Endoscopic ligating instrument

Claim 2

A flexible endoscopic instrument for ligating a multiplicity of lesions within a hollow body organ, such as the alimentary tract, said instrument comprising: (a) a flexible fiber optic endoscope having a forward insertion end and a rearward end, said endoscope including means for illumination and viewing through said endoscope, means for providing a suction force at said insertion end, and a working channel; (b) a tubular member having a forward distal end, a rearward end and a longitudinal axis, said rearward end having means for providing attachment to the insertion end of the endoscope; (c) a plurality of string-like cords of flexible substantially inelastic material, each said cord being folded over the distal end of the tubular member with a first portion of each said cord overlaying a part of the exterior of said tubular member and a second portion thereof being disposed internally of said tubular member, said cords being oriented in angular spacing about the longitudinal axis of said tubular member; (d) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member in coaxial relation thereto and each of said rings being in overlying contacting relation to all of said plurality of cords, said rings being spaced from one another in the longitudinal direction of the tubular member at successively greater different distances from the distal end of the tubular member; and (e) means for imparting relative sliding motion between said cords and said tubular member to dislodge each of the elastic rings in controlled sequence during a single insertion of the endoscope into the body organ whereby each of the elastic rings can be dislodged from the endoscope and placed in ligating relation to a lesion when lesion tissue is drawn into the tubular member by said suction means with each ring being applied to a different one of multiple lesions present in the body organ, said means for imparting relative sliding motion comprising a flexible line element threaded through the working channel of the endoscope and connecting at one end to said cords disposed within said tubular member and exiting the endoscope at the rearward end thereof whereby a pulling force may be exerted on the other end of the line element to cause sliding movement of the cords over said tubular member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

Claim 3

A flexible endoscopic instrument for ligating a multiplicity of lesions within a hollow body organ, such as the alimentary tract, said instrument comprising: (a) a flexible fiber optic endoscope having a forward insertion end and a rearward end, said endoscope including means for illumination and viewing through said endoscope, means for providing a suction force at said insertion end, and a working channel; (b) a tubular member having a forward distal end, a rearward end and a longitudinal axis, said rearward end having means for providing attachment to the insertion end of the endoscope; (c) a plurality of string-like cords of flexible substantially inelastic material, each said cord being folded over the distal end of the tubular member with a first portion of each said cord overlaying a part of the exterior of said tubular member and a second portion thereof being disposed internally of said tubular member, said cords being oriented in angular spacing about the longitudinal axis of said tubular member; (d) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member in coaxial relation thereto and in overlying relation to said cords, said rings being spaced from one another in the longitudinal direction of the tubular member and between at least one pair of adjacent elastic rings each of said cords having a slack segment of cord of a length which is at least equal to the distance between the distal end of the tubular member and the ring of said pair which is furthest from said distal end; and (e) means for imparting relative sliding motion between said cords and said tubular member to dislodge each of the elastic rings in controlled sequence during a single insertion of the endoscope into the body organ whereby each of the elastic rings can be dislodged from the endoscope and placed in ligating relation to a lesion when lesion tissue is drawn into the tubular member by said suction means with each ring being applied to a different one of multiple lesions present in the body organ, said means for imparting relative sliding motion comprising a flexible line element threaded through the working channel of the endoscope and connecting at one end to said cords disposed within said tubular member and exiting the endoscope at the rearward end thereof whereby a pulling force may be exerted on the other end of the line element to cause sliding movement of the cords over said tubular member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

Claim 4

A flexible endoscopic instrument for ligating a multiplicity of lesions within a hollow body organ, such as the alimentary tract, said instrument comprising: (a) a flexible fiber optic endoscope having a forward insertion end and a rearward end, said endoscope including means for illumination and viewing through said endoscope, means for providing a suction force at said insertion end, and a working channel; (b) a tubular member having a forward distal end, a rearward end and a longitudinal axis, said rearward end having means for providing attachment to the insertion end of the endoscope; (c) a plurality of string-like cords of flexible substantially inelastic material, each said cord being folded over the distal end of the tubular member with a first portion of each said cord overlaying a part of the exterior of said tubular member and a second portion thereof being disposed internally of said tubular member, said cords being oriented in angular spacing about the longitudinal axis of said tubular member; (d) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member in coaxial relation thereto and in overlying relation to said cords, said rings being spaced from one another in the longitudinal direction of the tubular member and between at least one pair of adjacent elastic rings each of said cords having a slack segment of cord of a length which is at least equal to the distance between the distal end of the tubular member and the ring of said pair which is furthest from said distal end; and (e) means for imparting relative sliding motion between said cords and said tubular member to dislodge each of the elastic rings in controlled sequence during a single insertion of the endoscope into the body organ whereby each of the elastic rings can be dislodged from the endoscope and placed in ligating relation to a lesion when lesion tissue is drawn into the tubular member by said suction means with each ring being applied to a different one of multiple lesions present in the body organ, said means for imparting relative sliding motion comprising a flexible line element threaded through the working channel of the endoscope and connecting at one end to said cords disposed within said tubular member and exiting the endoscope at the rearward end thereof whereby a pulling force may be exerted on the other end of the line element to cause sliding movement of the cords over said tubular member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

Claim 5

An endoscopic ligating instrument as set forth in claim 2 wherein each said cord on the portion thereof which overlies said rigid tubular member includes a series of shoulders at spaced intervals and against each of which a different one of said elastic rings is placed in abutting engagement and facing the distal end of said rigid tubular member and wherein each of said shoulders of a cord is in substantially co-planar relationship with a shoulder of each of the other cords.

