Method and apparatus for delivery of a ligating suture

Abstract

An apparatus for ligating a medical protrusion comprises a ligating suture having a proximal end and a distal end configured to circumscribe the medical protrusion, and a one-way lock positioned there between. The apparatus further comprises an endoscope, a cutter blade configured to cut the suture, and a device for ligating a medical protrusion. The device comprises a tubular body having a proximal end and a distal end, a handle positioned at the proximal end, an endoscope controller operably connectable to the endoscope, a cutting controller operably connectable to the cutter blade, a suture controller configured to be operatively coupled with the suture, a curved bridge positioned at the distal end, the bridge having a proximal end and a distal end, and an armature, having a proximal end and a distal end, configured to releaseably retain at least a portion of the suture.

1 . A device for ligating a medical protrusion, the device comprising:
 a) a tubular body having a proximal end and a distal end;   b) a handle positioned at the proximal end;   c) an endoscope controller operably connectable to an endoscope having at least one lighting means and at least one image capturing means positioned at the distal end;   d) a cutting controller operably connectable to a cutter blade;   e) a suture controller configured to be operatively coupled with a ligating suture;   f) a curved bridge positioned at the distal end, said bridge having a proximal end and a distal end; and   g) an armature connected to the distal end of the bridge and configured to releaseably retain at least a portion of the ligating suture, said armature having a distal and proximal end,   wherein the armature is configured to place at least a portion of the ligating suture about the medical protrusion and wherein the manipulation of the suture controller is configured to cause the ligating suture to ligate the medical protrusion and wherein manipulation of the cutting controller is configured to result in the separation of at least a portion of the ligating suture from the ligated medical protrusion.   
   
   
       2 . The device of  claim 1 , wherein the cutter blade is removable. 
   
   
       3 . The device of  claim 1 , wherein the endoscope can move with respect to the device allowing the user to visually capture the medical protrusion to be ligated. 
   
   
       4 . The device of  claim 1 , wherein the armature is balloon shaped wherein the distal end is round and the proximal end is “V” shape. 
   
   
       5 . The device of  claim 1 , wherein the endoscope is removable. 
   
   
       6 . The device of  claim 1 , wherein the armature, when viewed from the side, is curved. 
   
   
       7 . The device of  claim 1 , wherein the armature is offset with respect to the tubular body axis. 
   
   
       8 . The device of  claim 1 , wherein the armature is configured to receive the removable ligating suture manually. 
   
   
       9 . The device of  claim 1 , wherein the armature has “C” shaped cross section. 
   
   
       10 . The device of  claim 9 , wherein the edges of the “C” shape armature cross section are configured to provide a narrower opening than the suture diameter. 
   
   
       11 . The device of  claim 1 , wherein the armature is configured such that the cutter blade cuts the suture in such a way as to leave little excess suture material with the ligated medical protrusion. 
   
   
       12 . The device of  claim 1 , wherein the armature distal end is movable with respect to the curved bridge. 
   
   
       13 . The device of  claim 1  further comprising an armature movement controller operably connected to the armature, wherein the armature movement controller is configured to control movement of the armature about an axis passing through the armature proximal end and parallel to the plane of the armature. 
   
   
       14 . The device of  claim 1  further comprising a ligating loop having a distal one way locking loop and a proximal support member. 
   
   
       15 . The device of  claim 14 , wherein the ligating suture is configured such that pulling the support member in the proximal direction, causes the constriction of the distal one-way locking loop when circumscribed about a medical protrusion. 
   
   
       16 . The device of  claim 14 , wherein the one-way lock is a preformed ball having a projection at an angle with respect to its base, and wherein the projection is configured to allow slidable movement of the suture in one direction only. 
   
   
       17 . The device of  claim 14 , wherein the ligating suture is biodegradable. 
   
   
       18 . The device of  claim 14 , where the ligating suture is elastized. 
   
   
       19 . An apparatus for ligating a medical protrusion, the apparatus comprising:
 a) a ligating suture, said suture having a proximal end and a distal end configured to circumscribe the medical protrusion, and a one-way lock positioned there between;   b) an endoscope having at least one lighting means and at least one image capturing means;   c) a safety cutter blade configured to cut the suture at the proximal end of the one-way lock; and   d) a device for ligating a medical protrusion, the device comprising
 i) a tubular body having a proximal end and a distal end, 
 ii) a handle positioned at the proximal end, 
 iii) an endoscope controller operably connectable to the endoscope, 
 iv) a cutting controller operably connectable to the cutter blade, 
 v) a suture controller configured to be operatively coupled with the suture, 
 vi) a curved bridge positioned at the distal end, said bridge having a proximal end and a distal end, and 
 vii) an armature configured to releaseably retain at least a portion of the suture, said armature having a proximal end and a distal end, 
   wherein the armature is configured to place at least a portion of the suture about the medical protrusion and wherein the manipulation of the suture controller is configured to cause the suture to ligate the medical protrusion and wherein manipulation of the cutting controller is configured to result in the separation of at least a portion of the ligating suture from the ligated medical protrusion.   
   
