Ring applicator and method for applying elastic rings to anatomical tissue structures

A ring applicator for applying elastic rings to anatomical tissue during a surgical procedure comprising:

• an outer tubular member having an aperture formed therein;
• a middle tubular member movably disposed within said outer tubular member and having an aperture formed therein;
• an elongate inner member movably disposed within said middle tubular member, said inner member including a forceps at a distal end;
• a distal handle connected to said inner member via slots in said outer and middle tubular members;
• a proximal handle pivotally connected to said middle tubular member via a slot in said outer tubular member;
• and
• a pusher having a proximal end pivotally connected with said proximal handle and a distal end movable between a latched position where said distal end of said pusher protrudes into said apertures to prevent pivotal movement of said proximal handle and relative axial movement between said outer and middle tubular members, and an unlatched position where said distal end of said pusher is disengaged from said aperture in said middle tubular member to permit pivotal movement of said proximal handle in order to move said outer tubular member axially relative to said middle tubular member.

A ring applicator for applying elastic rings to anatomical tissue in surgical procedures comprising:

• an outer tubular member having proximal and distal ends;
• a middle tubular member movably disposed within said outer tubular member, said middle tubular member having a distal end configured to receive an elastic ring in an expanded condition and a proximal end;
• and
• an elongate inner member movably disposed within said middle tubular member and including a pair of opposed grasping members at a distal end, said grasping members including pivot arms of unequal length with distal tips oriented transverse to said arms such that one of said tips is disposed proximally of the other tip when said grasping members are in a closed condition, wherein at least a portion of one of said grasping members has a color allowing said one grasping member to be visually distinguished from the other grasping member when said grasping members are viewed remotely via an endoscope.

A ring applicator for applying elastic rings to anatomical tissue in surgical procedures comprising:

• an outer tubular member having proximal and distal ends;
• a middle tubular member movably disposed within said outer tubular member, said middle tubular member having a distal portion configured to receive an elastic ring in an expanded condition and a proximal portion;
• and
• an elongate inner member movably disposed within said middle tubular member and including a forceps at a distal end for grasping anatomical tissue and drawing the tissue into said middle tubular member;
• wherein said outer tubular member and said middle tubular member include respective transparent distal portions for viewing anatomical tissue drawn into said middle tubular member, and wherein at least one of said outer tubular member and said middle tubular member include scale markings on the respective transparent distal portion.

A ring applicator for applying elastic rings to anatomical tissue during surgical procedures comprising:

• an outer tubular member having proximal and distal ends;
• a middle tubular member movably disposed within said outer tubular member, said middle tubular member having a distal portion configured to receive an elastic ring in an expanded condition and a proximal portion;
• an elongate inner member movably disposed within said middle tubular member and having a forceps at a distal end movable between an extended position where said forceps protrudes from said middle tubular member in an open configuration, and a retracted position where said forceps is disposed within said middle tubular member in a closed configuration;
• a distal handle connected to said inner member via slots in said outer and middle tubular members;
• and
• a proximal handle pivotally connected to said middle tubular member via a slot in said outer tubular member;
• wherein said proximal and distal handles are axially movable relative to one another to cause said forceps to move between said retracted and extended positions relative to said middle tubular member, and wherein said proximal handle is pivotably movable relative to said tubular members when said handles are drawn together to cause said outer and middle tubular members to move relative to one another such that an elastic ring mounted on a distal end of said middle tubular member is ejected.

A method of applying elastic rings to anatomical tissue during surgical procedures using a ring applicator having a middle tubular member disposed within an outer tubular member, and an inner member with forceps disposed within the middle tubular member, said method comprising the steps of:

• positioning the middle tubular member to protrude distally from the outer tubular member;
• adjusting a stop mechanism on the proximal end of the outer tubular member to position a stop member against a first of a plurality of longitudinally spaced abutment surfaces along a proximal portion of the middle tubular member such that the middle tubular member is prevented from moving axially relative to the outer tubular member;
• loading an elastic ring onto a distal portion of the middle tubular member;
• inserting the ring applicator into the body;
• grasping a first anatomical tissue structure using the forceps;
• pulling the first anatomical tissue structure into the middle tubular member;
• adjusting the stop mechanism on the proximal end of the outer tubular member to position the stop member proximally of a second abutment surface along the proximal portion of the middle tubular member so that the outer tubular member can move axially about one ring width relative to the middle tubular member;
• ejecting the elastic ring by moving the outer tubular member distally relative to the middle tubular member until the stop member contacts the second abutment surface;
• and
• releasing the first anatomical tissue structure from the middle tubular member.