Claim 6

An endoscopic ligating instrument as set forth in claim 2 wherein each said cord on the portion thereof which overlies said rigid tubular member includes a series of knots at spaced intervals and against each of which a different one of said elastic rings is placed in abutting engagement and facing the distal end of said rigid tubular member and wherein each of said knots of a cord is in substantially co-planar relationship with a knot of each of the other of said cords.

Claim 7

A flexible endoscopic instrument for ligating a multiplicity of lesions within a hollow body organ, such as the alimentary tract, said instrument comprising: (a) a flexible fiber optic endoscope having a forward insertion end and a rearward end, said endoscope including means for illumination and viewing through said endoscope, means for providing a suction force at said insertion end, and a working channel; (b) a tubular member having a forward distal end, a rearward end and a longitudinal axis, said rearward end having means for providing attachment to the insertion end of the endoscope; (c) a plurality of string-like cords of flexible substantially inelastic material, each said cord being folded over the distal end of the tubular member with a first portion of each said cord overlaying a part of the exterior of said tubular member and a second portion thereof being disposed internally of said tubular member, said cords being oriented in angular spacing about the longitudinal axis of said tubular member; (d) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member in coaxial relation thereto and in overlying relation to said cords, said rings being spaced from one another in the longitudinal direction of the tubular member at successively greater different distances from the distal end of the tubular member, such that the length of each cord between each pair of adjacent elastic rings is at least equal to the distance between the distal end of the tubular member and the furthest ring of said pair from said distal end; and (e) means for imparting relative sliding motion between said cords and said tubular member to dislodge each of the elastic rings in controlled sequence during a single insertion of the endoscope into the body organ whereby each of the elastic rings can be dislodged from the endoscope and placed in ligating relation to a lesion when lesion tissue is drawn into the tubular member by said suction means with each ring being applied to a different one of multiple lesions present in the body organ, said means for imparting relative sliding motion comprising a flexible line element threaded through the working channel of the endoscope and connecting at one end to said cords disposed within said tubular member and exiting the endoscope at the rearward end thereof whereby a pulling force may be exerted on the other end of the line element to cause sliding movement of the cords over said tubular member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

Claim 8

A flexible endoscopic instrument for ligating a multiplicity of lesions within a hollow body organ, such as the alimentary tract, said instrument comprising: (a) a flexible fiber optic endoscope having a forward insertion end and a rearward end, said endoscope including means for illumination and viewing through said endoscope, means for providing a suction force at said insertion end, and a working channel; (b) a tubular member having a forward distal end, a rearward end and a longitudinal axis, said rearward end having means for providing attachment to the insertion end of the endoscope; (c) a plurality of string-like cords of flexible substantially inelastic material, each said cord being folded over the distal end of the tubular member with a first portion of each said cord overlaying a part of the exterior of said tubular member and a second portion thereof being disposed internally of said tubular member, said cords being oriented in angular spacing about the longitudinal axis of said tubular member; (d) a plurality of elastic ligating rings removably mounted in stretched condition on said tubular member in coaxial relation thereto and in overlying relation to said cords, said rings being spaced from one another in the longitudinal direction of the tubular member at successively greater different distances from the distal end of the tubular member, such that the length of each cord between each pair of adjacent elastic rings is at least equal to the distance between the distal end of the tubular member and the furthest ring of said pair from said distal end; and (e) means for imparting relative sliding motion between said cords and said tubular member to dislodge each of the elastic rings in controlled sequence during a single insertion of the endoscope into the body organ whereby each of the elastic rings can be dislodged from the endoscope and placed in ligating relation to a lesion when lesion tissue is drawn into the tubular member by said suction means with each ring being applied to a different one of multiple lesions present in the body organ, said means for imparting relative sliding motion comprising a flexible line element threaded through the working channel of the endoscope and connecting at one end to said cords disposed within said tubular member and exiting the endoscope at the rearward end thereof whereby a pulling force may be exerted on the other end of the line element to cause sliding movement of the cords over said tubular member, each said cord being arranged in slack condition between each pair of adjacent elastic rings.

Claim 9

An endoscopic ligating instrument as set forth in claim 5 wherein each said cord on the portion thereof which overlies said rigid tubular member includes a series of radially extending shoulders at spaced intervals and against each of which a different one of said elastic rings is placed in abutting engagement and facing the distal end of said rigid tubular member and wherein each of said shoulders of a cord is in substantially co-planar relationship with a shoulder of each of the other cords.

Claim 10

An endoscopic ligating instrument as set forth in claim 5 wherein each said cord on the portion thereof which overlies said rigid tubular member includes a series of knots at spaced intervals and against each of which a different one of said elastic rings is placed in abutting engagement and facing the distal end of said rigid tubular member and wherein each of said knots of a cord is in substantially co-planar relationship with a knot of each of the other of said cords.