary device has three primary parts. e.g. a first part a second pad II and a third part IlL The first part I (as shown in, e g, Figs 1-31)) comprises a hollow portion I which includes a tapered end or insertion tip 16 which is stutured or configured for an insertion into or propagation through a bodily lumen or another anatomical stroture, a first handle grip 5 (which is proximalwith 5 respect to the tip 16) and a connecting section 4. The second part Ill (as shown ineog., Figs. 1, 2 and 4A-4lD) comprises a second handle grip 8 ((which is distal with respect to the tip 16) and a first closure member 9, which can be norrieasibly connected The third part III (as shown in, e.g, Figs, 1 2 and 5A-5D) comprises a second closure member 10 The exemplary device provides a handle 2 which comprises the first handle grip 5 of the first part I and the 20 second handle grip 8 of the second part IL [0055s Referring to Figs, 1, 2, 6A and 613 the exemplary device has a first spring 12 and a second spring 13, whereas the first spring 12 can be provided closer to the tip 16 than the second spring 13, and both of which can have two or more fixation points. The tirst spring 12 can includes (i) a first fixation point 1 2a provided at or on the first handle grip 5 of -13 the first part I (as also shown in Figs 3A and 3C) and (ii) a second fixation point 14 (as also shown in Figs. 4A, 4C and 41)) located on and below a surface of the first closure members The second spring 13 also has (i) a first fixation point 13a located on or at the second closure member 10 (as also shown in Figs, 5B and SC), and (ii) a second fixation point 15 located on 5 and below the surface of the first closure member 9 (as also shown in Fig. 4D) When the exemplary device is assembled, the second spring 13 is provided or positioned just below a particular surface 20 of the second closure member 10, while also being coupled to the first fixation point t3a thereof Any of the txation points 12a, 1,3a, 14 and/or15 can be metal and/or plastic knob(s) or other members to which the respective first 0 and second springs 12, 13 can be attached, clipped unto and/or adhered to, e.g. possibly with glue, lips, etc The exemplary details of the first and second springs 12, 13 are lustrated in Figs, 6A and 6B, However, it should be understood that other shapes and/or or sizes of the springs are conceivable aare re within the scope of the exemplary embodiments of the present disclosure. 5 [0571 1 gs. and 2 show that the first spring 12 couples the first part Iand the second part 11 to one another These drawings also illustrate that the second spring 13 couples the first and second closure menumrs 9, 10 to one another, which are slidably engaged with each other [00581 As shown in Figs. I and 2, the exemplary device includes a window 6 which is 20 enclosed between and formed by at least two opposing clamping surfaces, e.g.. afirst opposing clamping surface 7a (which is part of the hollow portion I of the first part I), and a second opposing clamping surface ' (which is part of the second closure member 10 of the third part Il and provided on the edge thereof). The second clamping surface 7b is moved toward the first clamping surtace 7a by movable the third part Il- toward the first clamping 14 surface 7'a to close or reduce the size of the window 6 and away fronm such first clamping surface 7a to open or increase the size of the window 6, Such movement of the third part Il can be actuated by squeezing and/or releasing the handle 2 of the exemplary device. 10059} For example, according to one exemplary embodiment of the present. 5 disclosure, when the second handle grip 8 is moved toward the first handle grip by squeezing, during suh exemplary squeezing motion by the operator's hand, the window 6 size is reduce, by, eg, being closed until it meets an obstale, su asf example, a protruding tissue 17 (as shown in Fig, 1), In addition, the window 6 is intended to be closed when the first and second opposing clamping surfaces 7a 7b meet each other (as shown in 0 Fig, 2). Thus, the window 6 becomes bigger when the second closure member 10 moves away from the first opposing clamping surface 7a, and smaller when the second closure member 10 moves towards the first opposing clamping surface 7a [-00601 In an exemplary operation, when the second handle grip 8 is moved toward the first handle grip 5, for exampled a squeezing motion by the hand of the operator, the 5 second put 11 pulls on the second spring i3 This is because the second spring 13 is connected at one end thereof to the second pat II via the second fixation point 15 (as shown in Figs; 4A 4C and 4D) which is located on and below a surface of the first closure member 9 of the second part iT The strength of the second spring 13 is selected or configured so as to facilitate the second main par 11 to pull the second closure member 10 in the same direcon 0 as the direction of propagation of the first closure member 9. indeed, during the exemplary operation, the second closure member 10 moves the first closure member 9 forward toward the first clamping surface 7a by pulling (e.g., likely without significant stretching) the second. spring 13, provided that the second 'iasure member 10 does not meet the obstacle in the window 6. Indeed, such puHing motion is effectuated since another end of the second spring - 15 - 13 is connected to the first fixation point 13a located on or at the second closure member 10 and below the particular surface 20 thereof (as also shown in Figs. 58 and S0). Thus. the second spring 13 acts as a spring coup ing arrangement between the second part 11 and the third part III 5 [006l As shown in Fig 1, if the second closure member 10 meetsthe obstacle in the window 6 (e, the protruding tissue), the forward motion of the second closure member 10 in the same direction as that of the second part 11 stops completely or for themost part At the same time, the second part 11 of the exemplary device continues to nove forward in the same direction, and also(simultaneousy) cause the second spring 13 to stretch As a result, 0 the first closure member 9 slides over the second closure member 10 towards e first clamping surface 7a or the end or tip 16.ithout further affecting the forward movement of the second closure member 10 and absent any further significant compression of the tissue situated within the window 6, [00621 This exemplary effect is caused by the fact that when the second opposing 5 clamping surface of the second closure member 10 contacts and attempts to press on the tissue provided within the window 6 this negative pressure cases the second spring 13 to stretch, In this manner, While the second closure member it of the third part Ill is prevented from moving forward by the tissue, a tension is continued on the second spring 13, although allowing the first closure member 9 of the second partw to continue its forward motion 20 toward the tip 16. Such tension on the second spring 13facilitates an approximately constant compression on the tissue. Indeed, as a result, a constant tissue compression (e.g, on the tissue or on any~ other object) can be accomplished in the window 6. Such constant tension or compression can be largely separate from or independent of the frce exerted by the operator on the handle 2, For example, the compression of the tissue can be mainly dependent upon -16 various properties of the second spring 13 the connections thereof to the first and second parts 11, llI, and the properties of the compressed tissue 17 in the window 6. 10061 In addition, according to another exemplary embodiment of the present disclosure; the first spring 12 can be usefI in facilitating the operation of the exemplary 5 device. For example, when the second hande grip 8 is moved toward the ist handle grip 5, e~g, during the squeezing motion by the hand of the operator, the second part I is smiultaeously pulls on and stretches the first spring 12 (as shown in Fig. 2) This is because one end of the first spring 12 is coupled to the second fixation point 14 (as shown in Figs. 4A, 4and 4D) located on and below the surface of the first closure member 9 of the second part 0 I, and the other end of the first spring 12 is coupled to the first fixation point 12a provided at or on the first handle grip 5 of the first part I(as shown in Figs. 3A and 3C In this manner, the first spring 12 is stretched by the forward movement of the first closure member 9 toward the first clamping surface 7a or the end or tip 16, while the first part I is stationary with respect to the tip 16. 5 [00641 During the exemplary operation, and rferring to Fig. 1, when the squeezed handle 2 is released, the first spring 12 has the tension to cause itself to return to its original (egg., non-stretched or less-stretch) configuration, thereby pulling on the first closure nenber 9 of the second part IT until the second part 1 returns to its non-deployed (egg open or origial) position. Again, this is caused by the first spring 12 being attached to a stationary 20 first part I via the first fixation point I 2a " ad puhIing the first closure member 9 of the second part UI back to its original position due to the first spring 12 being connected to the second fixation point 14 of the first closure member 9, In addition, as the second part HU is i the process of retuming to its non-deployed position (shown in Fig, 2) with the assistance of the first spring 12 the second part II also pulls on and effectuates further tension of the second - 17spring 13, which pulls back the second closure member 10 due to its couple ing to the first fixation point 13a thereof until the second closure member 10 returns to its nonAepoyed position. When the second closure member 10 moves back to such position, ie window 6 becomes enlargedeg, until it is fily open (as shown in Fig 2). 3 [065I It will further be appreciated by those having ordinary skill in the art that, in generate terms used herein, and especially in the appended claims, are generally intended as open, i addition, to the extent that the prior art knowledge has not been explicitly incorporated by reference herein above, it is explicitly being incorporated herein in its entirety. All publications referenced above are incorporated herein by reference in their 0 entireties. In the event of a conflict between the teachings of the application and those of the incorporated documents, the teachings of the application shall control. Various exemplary embodiments described herein can be used together in combination and/or separately from one another in accordance with further exempyry embodiments of the present disclosure 8S