A method of applying elastic rings to anatomical tissue structures during surgical procedures using a ring applicator having a middle tubular member disposed within an outer tubular member and connected to a proximal handle, and an inner member with forceps disposed within the middle tubular member and connected to a distal handle, said method comprising the steps of:

• positioning the middle tubular member in a loading position where a distal end of the middle tubular member protrudes distally from the outer tubular member;
• locking the middle tubular member in the loading position;
• moving the forceps to a retracted position within the middle tubular member by sliding the proximal and distal handles together such that the handles abut one another;
• loading an elastic ring onto a distal portion of the middle tubular member;
• inserting the ring applicator into the body;
• moving the forceps to an extended position protruding from the middle tubular member by sliding the proximal and distal handles apart such that the handles are axially spaced from one another;
• positioning the forceps around a first anatomical structure;
• pulling the first anatomical tissue structure into the middle tubular member with the forceps by sliding the proximal and distal handles together such that the handles abut one another;
• unlocking the middle tubular member so that the outer and middle tubular members can move axially relative to one another;
• and
• ejecting the elastic ring onto the first anatomical structure by pivoting the proximal handle about the point of contact between the handles to cause the outer tubular member to move distally relative to the middle tubular member.

A method of applying elastic rings to anatomical tissue structures during surgical procedures using a ring applicator having a middle tubular member disposed within an outer tubular member and connected to a proximal handle, and an inner member with forceps disposed within the middle tubular member and connected to a distal handle, said method comprising the steps of:

• positioning the middle tubular member in a loading position where a distal end of the middle tubular member protrudes distally from the outer tubular member;
• locking the middle tubular member in the loading position;
• moving the forceps to a retracted position within the middle tubular member by sliding the proximal and distal handles together such that the handles abut one another;
• loading an elastic ring onto a distal portion of the middle tubular member;
• inserting the ring applicator into the body via an incision;
• moving the forceps to an extended position protruding from the middle tubular member by sliding the proximal and distal handles apart such that the handles are axially spaced from one another;
• positioning the forceps around a first anatomical structure;
• pulling the first anatomical tissue structure into the middle tubular member with the forceps by sliding the proximal and distal handles together such that the handles are axially spaced a small distance apart;
• moving a knuckle slide disposed within the distal handle proximally relative to the distal handle such that a proximal surface of the knuckle slide abuts the proximal handle;
• unlocking the middle tubular member so that the outer and middle tubular members can move axially relative to one another;
• ejecting the elastic ring onto the first anatomical structure by pivoting the proximal handle about the point of contact between the proximal handle and the knuckle slide to cause the outer tubular member to move distally relative to the middle tubular member.

A method of applying elastic rings to anatomical tissue structures during surgical procedures using a ring applicator having a middle tubular member disposed within an outer tubular member, an elastic ring mounted on a distal portion of the middle tubular member, and an inner member with a forceps disposed within the middle tubular member, the forceps having opposed grasping members of unequal length and of different color, said method comprising the steps of:

• inserting a distal end of the ring applicator into a body cavity;
• spreading the grasping members apart;
• observing the color of the grasping members to determine which grasping member is shorter;
• positioning the anatomical tissue proximally of the tip of the shorter grasping member;
• grasping the anatomical tissue using the forceps;
• pulling the anatomical tissue into the middle tubular member using the forceps;
• and
• ejecting a ring from the middle tubular member onto the anatomical tissue by moving the outer tubular member distally relative to the middle tubular member.

A method of applying elastic rings to anatomical tissue structures during surgical procedures using a ring applicator having a middle tubular member disposed within an outer tubular member, an elastic ring mounted on a distal portion of the middle tubular member, and an inner member with a forceps disposed within the middle tubular member, the outer and middle tubular members each having transparent distal tips, said method comprising the steps of:

• inserting the ring applicator into a body cavity;
• grasping an anatomical tissue structure using the forceps;
• pulling the anatomical tissue structure into the middle tubular member using the forceps;
• viewing the anatomical tissue structure through the transparent tips of the outer and middle tubular members;
• determining whether a desired length of the anatomical tissue structure is pulled into the middle tubular member based upon scale markings on one or both of the transparent tips;
• and
• when the desired length is determined, ejecting a ring from the middle tubular member onto the anatomical tissue by moving the outer tubular member distally relative to the middle tubular member.