WO2023111663A1 - Appareil de ligature amélioré pour le traitement des hémorroïdes - Google Patents

Appareil de ligature amélioré pour le traitement des hémorroïdes Download PDF

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Publication number
WO2023111663A1
WO2023111663A1 PCT/IB2021/061993 IB2021061993W WO2023111663A1 WO 2023111663 A1 WO2023111663 A1 WO 2023111663A1 IB 2021061993 W IB2021061993 W IB 2021061993W WO 2023111663 A1 WO2023111663 A1 WO 2023111663A1
Authority
WO
WIPO (PCT)
Prior art keywords
tube
static
compressive element
stage actuation
static tube
Prior art date
Application number
PCT/IB2021/061993
Other languages
English (en)
Inventor
Dr. Rajashekhar RAO
Original Assignee
Rao Dr Rajashekhar
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Rao Dr Rajashekhar filed Critical Rao Dr Rajashekhar
Publication of WO2023111663A1 publication Critical patent/WO2023111663A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A61B17/12013—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00818—Treatment of the gastro-intestinal system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A61B2017/12018—Elastic band ligators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30—Surgical pincettes without pivotal connections
    • A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0807—Indication means

Definitions

  • the embodiments herein generally relate to a ligaturing apparatus. More particularly, the disclosure relates to an improved ligaturing apparatus for treatment of haemorrhoids.
  • Hemorrhoids refer to swelling and inflammation of veins of the anorectal region. Rubber band ligation is one of the most common methods used for treating hemorrhoids, wherein the procedure includes tying each hemorrhoid at its base using rubber bands, for cutting off the blood flow to the hemorrhoid.
  • the main objective of the present disclosure is to provide an improved ligaturing apparatus for treatment of hemorrhoids.
  • Another objective of the present disclosure is to provide a ligaturing apparatus with improved flexibility for locating the hemorrhoids.
  • Still another objective of the present disclosure is to provide a ligaturing apparatus with a single trigger for two staged actuation for positioning over the hemorrhoids.
  • Yet another objective of the present disclosure is to provide a ligaturing apparatus with improved control in locating, positioning and treating of hemorrhoids.
  • an embodiment herein provides an improved ligaturing apparatus for treatment of hemorrhoids.
  • the ligaturing apparatus comprises a dynamic tube including a first end and a second end and a static tube extending through the dynamic tube, wherein the static tube includes a proximal end towards the first end and a distal end towards the second end.
  • a static tip is engaged with the first end of the dynamic tube, including ligation bands for deploying around the hemorrhoids.
  • a vacuum hose is connected to a suction source for imparting suction through the static tube.
  • a primary compressive element is operatively connected between the vacuum hose and the static tube, provided for producing a first stage actuation and a second stage actuation and a secondary compressive element is operatively coupled to the first end of the static tube for positioning the static tube relative to the dynamic tube over the hemorrhoid.
  • the primary compressive element actuates the secondary compressive element for positioning the proximal end over the hemorrhoid in the first stage actuation and the primary compressive element fluidly connects the vacuum hose with the static tube for imparting suction through the proximal end of the static tube over the hemorrhoids in the second stage actuation.
  • the dynamic tube with the static tip rotatable relative to the static tube for facilitating location of the hemorrhoids and a rotation controller is connected to the second end of the dynamic tube for controlling rotation of the dynamic tube.
  • a trigger provided for triggering the first stage actuation and the second stage actuation, an actuating element connected to the trigger and engaged with the primary compressive element for compressing the primary compressive element, thereby producing the first stage actuation and the second stage actuation.
  • the first stage actuation includes compressing the primary compressive element thereby compressing the secondary compressive element and moving the static tube relative to the dynamic tube towards the hemorrhoid and restricting the compression of the secondary compressive element for locking the position of the proximal end of the static tube relative to the hemorrhoid.
