WO2001034038A2

WO2001034038A2 - Band applicator for appendicular and meso-appendicularstumps

Info

Publication number: WO2001034038A2
Application number: PCT/IN2000/000109
Authority: WO
Inventors: Hanamaraddi T. Gangal; Parag H. Gangal; Madhumalti H. Gangal
Original assignee: Gangal Hanamaraddi T
Priority date: 1999-11-11
Filing date: 2000-11-10
Publication date: 2001-05-17
Also published as: WO2001034038A3; AU3048801A

Abstract

A telescopic band applicator for use in applying an elastic band to a stump of tubular tissue includes an outer tubular member, a middle tubular member telescopically received within the outer tubular member, and an inner tubular rod member telescopically received within the middle tubular member. A plurality of concave prongs at the end of inner tubular rod member are adapted and arranged to grasp, twist, stretch mould and compress the stump tissue. All these leading to suitably drawing the stump within the inner cylindrical surface of the middle tubular member for banding to provide the effect of conventional ligature of the stump. Here in this concept a linear force used in the instrument is utilised to put a band serving the purpose of a ligature, in surgery. Using the linear force to get spit into quite a few forces to bring in effects stated above does this. This concept may have industrial and scientific utility, needing to be evaluated. In other words: 1) grasp the site of banding the stump, 2) stretch the site and twist it clockwise, 3) mould the stump within the prongs by providing the anticlockwise rotation effect on the surface of the covered stump, to displace the tissue bulged between prongs, 4) compress the entire stump tissue thus covered by the prongs. All these leading to suitably drawing the stump within the inner cylindrical surface of the middle tubular member for banding to provide the effect of conventional ligature of the stump.

Description

BAND APPLICATOR FOR APPENDICULAR AND MESO-APPENDICULARSTUMPS TECHNICAL FIELD

This invention based on physics and mathematics is applicable in any field. Here exampled as surgical devices and instruments, more particularly to be used as a laparoscopic instrument for applying bands to stumps of tubular tissue.

BACKGROUND ART

An instrument known as a Yoon-Band Applicator has long been used to apply an elastic occluding ring on to an anatomical tubular structure, such as in female sterilisation procedures. Said applicator is disclosed in U.S. Pat. No 4,374,523 to Yoon now expired. _n the conventional use of such an applicator, size shape of tissue involved is well adapted to receive the elastic ring or the band from the applicator In appendectomy procedures, however, the appendicular and meso-appendicular stumps are sized such that extreme difficulties in using conventional Yoon Band Applicators have been experienced. The conventional Yoon Band Applicator has only two forceps hooks that are constant in width and relatively thin. In using the conventional Yoon Band Applicator, the difficulties encountered included the very poor grip on the appendix, appendicular stump, or meso-appendicular stump. The poor grip was caused by the prongs of the Yoon Band Applicator being only two and also too narrow for a proper grip. This caused the appendicular stump and the grasped tissues to bulge and protrude in between the two thin prongs of the application. The bulging and protrusion of the stump between the two prongs made application of the elastic bands extremely difficult. Thus it is apparent that a need presently exists for a band applicator that is specifically adapted to applying bands to appendicular and meso-appendicular stumps.

SUMMARY OF THE DISCLOSURE

A telescopic band applicator for use in applying an elastic band to a stump of tubular tissue, such as an appendicular or meso-appendicular stump, includes conventional outer, middle tubular and inner tubular rod members arranged in a telescoping relationship. Instead of two narrow forceps prongs as in a conventional applicator, a plurality and preferably four concave elongated triangular prongs are provided. The concave prongs are adapted and arranged to grasp, twist, stretch, mould, and compress the stump to be drawn into the inner cylindrical surface of the middle tubular member, and band it.

BRIEF DESCRIPTION OF THE DRAWINGS

A more complete understanding of the invention and its advantages will be apparent from the detailed description taken in conjunction with the accompanying drawings, in which:

FIGS. 1 and 2 are diagrammatic illustrations of the invention and it's preferred environment;

FIG. 3 is a end perspective view of the instrument of the present invention; FIG. 4 is a side view of the instrument with the inner tubular rod member withdrawn into the middle tubular member;

FIG. 5 is a side view of the end of the inner tubular rod member showing the prongs of the present invention;

FIG. 6 is a partially broken away side view similar to FIG 5;

FIG. 7 is a sectional view taken along lines 7-7 of FIG 6;

FIG. 8 is a sectional view taken along lines 8-8 of FIG 6; and

FIG. 9 is a sectional view taken along lines 9-9 of FIG.4. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring initially to FIGS.l and 2 where like numerals refer to like and corresponding elements, an instrument 10 is a telescopic band applicator specially adapted for use in applying an elastic band 12 to the stump of an appendix 14, after removal of the appendix. As will be described in detail below, prongs 16 of the instrument 10 are specially adapted to perform this function. As shown in FIG, 2, band 12, has been applied to stump 18 as will hereinafter be described.

