Ligating instrument with multiple loop ligature supply and methods therefor

A ligating instrument for forming ligatures in anatomical structure at an internal operative site in the body comprising

• an elongate member having a distal end for being introduced at the operative site, a proximal end for being disposed externally of the body and a lumen between said distal and proximal ends;
• a plurality of preformed, contractible ligature loops of filamentous ligature material received within said lumen, said ligature loops being withdrawable from said distal end of said elongate member for positioning around anatomical structure and having knotting elements movable along said ligature material in a direction to contract said ligature loops around the anatomical structure, said elongate member including jaws at said distal end movable from a closed position wherein said ligature loops cannot pass through said jaws to an open position wherein said ligature loops can pass through said jaws for withdrawal from said distal end of said elongate member;
• and
• an operating member carried by said elongate member and operable from said proximal end of said elongate member for moving said knotting elements in said direction to contract said ligature loops around the anatomical structure to form ligatures, said operating member being movable longitudinally along said elongate member and relative to said ligature material for moving said knotting elements distally along said ligature material in the direction of the anatomical structure, said operating member including a distal tip disposed around said ligature material and movable from a tip closed position in which said knotting elements cannot pass through said tip to a tip open position in which said knotting elements can pass through said tip for withdrawal of said ligature loops from said distal end of said elongate member.

A ligating instrument for forming ligatures in anatomical structure at an internal operative site in the body comprising

• an elongate member having a distal end for being introduced at the operative site, a proximal end for being disposed externally of the body and a lumen between said distal and proximal ends;
• a plurality of preformed, contractible ligature loops of filamentous ligature material received within said lumen, said ligature loops being withdrawable from said distal end of said elongate member for positioning around anatomical structure and having knotting elements movable along said ligature material in a direction to contract said ligature loops around the anatomical structure;
• an operating member carried by said elongate member and operable from said proximal end of said elongate member for moving said knotting elements in said direction to contract said ligature loops around the anatomical structure to form ligatures;
• and
• a cutter carried by said elongate member for cutting said ligature material proximally of ligatures formed with said ligature loops.

A ligating instrument for forming ligatures in anatomical structure at an internal operative site in the body comprising

• an elongate member having a distal end for being introduced at the operative site, a proximal end for being disposed externally of the body and a lumen between said distal and proximal ends;
• a plurality of preformed contractible ligature loops of filamentous ligature material received within said lumen, said ligature loops being withdrawable from said distal end of said elongate member for positioning around anatomical structure and having knotting elements movable along said ligature material in a direction to contract said ligature loops around the anatomical structure;
• an operating member carried by said elongate member and operable from said proximal end of said elongate member for moving said knotting elements in said direction to contract said ligature loops around the anatomical structure to form ligatures;
• and
• a spool at said proximal end of said elongate member for moving said ligature material distally relative to said elongate member for withdrawal of said ligature loops from said distal end of said elongate member, said spool being rotatable to wind and unwind said ligature material thereon.

A ligating instrument for forming ligatures in anatomical structure at an internal operative site in the body comprising

• an elongate member having a distal end for being introduced at the operative site, a proximal end for being disposed externally of the body and a lumen between said distal and proximal ends;
• a plurality of preformed closed, contractible ligature loops of filamentous ligature material received within said lumen, said ligature loops being withdrawable from said distal end of said elongate member for positioning around anatomical structure and having knotting elements formed from said ligature material, said knotting elements being movable along said ligature material in a direction to contract said ligature loops around the anatomical structure;
• and
• an operating member carried by said elongate member and operable from said proximal end of said elongate member for moving said knotting elements in said direction to contract said ligature loops around the anatomical structure to form ligatures.