  • a coupling member is engaged with the primary compressive element at a first end and connected to the vacuum hose at a second end, a connecting element is provided circumferentially inside the coupling member, an annular groove is formed between an inner surface of the coupling member and an outer surface of the connecting element and the primary compressive element engaged with the coupling member in the annular groove.
  • the second stage actuation includes compressing the primary compressive element for connecting the distal end of the static tube with the connecting element of the coupling member and imparting suction from the vacuum hose to the proximal end of the static tube for drawing the hemorrhoid.
  • the vacuum hose is movable relative to the static tube during the first stage actuation and the vacuum hose is restricted relative to the static tube during the second stage actuation.
  • the static tip includes a tapered end inclined at an angle relative to a vertical axis for accurately positioning the static tip relative to the hemorrhoid and the static tip includes a plurality of slots with an inclined surface for accommodating the ligation bands and deploying the ligation bands around the hemorrhoid.
  • the primary compressive element and the secondary compressive element include a spring.
  • a handle is provided for holding and a slit is provided on the handle for displaying position of indicators of the coupling member corresponding to the first stage actuation and the second stage actuation.
  • FIG.l illustrates a schematic of an exploded view of the ligaturing apparatus for treatment of hemorrhoids, according to an embodiment herein;
  • FIG. 2 illustrates a schematic of a side view of the ligaturing apparatus for treatment of hemorrhoids, according to an embodiment herein;
  • FIG. 3 illustrates a perspective view of a static tip of the ligaturing apparatus, according to an embodiment herein;
  • FIG.4 illustrates a schematic of a coupling member of the ligaturing apparatus , according to an embodiment herein. LIST OF NUMERALS
  • Fig.l illustrates a schematic of an exploded view of the ligaturing apparatus.
  • the apparatus is provided for performing rubber band ligation for treating hemorrhoids.
  • the apparatus 100 includes a dynamic tube 101 and a static tube 103.
  • the dynamic tube 101 extends from a first end 101a to a second end 101b.
  • the dynamic tube 101 encloses a portion of the static tube 101, wherein the static tube 103 is provided inside the dynamic tube 101 extending from the first end 101a till the second end 101b.
  • the static tube 103 includes a proximal end 103a towards the first end 101a and a distal end 103b towards the second end 101b.
  • the first end 101a of the dynamic tube is engaged with a static tip 102.
  • the static tip 102 encloses the proximal end 103a of the static tube.
  • the static tip 102 is fixed to the first end 101a of the dynamic tube 101.
  • the static tip 102 includes a plurality of slots 102a for accommodating ligation bands 115.
  • the ligation bands 115 are provided for tying around the hemorrhoids, for cutting of the blood supply to the hemorrhoids.
  • the static tip 102 is provided for positioning over the hemorrhoids and deploying the ligation bands 115 from the slots 102a over the hemorrhoids.
  • the dynamic tube 101 with the static tip 102 is rotatable relative to the static tube 103.
  • a rotation controller 107 is connected to the second end 101b of the dynamic tube 101.
  • the rotation controller 107 is provided for controlling rotation of the dynamic tube 101 relative to the static tube 103.
  • the rotation of the dynamic tube 101 with the static tip 102 facilitates flexible movement of the apparatus in the anorectal region of the patient for locating the hemorrhoid and positioning the static tip 102 over the located hemorrhoid.
  • the rotation controller 107 is capable of rotating the dynamic tube 101 with the static 102 in an angle ranging from 0° to 360°.
  • a vacuum hose 110 is provided for imparting suction over the hemorrhoid for facilitating deploying of ligation bands.
  • the vacuum hose 110 a first end 110a and a second end 110b.
  • the second end 110b is connected to an external suction source for imparting suction through the vacuum hose 110.
  • a barb fitting 111 is fitted to the second end 110b for connecting the vacuum hose 110 to the external suction source.
  • the first end 110a of the vacuum hose is connected to a coupling member 109.
  • a coupling member 109 is provided for controlling a connection between the vacuum hose 110 and the static tube 103.
  • the coupling member 109 includes a first end 109a and a second end 109b.
  • the first end 109a is capable of connecting to a first end 110a of a vacuum hose 110 and the second end 109b of the coupling member 109 is connected to the distal end of the static tube 103.
  • the coupling member 109 is provided for conveying the suction from the vacuum hose 100 through the static tube 103 for imparting suction through the proximal end 103a of the static tube 103 over the hemorrhoid, thereby facilitating grasping of the hemorrhoid for deploying the ligation bands 115.
