# US 5,704,943 A · Ligating instrument with multiple loop ligature supply and methods therefor > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 5,704,943 A - Document ID: US5704943A - Status: Granted - Kind: A - Application number: 08/533,504 - Filed: 1995-09-25 - Granted: 1998-01-06 - Earliest claimed: 1995-09-25 - Inventors: InBae Yoon; Cynthia D. Yoon - Web page: https://patentgrep.com/patent/US5704943A ## CPC - A61B 17/12013: {for use in minimally invasive surgery, e.g. endoscopic surgery} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A ligating instrument for forming ligatures in anatomical structure at an internal operative site in the body includes an elongate instrument body having a distal end for positioning at the operative site, a proximal end for positioning externally of the body and a lumen between the distal and proximal ends, a length of filamentous ligature material disposed in the lumen and forming a plurality of contractible ligature loops having knotting elements 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 to contract the ligature loops. The ligature loops are withdrawable through the distal end of the instrument body for positioning around anatomical structure at the operative site. The operating member is movable, from externally of the body, to move the knotting elements to contract the ligature loops around the anatomical structure to form ligatures. A method of forming ligatures includes introducing the distal end of the instrument body at the operative site, withdrawing a ligature loop including the knotting element thereof through the distal end of the instrument body, positioning the withdrawn ligature loop around anatomical structure, and moving the operating member, from externally of the body, to move the knotting element of the withdrawn ligature loop to contract the ligature loop around the anatomical structure to form a ligature. ## Claims ### Claim 1 A ligating instrument for forming ligatures in anatomical structure at an internal operative site in the body comprising an elongate instrument body 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 ligature supply including 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 instrument body 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, each of said ligature loops including a loop segment of said ligature material extending continuously from one of said knotting elements and back to said one knotting element to form a closed loop, said ligature loops being connected to one another by connecting segments of said ligature material extending between said ligature loops; and an operating member carried by said instrument body and operable from said proximal end of said instrument body for moving said knotting elements in said direction to contract said ligature loops around the anatomical structure to form ligatures. ### Claim 2 (depends on 1) A ligating instrument as recited in claim 1 wherein said connecting segments extend between said knotting elements. ### Claim 3 (depends on 1) A ligating instrument as recited in claim 1 wherein each of said knotting elements is a knot formed of said ligature material. ### Claim 4 (depends on 3) A ligating instrument as recited in claim 3 wherein said loop segments, said knots and said connecting segments are formed from a continuous length of said ligature material. ### Claim 5 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. ### Claim 6 (depends on 5) A ligating instrument as recited in claim 5 wherein said tip is normally disposed in said tip closed position and is moved to said tip open position by engagement of said tip by said jaws. ### Claim 7 (depends on 6) A ligating instrument as recited in claim 6 wherein said jaws are normally disposed in said open position and further including an actuating member carried by said elongate member for maintaining said jaws in said closed position and for selectively releasing said jaws for movement to said open position. ### Claim 8 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. ### Claim 9 (depends on 8) A ligating instrument as recited in claim 8 wherein said cutter is disposed within said elongate member. ### Claim 10 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. ### Claim 11 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. ### Claim 12 (depends on 11) A ligating instrument as recited in claim 11 wherein said operating member is 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. ### Claim 13 (depends on 12) A ligating instrument as recited in claim 12 wherein said operating member includes a pusher having a distal tip disposed around said ligature material and movable from a closed position in which said knotting elements cannot pass through said tip to an 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. ### Claim 14 (depends on 11) A ligating instrument as recited in claim 11 and further including means 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. ### Claim 15 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. ### Claim 16 (depends on 15) A ligating instrument as recited in claim 15 and further including an elongate actuating member disposed in said lumen, said knot pusher being movable relative to said elongate actuating member to move said distal end between said open and closed positions. ### Claim 17 (depends on 16) A ligating instrument as recited in claim 16 wherein said distal end of said knot pusher is resiliently biased to be normally disposed in said closed position and said knot pusher is movable longitudinally along said elongate actuating member to move said distal end of said knot pusher from said closed position to said open position. ### Claim 18 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. ### Claim 19 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. ### Claim 20 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. ### Claim 21 (depends on 20) A method of forming ligatures as recited in claim 20 wherein said step of providing includes providing a cutter around the length of ligature material and further including, prior to said step of forming another ligature, the step of cutting the length of ligature material proximally of the ligature. ### Claim 22 (depends on 20) A method of forming ligatures as recited in claim 20 wherein said step of withdrawing includes moving the distal end of the instrument body from a closed position preventing passage of the ligature loop therethrough to an open position permitting passage of the ligature loops including the knotting elements thereof through the distal end of the instrument body. ### Claim 23 (depends on 22) A method of forming ligatures as recited in claim 22 wherein said step of moving includes moving the operating member longitudinally relative to the length of ligature material.