Dual ligating and dividing apparatus

Ligating apparatus comprising:

• a shaft having a distal end, a proximal end, and a slot near the distal end in which tissue may be positioned;
• a first suture detachably mounted at the distal end, the suture having a free end disposed on a first side of the slot, a knotted loop disposed on a second side of the slot opposite the free end and a cinching line extending proximally from the knotted loop;
• means on the shaft for threading the free end through the knotted loop while tissue is positioned in the slot such that the suture forms a ligature surrounding the tissue;
• a first rod slidably mounted in the shaft for pulling the free end axially relative to the shaft to tighten the ligature;
• and
• an actuator connected to the cinching line and slidably coupled to the shaft at the proximal end, wherein proximal translation of the actuator draws the cinchline to tighten the knot.

Dual ligating and dividing apparatus comprising:

• a shaft having a distal end, a proximal end, and a laterally-oriented slot near the distal end in which tissue may be positioned;
• a pair of sutures detachably mounted at the distal end parallel to and spaced apart from one another, the sutures each having a free end disposed on a first proximally-facing side of the slot, a knotted loop disposed on a second distally-facing side of the slot and a cinching line extending proximally from the knotted loop;
• a pair of rods slidably mounted in the shaft and extending through the knotted loops, the rods each having a distal end with means for retrieving the free ends and drawing the free ends through the knotted loops;
• an actuator coupled to the shaft at the proximal end, the first and second cinchlines being connected to the actuator;
• and
• a blade slidably mounted to the shaft between the sutures and movable with respect to the slot for dividing tissue.

A method of ligating a body structure, said method comprising:

• providing a ligation apparatus having a shaft with a distal end and a proximal end, a rod which is axially translatable relative to the shaft, and an actuator which is separately axially translatable relative to the shaft;
• positioning the apparatus such that a portion of the body structure is within a slot at the distal end of the shaft, with a free end of a first suture being disposed on one side of the slot and a knotted loop in the suture being disposed on an opposing side of the slot;
• threading the free end through the knotted loop such that the suture forms a first ligature surrounding the structure;
• retrieving the free end with the distal end of the rod;
• tightening the first ligature tightly around the structure by sliding the rod in a proximal direction relative to the shaft;
• and
• cinching the knotted loop using the actuator, the actuator being connected to a cinchline extending proximally from the knotted loop.

Ligating apparatus comprising:

• a shaft having a proximal end and a distal end;
• a length of suture having a proximal end, a distal end, and a knotted loop in the suture spaced proximally from the distal end;
• means near the distal end of the shaft for detachably supporting the distal end of the suture and the knotted loop in a spaced-apart configuration to define a receiving space therebetween, whereby the receiving space can be placed over a tissue structure to be ligated;
• means actuable from the proximal end of the shaft for capturing the distal end of the suture and drawing said distal end through the knotted loop to form a ligature around the tissue structure;
• and
• means actuable from the proximal end of the shaft for drawing proximally on the proximal end of the suture to tighten the knotted loop onto the distal end of the suture which has been drawn therethrough.