  • the coupling member 109 is rotatable relative to the static tube 103 and enables movement of the vacuum hose 110 relative to the static tube 103.
  • a primary compressive element 105 is engaged with the connecting portion 109 at the first end 109a.
  • the primary compressive element 105 is provided for actuating the connection between the static tube 103 and the vacuum hose 110.
  • a secondary compressive element 106 is engaged with the proximal end 103a of the static tube 103. Compression of the secondary compressive element 106 moves the static tube 103 relative to the dynamic tube 101 for extending the proximal end 103a of the static tube 103 towards the hemorrhoid during positioning of the static tip 102 over the located hemorrhoid. In an embodiment, compression of the secondary compressive element 106 is restricted for controlling movement of the static tube 103 relative to the dynamic tube 101.
  • the primary compressive element 105 and the secondary compressive element 106 including but not limited to a spring.
  • a trigger 114 provided for facilitating a surgeon in operating the apparatus for locating, position and ligaturing the hemorrhoids.
  • the trigger 114 is connected to an actuating element 104a engaged with the primary compressive element 105. Movement of the actuating element 104a is controlled based on movement of the trigger 114 by the surgeon based on requirement.
  • the actuating element 104a enables a first stage actuation and a second stage actuation of the apparatus.
  • the first stage actuation includes compressing the primary compressive element 105. Compression of the primary compressive element 105 pushes the static tube 103 relative to the dynamic tube 101, thereby compressing the secondary compressive element 106. The compression of the secondary compressive element 106 is restricted for limiting extension of the proximal end 103b of the static tube over the hemorrhoid. The primary compressive element 105 is compressed till the restricted compression of the secondary compressive element 106 for locking a position of the proximal end 103a of the static tube relative to the hemorrhoid.
  • the second stage actuation includes further compressing of the primary compressive element 105 for establishing connection between the distal end of the static tube 103 with the first end of the vacuum hose 110 through the coupling member 109.
  • the second stage actuation conveys suction through the proximal end 103b of the static tube from the vacuum hose for drawing the hemorrhoid and deploying the ligation band 115 over the hemorrhoid.
  • the movement of the actuating element 114a is controlled for limiting the compression of the primary compressive element 105 and preventing connection between the vacuum hose 110 and the static tube 103 during first stage actuation.
  • the first stage actuation produces a click sound indicating locking of the position of the static tube 103 over the hemorrhoid.
  • a handle 112 is provided for facilitating the surgeon in holding the apparatus and operating the trigger 114.
  • the handle 112 includes a slit 113 provided for indicating the first stage actuation and the second stage actuation based on position of the coupling member 109.
  • Fig. 2 illustrates a side view of the ligaturing apparatus for treatment of hemorrhoids.
  • the handle 112 is ergonomic for enabling the surgeon in improved handling of the apparatus and operating the trigger 114 for producing the first stage actuation and the second stage actuation.
  • the rotation controller 107 is rotatable by the surgeon for controlling rotation of the dynamic tube 101 with the static tip 102a.
  • the static tip 102 includes a tapered end 201 for improved positioning over the hemorrhoid.
  • the tapered end 201 is inclined at an angle relative to a vertical axis for locating and positioning over the hemorrhoids situated at varied angles in the anorectal region.
  • Fig. 3 illustrates a perspective view of the static tip of the ligaturing apparatus.
  • the static tip 102 includes the slots 102a for accommodating the ligation bands.
  • the slots 102a include an inclined surface 302.
  • the inclined surface 302 includes a decreasing slope for restricting the ligation bands in that slot 102a, and allowing deployment of the ligation bands 115 onto the hemorrhoids during the second stage actuation.
  • the static tip 102 includes plurality of depressions 302 provided for engaging with the first end 101a of the dynamic tube 101.
  • Fig. 4 illustrates a perspective of the coupling member of the ligaturing apparatus.
  • the coupling member 109 includes the first end 109a and the second end 109b, an inner element 402, an annular groove 403, and stage indicators 404.