   
       20 . The apparatus of  claim 18 , wherein the cutter blade is removable. 
   
   
       21 . The apparatus of  claim 18 , wherein the endoscope is movable with respect to the apparatus allowing the user to visually capture the medical protrusion to be ligated. 
   
   
       22 . The apparatus of  claim 18 , wherein the endoscope is removable. 
   
   
       23 . The apparatus of  claim 18 , wherein the armature is balloon shaped with a rounded distal end and a “V” shaped proximal end. 
   
   
       24 . The apparatus of  claim 18 , wherein the armature, when viewed from the side, is curved. 
   
   
       25 . The apparatus of  claim 18 , wherein the armature is offset with respect to the tubular body axis. 
   
   
       26 . The apparatus of  claim 18 , wherein the armature is configured to receive the removable suture manually. 
   
   
       27 . The apparatus of  claim 18 , wherein the armature has “C” shaped cross section. 
   
   
       28 . The apparatus of  claim 18 , wherein the edges of the “C” shape armature cross section are configured to provide a narrower opening than the suture diameter. 
   
   
       29 . The apparatus of  claim 18 , wherein the armature is configured such that the cutter blade cuts the suture in such a way as to leave little excess suture material with the ligated medical protrusion. 
   
   
       30 . The apparatus of  claim 18 , wherein the armature distal end is movable with respect to the curved bridge. 
   
   
       31 . The apparatus of  claim 18  further comprising an armature movement controller operably connected to the armature, wherein the armature movement controller is configured to control movement of the armature about an axis passing through the armature proximal end and parallel to the plane of the armature. 
   
   
       32 . The apparatus of  claim 18  further comprising a ligating loop having a distal one-way locking loop and a proximal support member. 
   
   
       33 . The apparatus of  claim 18 , wherein the ligating suture is configured such that pulling the support member in the proximal direction, causes the constriction of the distal one-way locking loop when circumscribed about a medical protrusion. 
   
   
       34 . The apparatus of  claim 18  wherein the suture is biodegradable. 
   
   
       35 . A method for ligating a medical protrusion, the method comprising:
 a) delivering the suture to a site of the medical protrusion, wherein said suture comprises a proximal end and a distal end having a shape of a balloon, and a one-way lock positioned there between;   b) mounting the suture distal end around the protrusion using a device having a balloon shaped, concave upwards armature by circumscribing the armature around the protrusion;   c) constricting the suture distal end to provide a ligation around the medical protrusion; and   d) cutting the suture distal end and the lock from the rest of the suture.   
   
   
       36 . A method for loading a suture to a device for ligating a medical protrusion, the method comprising:
 a) providing the suture comprising a proximal end and a distal end having a shape of a balloon, a one-way lock and a cord positioned there between;   b) providing the device comprising an armature configured to releaseably retain at least a portion of the suture, said armature having a proximal end and a distal end;   c) pressing the lock at the armature proximal end;   d) pressing an edge of the suture distal end into a side of the armature, sliding in the suture distal end into the rest of the armature around its circumference; and   e) coupling the suture proximal end with the hook.   
   
   
       37 . A method for ligating a medical protrusion with a suture, the method comprising:
 a) mounting the suture to the device;   b) negotiating the device to reach the site of the medical protrusion inside a patient's body;   c) delivering the suture to a site of the medical protrusion, wherein the suture comprises a suture proximal end and a suture distal end having a shape of a balloon, and a one-way lock positioned there between;   d) mounting the suture distal end around the protrusion using a device having a balloon shaped, concave upwards armature by circumscribing the armature around the protrusion;   e) constricting the suture distal end to provide a ligation around the medical protrusion; and   f) cutting the suture distal end and the lock from the rest of the suture.   
   
   
       38 . The method of  claim 34 , wherein negotiating the device to reach the site of the medical protrusion inside a patient's body comprises ascertaining the movement of the device using an endoscope.