Claims (10)

1. A device for treatment of hemorrhoids comprising: a first part having a hollow portion including a tapered insertion tip, a first handle grip, and a first clamping surface; 5 a second part having a second handle grip, the second part being movable in relation to the first part; a third part defining a second clamping surface; and a spring coupling the second part to the third part to facilitate movement of the second part independently of the third part; 10 wherein the first and second clamping surfaces define a window, the second clamping surface being movable toward the first clamping surface to reduce a size of the window.

2. The device of claim 1, wherein the spring has a first fixation point on the third part and a second fixation point on the second part. 15

3. The device of claim 2, wherein the second part includes a first closure member and the third part includes a second closure member, the first fixation point of the spring being on the second closure member and the first fixation point of the spring being on the first closure member.

4. The device of claim 3, wherein the second clamping surface is a part of the 20 second closure member.

5. The device of claim 4, wherein the spring is configured to allow the first closure member to slide over the second closure member when the second clamping surface meets an obstacle in the window.

6. The device of claim 5, wherein forward motion of the first closure member 25 over the second closure member creates tension in the spring.

7. The device of claim 4, wherein the second handle grip is movable towards the first handle grip to move the second clamping surface towards the first clamping surface and reduce the size of the window. - 20

8. The device of any one of claims 1 to 7, wherein the spring has a strength to facilitate constant compression of tissue between the first and second clamping surfaces.

9. The device of any one of claims 1 to 8, further including a spring coupling the 5 first part and the second part, wherein the spring coupling the first part and the second part defines a first spring and the spring coupling the second part to the third part defines a second spring.

10. The device of claim 9, wherein the first spring is positioned to urge the first and second clamping surfaces apart. 10