  • the coupling member 109 includes a connecting component 402 provided inside the coupling member 109, wherein the connecting component 402 is provided at a distance from the first end 109a.
  • the annular groove 403 is formed between an outer surface of the connecting component 109 and an inner surface of the coupling member 109.
  • the primary compressive element 105 is provided in the annular groove 403 of the coupling member, wherein a stopper is provided in the annular groove for limiting compression of the primary compressive element 105.
  • the primary compressive element 105 is compressed in the annular groove 403 for compressing the secondary compressive element 106.
  • the primary compressive element 105 is compressed against the annular grove 403 for connecting the distal end of the static tube 103 with the connecting portion 402 of the coupling member 109.
  • the indicators 404 are provided for indicating the actuation stage of the apparatus based on position of the coupling member 109.
  • the position of the indicators 404 is dependent on the compression of the primary compressive element 105.
  • the first stage actuation compresses the primary compressive element in the annular groove 403, moving the indicators to a first position corresponding to the position of the coupling member 109 due to the compression.
  • the second stage actuation compresses the secondary compressive element further in the annular groove 403, moving the indicators 404 to a second position corresponding to the position of the coupling member 109 due to the compression.
  • the slit provided in the handle displays the position of the indicators 404, thereby providing feedback to the surgeon corresponding to the first stage actuation and the second stage actuation.
  • a main advantage of the present disclosure is that the ligaturing apparatus provides improved locating and positioning for treatment of hemorrhoids.
  • Another advantage of the present disclosure is that the ligaturing apparatus provides improved flexibility to the surgeon for treating hemorrhoids.
  • Still another advantage of the present disclosure is that the ligaturing apparatus facilitates faster and smoother treatment of hemorrhoids, thereby assisting the surgeon and the patient.
  • Yet another advantage of the present disclosure is that the ligaturing apparatus improves accuracy in detection and treatment of the hemorrhoids.
  • Still another advantage of the present disclosure is that the ligaturing apparatus is ergonomic, compact and light in weight, thereby providing convenience to the surgeon in treatment of hemorrhoids.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Reproductive Health (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente divulgation concerne un appareil de ligature pour le traitement des hémorroïdes. L'appareil comprend un tube dynamique (101), et un tube statique (103) s'étendant à travers le tube dynamique (101). Un tuyau à vide (110) est relié à une source d'aspiration pour communiquer une aspiration à travers le tube statique (103), un élément de compression (105), prévu pour produire un actionnement de première phase et un actionnement de seconde phase, est relié de manière fonctionnelle entre le tuyau à vide (110) et le tube statique (103), et un élément de compression secondaire (106) est couplé de manière fonctionnelle au tube statique (101) pour positionner le tube statique (103). L'élément de compression principal (105) actionne l'élément de compression secondaire (106) pour positionner le tube statique (103), l'actionnement de première phase et l'élément de compression principal (105) relient fluidiquement le tuyau à vide (110) au tube statique (103) pour communiquer une aspiration à travers le tube statique (103) dans l'actionnement de seconde phase.
PCT/IB2021/061993 2021-12-15 2021-12-19 Appareil de ligature amélioré pour le traitement des hémorroïdes WO2023111663A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IN202141058319 2021-12-15
IN202141058319 2021-12-15

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WO2023111663A1 true WO2023111663A1 (fr) 2023-06-22

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104546049A (zh) * 2014-12-25 2015-04-29 江苏安特尔医疗科技有限公司 痔疮套扎器
US20190150930A1 (en) * 2015-12-23 2019-05-23 Horten Medical Pty Ltd Multiband ligation device
US20210022746A1 (en) * 2019-07-22 2021-01-28 Boston Scientific Scimed, Inc. System, device and method for treatment of hemorrhoids

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104546049A (zh) * 2014-12-25 2015-04-29 江苏安特尔医疗科技有限公司 痔疮套扎器
US20190150930A1 (en) * 2015-12-23 2019-05-23 Horten Medical Pty Ltd Multiband ligation device
US20210022746A1 (en) * 2019-07-22 2021-01-28 Boston Scientific Scimed, Inc. System, device and method for treatment of hemorrhoids

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