A ligating instrument for forming ligatures in anatomical structure at an internal operative site in the body comprising

• an elongate knot pusher having a distal end for positioning at the operative site, a proximal end for positioning externally of the body and a lumen between said distal and proximal ends, said distal end being movable, from externally of the body, between a closed position and an open position;
• and
• a continuous length of filamentous ligature material disposed in said lumen and forming a plurality of interconnected, closed ligature loops and forming a knot for each ligature loop movable longitudinally along said length of ligature material to tighten said ligature loops around anatomical structure to form ligatures, said ligature loops including said knots thereof being withdrawable through said distal end when said distal end is in said open position to deploy said ligature loops at the operative site for positioning around anatomical structure, said knots having a size preventing passage of said knots through said distal end when said distal end is in said closed position, said knot pusher being movable, from externally of the body, along said length of ligature material with said distal end in said closed position to move said knots of said deployed ligature loops along said length of ligature material to tighten said deployed ligature loops around anatomical structure to form ligatures.

A ligating instrument for forming ligatures in anatomical structure at an internal operative site in the body comprising

• an elongate knot pusher having a distal end for positioning at the operative site, a proximal end for positioning externally of the body and a lumen between said distal and proximal ends, said distal end being movable, from externally of the body, between a closed position and an open position;
• a length of filamentous ligature material disposed in said lumen and forming a plurality of interconnected ligature loops and a knot for each ligature loop movable longitudinally along said length of ligature material to tighten said ligature loops around anatomical structure to form ligatures, said ligature loops including said knots thereof being withdrawable through said distal end when said distal end is in said open position to deploy said ligature loops at the operative site for positioning around anatomical structure said knots having a size preventing passage of said knots through said distal end when said distal end is in said closed position, said knot pusher being movable, from externally of the body, along said length of ligature material with said distal end in said closed position to move said knots of said deployed ligature loops along said length of ligature material to tighten said deployed ligature loops around anatomical structure to form ligatures;
• and
• a cutter disposed around said ligature material and operable from externally of the body to cut said length of ligature material proximally of the ligatures.

A ligating instrument for forming ligatures in anatomical structure at an internal operative site in the body comprising

• an elongate knot pusher having a distal end for positioning at the operative site, a proximal end for positioning externally of the body and a lumen between said distal and proximal ends, said distal end being movable from externally of the body, between a closed position and an open position, and
• a length of filamentous ligature material disposed in said lumen and forming a plurality of interconnected ligature loops and a knot for each ligature loop movable longitudinally along the ligature material to tighten said ligature loops around anatomical structure to form ligatures, said ligature loops being arranged in spaced pairs along said length of ligature material, said ligature loops including said knots thereof being withdrawable through said distal end when said distal end is in said open position to deploy said ligature loops at the operative site for positioning around anatomical structure, said knots having a size preventing passage of said knots through said distal end when said distal end is in said closed position, said knot pusher being movable, from externally of the body, along said length of ligature material with said distal end in said closed position to move said knot of said deployed ligature loops along said length of ligature material to tighten said deployed ligature loops around anatomical structure to form ligatures.

A method of forming ligatures in anatomical structures at an internal operative site in the body comprising the steps of

• providing a ligating instrument including an elongate instrument body having a distal end, a proximal end and a lumen between the distal and proximal ends, a length of filamentous ligature material disposed in the lumen and forming a plurality of interconnected, closed ligature loops and forming a knotting element for each ligature loop movable along the length of ligature material to contract the ligature loops and an operating member movable relative to the length of ligature material to move the knotting elements;
• introducing the distal end of the instrument body at the internal operative site;
• withdrawing a ligature loop including the knotting element thereof through the distal end of the instrument body to deploy the ligature loop at the operative site;
• positioning the deployed ligature loop around anatomical structure;
• moving the operating member relative to the length of ligature material from externally of the body to move the knotting element of the deployed ligature loop distally along the length of ligature material in the direction of the anatomical structure to contract the deployed ligature loop around the anatomical structure to form a ligature;
• and
• forming another ligature at the operative site with the ligating instrument without withdrawing the ligating instrument from the body.