Referring now to FIGS.3-9, where like numerals indicate like and corresponding elements, instrument 10 includes an outer tubular member 30 a middle tubular member 32 telescopically received within the outer tubular member 30 and an inner tubular rod member 34, telescopically received within the middle tubular member 32. As best shown in FIG, 6 middle tubular members 32 have a cylindrical inner surface 36.

Four prongs 37 are attached to an end 38 of inner tubular rod member 34. In the preferred embodiment, prongs 37 are arranged into a first pair of opposed identical prongs 40 and second pair of opposed identical prongs 42. Each of the first pair of prongs 40 has an inwardly facing forceps hook 44 at the distal end 46 thereof.

Each prong 37 is formed in the shape of roughly an elongated triangle. The triangle has a narrow portion at the end 48 of the prong 37, and also at the end 38 of the inner tubular rod member 34. The triangle is wider at the end portion of opposing distal end 46 of the prongs 37 forming the short base edge 54 side. Thus the triangle is divided for precise understanding of the description into initial / early narrow portion 63, an end portion 68 and an intervening intermediate portion 64. As best shown in FIG.6 the prongs 37 therefore have two elongated side edges 50 and 52, and a short base edge 54. Of the two elongated side edges, 50 is straight all along. The other side 52,^" is straight and parallel to initial / early portion of the side 50, then onwards it slightly deviates away from corresponding intermediate and end portions of the 50. Thus making the side 52 as an elongated and oblique side of the triangle. As best shown in FIG. 8, one side of the forceps hook 44 on the first pair of prongs 40, is in continuation of straight elongated side of 50, but extends inwardly and perpendicularly, at the extreme end of the base edge 54.1n the preferred embodiment, each forceps hook 44 has a Length (FIG.8) slightly in excess of 1/2 of the diameter D (FIG.6.) of inner cylindrical surface 36. As best shown in FIGS.7. 8, and 9, end portion of each prong 37 has an inner concave and outer convex surface 56, 58. Each outer convex surface has a degree of curvature approximately the same as the inner cylindrical surface 36 of the middle tubular member 32. Each inner concave surface 56 of the prong 37 is concentric with the outer convex surface 58 of the prong 37.

As shown in FIGS 7-9, the straight elongated side (edge) 50 of the intermediate and end portion is tapered by grinding the inner edge to provide inwardly tapered surface 60 to enable merging onto concave surface 56. Similarly the oblique elongated side (edge) 52 of the similar portions is tapered by grinding the outer edge to provide outwardly tapered surface 62, to enable smooth merger to the outer convex surface of this prong to get smoothly overlapped by the inwardly tapered adjacent margin (edge) of the adjacent prong. Thus these two oppositely facing tapered surfaces on the opposite elongate side edges of all the four prongs thus provide modular effect on the tapered edge surfaces facilitating each-other to enable smooth overriding and overlapping of the adjacent marginal edges of the prongs. This imbrecating action of adjacent prongs as shown in FIG. 9 causes anticlock-wise rotation effect on the surface of the tissue grasped displaces the tissue likely to bulge between the prongs, as the inner tubular rod member is drawn into the middle tubular member. This arrangement of the prongs 37 permits imbrications and enables them to grasp, twist, stretch, mould, and compress the stump tissue within the interleaved prongs as they are drawn into the inner cylindrical surface 36 of the middle tubular member at that end time, the Band 12 can be perfectly positioned on the stump 18 (F1G.2) in a precise and efficient manner. In case the band fails to lodge in on the desired location, mere repeating the act in a more precise manner will enable to place another band still more proximally and correctly and the same act facilitates the removal of the first one.

As best shown in FIG. 6 in the preferred embodiment, an intermediate portion 64 of the prongs 37 has an included angle A with respect to the main axis 66 of the instrument of about 20 degrees, whereas an end portion 68 of each prong 37 has an included angle B with respect to axis 66 of about 15 degrees. In the preferred embodiment the four prongs 37 are equally placed about the axis 66 about ninety degrees apart.

