GB2443605A

GB2443605A - Ligation device

Info

Publication number: GB2443605A
Application number: GB0622539A
Authority: GB
Inventors: Mark Jessup
Original assignee: SOLAR MEDICAL PRODUCTS Ltd
Current assignee: SOLAR MEDICAL PRODUCTS Ltd
Priority date: 2006-11-11
Filing date: 2006-11-11
Publication date: 2008-05-14
Also published as: GB0622539D0

Abstract

A ligation device comprises an inner member having a ligature mounting portion at one end thereof and an outer member mounted on the inner member. The outer member is mounted on the inner member for relative movement between the members, which movement causes an end of the outer member proximal the ligature mounting portion to pass over the said ligature mounting portion of the inner member. The device further comprises a stop, which limits the movement of the outer member relative to the inner member.

Description

Ligation Device

Field of the Invention

The invention relates to a ligation device, in particular a device for rubber band ligation of haemorrhoids

Background of the Invention

Elastic band ligation is one of the most widely used methods of treatment for internal haemorrhoids. The procedure involves locating a haemorrhoid and placing one or more elastic bands around it to cut off the blood supply to the haemorrhoid. This results in tissue death Once the haemorrhoid tissue dies, it shrivels, drops off and both the elastic band and the tissue pass out of the patient during normal bowel movements.

In usual practice, a proctoscope is first inserted into the patient. The proctoscope includes a light and allows a surgeon to view the interior rectal cavity. One of the prior art haemorrhoid ligator devices for applying elastic bands is then inserted inside the proctoscope.

These known devices have an elastic band extended over their body and when the surgeon locates a haemorrhoid, the haemorrhoid is pulled (either manually or by suction) and an elastic band is dispensed from the device so that it "snaps" over the base of the haemorrhoid. If more than one haemorrhoid requires this treatment, the device is removed and reloaded with another elastic band prior to performing the ligation procedure again.

This is time-consuming and means that the surgeon must have an assistant present to reload the device with another elastic band, while the proctoscope is still inside the patient In some cases, it is necessary to use more than one elastic band is required to treat a single haemorrhoid.

In these cases, a surgeon using one of the prior art devices must locate the haemorrhoid, apply a ligature, remove the ligation device from the proctoscope, reload it with the help of an assistant, re-insert the device, locate the same haemorrhoid for a second time and repeat the treatment.

An improved haemorrhoid hgator device has been described in GB0512683. The device described in GB(J512683 relates to a multi-band device for treating haemorrhoids. It comprises an inner tube, on which several elastic binds can be mounted and art outer tube, which is pushed against the elastic bands to dispense them one at a time without the need to remove the device from the proctoscope between applications.

One disadvantage associated with the device in GB0512683 is that it may obstruct the surgeon's view of the haemorrhoid during the procedure. A further disadvantage is that the outer tube in not secured to the device in any way and once the last elastic band has been dispensed, the outer tube can slide freely and may become detached from the device.

Summary of the Invention

One aspect of the invention provides a device for treating haemorrhoids as specified in Claim 1.

Preferred aspects of the invention are specified in the claims dependent on Claim I and the description which follows.

The invention provides an improved device for the treatment of haemorrhojds, which increases visibility for the user, is easy to manufacture and safe to use. The device allows a surgeon to clearly view the end of the device from which a number of elastic bands can be released m one procedure.

Brief Description of the Drawings

In the drawings, which illustrate the preferred embodiments of the invention, by way of example: Figure 1 shows a schematic representation of one embodiment of the device for treating haemorrhoids.

Figure 2 shows the inner tube of the embodiment of Figure 1.

Figure 3 shows the outer tube of the embodiment of Figure 1.

Detailed Description of the Preferred Embodiments

With reference to Figure 1, a ligation device I comprises a tubular inner member 2, an outer member 3, a handle portion 4 and control wheel 5 The inner member 2 includes a ligature mounting portion 6, upon which a number of ligatures, such as elastic bands, may be mounted prior to using the device.

The internal diameter of the inner member 2 at the ligature mounting portion 6 Is sized to fit over a haemorrhoid.

The outer member 3 fits over the inner member 2 and is slidable along the inner member. The outer member 3 can be urged towards the ligature mounting portion 6 by turning the control wheel 5 Figure 2 shows the inner member 2 and the handle portion 4 of the ligation device 1. These may be moulded as a single unit during manufacture. The handle portion 4 includes a suction connector 7, to which a suction tube may be attached. The handle portion further includes a Suction control port 8, which may be in the form of a small hole.

When the suction control port 8 is blocked, for example by a surgeon's thumb pressing over the port, air is sucked into the inner member 2 by the suctional force at the suction connector 7. When the suction control port 8 is open air is drawn through the port and the sucuonal force through the inner member 2 is very much reduced.

The handle portion 4 further includes a screw thread 9, upon which a control wheel having a corresponding thread is mounted.

When the control wheel 5 is turned in a clockwise direction, it moves along the screw thread 9 towards the ligature mounting portion 6. This movement of the control wheel 5 urges the outer member 3 towards the ligature mounting portion 6. The Outer member 3 moves along the ligature mounting portion 6 and pushes the ligatures so that the ligature closest to the end of the inner member 2 is pushed off the ligature mounting portion 6 and is released.

The inner member 2 comprises a central portion 20 and a Ligature mounting portion 6 The external diameter of the ligature mounting portion 6 is greater than the diameter of the central portion 20 of the inner member 2. At the point where the ligature mounting portion 6 and the central portion 20 meet, the edge of the ligature mounting portion forms a stop 19.

Figure 3 shows an illustration of the outer member 3 The outer member 3 compnses a proximal end 14, a distal end 15 and a central portion 16.

