Device and method for applying large-diameter ligating loop

A method for applying a suture loop into a body cavity, said method comprising:

• introducing a cannula having a central lumen into the body cavity;
• introducing a suture loop protected by a sheath into the cannula;
• engaging the cannula with the sheath so that the sheath is held stationary relative to the cannula;
• and
• advancing the suture loop through the lumen and into the body cavity.

A method for applying a suture loop into a body cavity, said method comprising:

• introducing a cannula into a patient;
• providing a suture applier including a shaft, a length of suture having a free end and a pre-formed loop, a handle connected to a proximal end of said shaft, and a sheath on the distal end of the shaft protecting the preformed loop;
• introducing the suture applier and the sheath into the cannula:
• and
• exposing the suture loop through the distal end of the cannula.

Apparatus for applying and tightening a suture loop, said apparatus comprising:

• a hollow shaft having a proximal end and a distal end;
• a length of suture having a free end and a loop at another end, wherein the loop is held at the distal end of the shaft and the free end of the suture extends through the hollow shaft to the proximal end;
• a handle assembly comprising a housing having a protected interior attached to the proximal end of the shaft, said handle assembly including a slidably mounted actuator, said actuator comprising a puller;
• and
• a pulley on the puller positioned entirely within the protected interior, wherein the free end of the suture travels around the pulley and is secured to the handle, said pulley coupling the puller to the free end of the suture so that the free end is drawn proximally by the puller at a faster rate than the puller, whereby drawing proximally on the puller will tighten the suture loop.

Apparatus for applying and tightening a suture loop, said apparatus comprising:

• a hollow shaft having a proximal end and a distal end;
• a length of suture having a free end and a loop at another end, wherein the loop is held at the distal end of the shaft and the free end of the suture extends through the hollow shaft to the proximal end;
• a handle assembly comprising a housing having a protected interior attached to the proximal end of the shaft, said handle assembly including a slidably mounted actuator, said actuator comprising a pusher;
• and
• a pulley rotatably mounted in the interior of the housing having a small gear wheel and a large uptake wheel attached to the free end of the suture, wherein the pusher includes a gear face which mates with the gear wheel, said pulley coupling the pusher to the free end of the suture so that the free end is drawn proximally by the pusher at a faster rate than the pusher, whereby drawing proximally on the pusher will tighten the suture loop.

Apparatus for applying and tightening a pre-tied suture loop, said apparatus comprising:

• a shaft having proximal and distal ends;
• a length of suture having a free end and a knotted loop at the other end, wherein said knotted loop is held on the distal end of the shaft;
• and
• a handle assembly attached to the proximal end of the shaft and having means for selectively engaging and proximally translating the free end of the suture, whereby the free end may be successively engaged and drawn proximally to close the knotted loop.