Upon drawing the prongs 37, into the middle tubular member, each hook of first pair 40 of prongs 37 effects firm grasp on the tissue and clock-wise rotation on it. As the prongs slide further along the inner cylindrical surface 36, the other features of the prongs designed for, are now going to be gradually and sequentially effective to bring in other suitable changes on the stump. These will be, stretch of the tissue from the site of grasp, and to gradually obliterate the gap between the prongs, starting at the narrow portion 64 and to end at the broad distal end 46 of the prong 37.This progressive obliteration of the gap is effected by engagement of progressively wider distal portion of prongs. This is the result of oblique elongated edge of the elongated triangle shaped prongs. This synchronous overlapping (as shown in FIG.9) and imbrications of the side edges results in an anticlockwise rotation, the opposite of hook effect, on the surface of the tissue grasped in the prongs. This act avoids tissue bulge vagrancy between prongs, and thus provides an effect of twist on the enclosed tissue. Finally the tissue gets firmly compressed to be drawn suitably into middle tubular member of the applicator and to facilitate suitable banding of it. In the preferred embodiment, the four prongs 37 are equally spaced about the axis 66 about ninety degrees apart.

In operation, the following features enable the improved use of the applicator;

1. The one side of the two opposing forceps hooks at the distal ends on the short base edge of the first pair of prongs are also in line on the straight elongated side edge of the prong. Total length of the two hooks is a little more than the applicators middle tubular member's inner surface diameter.

2. The widening and concaving of the distal parts of the four prongs are such that they curve around the stump tissue and enfold it securely.

With this improved instrument, Yoon Banding an appendicular or meso-appendicular stump is simple and precise procedure.

Whereas the present invention has been described with the respect to a specific embodiment thereof, it will be understood that various changes and modifications will be suggested to one skilled in the art, and it is intended to encompass such changes and modifications as fall within the scope of the appended claims.

Claims

We claim;

1. A telescopic band applicator for use in applying an elastic band to a stump of tubular tissue, comprising; an outer tubular member, a middle tubular member telescopically received within the outer tubular member and having an inner cylindrical surface and an inner tubular rod member telescopically received within trie middle tubular member; and a plurality of partially cylindrical prongs at the end of the inner tubular rod member adapted and arranged to grasp, twist, stretch mould and compress the stump within the inner cylindrical surface of the middle tubular member.

2. The applicator of claim 1, the prongs being arranged as first and second opposed pairs of identical prongs.

3. The applicator of claim 2, with each of the first pair of prongs having an inwardly facing forceps hook at a distal end ( of short base as well as of the straight elongated side (edge)) thereof.

4. The applicator of claim 1 with each prong being formed in the shape of an elongated triangle being narrower at the end of the inner tubular rod member and wider at the opposing distal end of the prong.

5. The applicator of claim 4 with each prong having two elongated side edges and a short base edge at the distal end, and a forceps hook on the end of each of the first pair of prongs extending inwardly and perpendicularly from the short base edge as well as on the straight elongated side edge of the prong.

6. The applicator of claim 1 with each prong having inner concave and outer convex surface having a degree of curvature approximately the same as the inner cylindrical surface of the middle tubular member, and each inner cylindrical surface being concentric with the outer cylindrical surface of the prong.

7. The applicator of claim 1 with prongs having a predetermined width and elongated side edges of prongs being tapered inwardly on the straight side and outwardly on the oblique elongated side thus facilitating the imbrication of the adjacent margins of adjacent prongs as the inner tubular rod member is drawn into the middle tubular member to grasp, twist, stretch, mould and to compress the stump of tubular tissue within the interlevered prongs and draw it into the middle tubular member.

8. A telescopic band applicator for use in applying an elastic band to a stump of tubular tissue, comprising: an outer tubular member, a middle tubular member telescopically received within the outer tubular member and having an inner cylindrical surface, and an inner tubular rod member telescopically received within the middle tubular member; four prongs attached to an end of the inner tubular rod member, the prongs being arranged as first and second opposed pairs of identical prongs, each of the first pair of prongs having an inwardly facing forceps hook at a distal end thereof. each prong being formed in the shape of an elongated triangle being narrower at the end of the inner tubular rod member and wider at the opposing distal end of the prong, with two elongated side edges and a short base edge at the distal end, the forceps hooks on the first pair of prongs extending inwardly and perpendicularly from the short base edge, on the distal part of the straight elongated side and the sum total length of the two forceps hooks is slightly in excess of the diameter of the middle tubular member inner cylindrical surface; each prong having inner concave and outer convex surfaces, each outer convex surface having a degree of curvature approximately the same as the inner cylindrical surface of the middle tubular member, each inner cylindrical surface being concentric with the outer cylindrical surface of a prong; and the prongs having a predetermined width and the straight elongated side edges of the prongs being tapered inwardly and the oblique elongated edge of the prongs being tapered outwardly to facilitate adjacent prongs to imbricate as the inner tubular rod member is drawn into the middle tubular member to grasp, twist, stretch, mould and compress a stump of tubular tissue within the interleaved prongs and draw it into the inner cylindrical surface of the middle tubular member.