The proximal end 14 of the outer member 3 includes a flared "C" shaped portion 10. When the outer member 3 is fitted to the inner member 2, the "C" shaped portion 10 contacts the control wheel 5.

The distal end 15 of the outer member 3 includes a second flared "C" shaped portion 13 and a ring shaped portion 11. The central portion 16 and the distal end 15 of the outer member 3 are joined by a wall 21 The central portion 16 of the outer member 3 includes an opening 17 and a number of clasps 18 The opening 17 is sized to receive the inner member 2.

The ring shaped portion 11 of the outer member 3 fits over the ligature mounting portion 6 of the inner member 2. The central portion 16 and proximal end 14 of the outer member 3 snap fit over the inner member 2 The clasps iS extend partially around the inner member 2 to secure the outer member 3 to the inner member 2.

At the central portion 16, the internal diameter of the outer member 3 is similar to the outer diameter of the inner member 2. This means that when the surgeon is looking down the proctoscope, obstruction of his view of the haemorrhotd and the distal end of the ligation device is minimally obstructed by the outer member 3 is minimised.

At the wall 21, the internal diameter of the outer member 3 is less than the external diameter of the ligature mounting portion 6. Therefore the movement oldie outer member 3 along the inner member 2 is blocked when the wall 21 of the outer member 3 contacts the stop 19. The distance between wall 21 and the stop 19 determines the distance that the outer member 3 is able to slide along the inner member 2 during use.

The outer member 3 is therefore prevented from becoming detached from the inner member 2. Iii order to separate the two parts, a user must pull the outer member 3 away from the inner member 2, through the clasps 18 and then slide the ring shaped portion 11 over the end of the ligature mounting portion 6 When the device is ready for use, the ring shaped portion 11 is located over the ligature mounting portion 6 and ligatures are loaded on the ligature mounting portion 6. A suction tube is attached to the suction connector 7 and suction is turned on. The suction tube can be clipped into the suction tube gwdes 12 to restrict movement or twisting of the suction tube during the operation With the suction control port 8 uncovered, the surgeon inserts the device through a proctoscope and locates a hacmorrhoid Once the haemorrhoid is located, the surgeon places the end of the ligation device I over the haemorrhoid and covers the suction control port 8 with his thumb. This causes the haemorrhoid to be sucked into the inner member 2, so that the base of the haemorrhoid is positioned at the end of the ligation device 1.

Next, the surgeon turns the control wheel 5 in a clockwise direction, which causes the control wheel to move along the screw thread 9 in the direction of the ligature mounting portion 6. The control wheel pushes the "C" shaped portion 10 of the outer member 3, which moves the outer member 3 along the inner member 2 until the ring shaped portion 11 contacts the ligatures. As the control wheel 5 is turned further, the ring shaped portion 11 pushes the hgatures so that the ligature nearest the end of the ligation device I is pushed off and constricts around the base of the haemorrhoid If a further Ligature is required for the same haemorrhoid, the surgeon continues to turn the control wheel 5 until a second ligature is released.

The surgeon then uncovers the suction control port 8 and the haemorrhoid returns to its normal position.

The surgeon is then able to locate more haemorrhoids and repeat the procedure without removing the device from the proctoscope / anal passage The device can be operated using one hand and therefore does not require an assistant.

Claims

Claims 1. A ligation device comprising an inner member having a

ligature mounting portion at one end thereof, and an outer member mounted on the inner member for relative movement between said inner and outer members, which movement causes an end of the outer member proximal to the ligature mounting portion to pass over said ligature mounting portion, the device further comprising a stop to limit said relative movement between the said inner and outer members.
2 A ligation device as claimed in Claim 1, wherein the outer member is a snap fit over the inner member.
3. A ligation device as claimed in Claim I or 2, wherein the outer member includes a portion of smaller diameter than the diameter of the ligature mounting portion.
4. A ligation device as claimed in any preceding claim, wherein the outer member includes a longitudinal opening.
5. A ligation device as claimed in Claim 4, wherein the outer member includes at least one clasp extending into the opening.
6 A ligation device as claimed in any preceding claim, wherein the end of the Outer member further comprises a ring shaped member extending around the ligature mounting portion
7. A ligation device as claimed in any preceding claim, wherein the inner member is connectable to a source of suction and the device comprises a means for controlling suction in the inner tube
8. A ligation device as claimed in Claim 7, wherein the means for controlling suction is an opening connected to the inner tube.
9. A ligation device as claimed in any preceding claim, further compnsmg an adjustment member arranged to generate relative movement between the inner member and the outer member.
10. A ligation device as claimed in Claim 9, wherein the adjustment member engages with the outer tube.
11. A ligation device as claimed in Claim 10, wherein the adjustment member comprises a rotating wheel.
12. A ligation device as claimed in Claim 11, wherein the rotating wheel is mounted on a thread, rotation of the wheel causing the wheel to move axially with respect to the inner member to generate relative movement between the inner member and the outer member.
13. A ligation device as claimed in any preceding claim, further comprising a handle member, wherein the inner tube is mounted on the handle member.
14. A ligation device as claimed in Claim 13, wherein the handle member compnses at least one recess into which a suction tube is fitted.
15. A ligation device as claimed in any preceding claim, further compnsmg at least one ligature mounted on the ligature mounting portion, and wherein, in use, one of the at least one ligature is pushed off the free end of the ligature mounting portion by the action of the end of the outer member proximate the ligature mounting portion engaging with one of the at least one ligature, causing the or each at least one ligature to move axially on the ligature mounting portion.
16. A ligation device substantially as shown in, and as described with reference to, Figures 1 to 3 of the drawings.