LAPROSCOPIC KNOT APPLICATOR

Abstract

Laparoscopic Knot Applicator is a tool designed to facilitate application of surgeons Knot (FIG. 2) to ligate vessels and structures during laparoscopic procedures. Applying the secure surgeons knot in any surgical procedure is a life saving basic skill but it is a difficult task in laparoscopic surgeries. Operation of this tool (FIG. 3) ensures application of safer and secure knots compared to currently available techniques like clips, loops and Harmonic scalpel. Simple design of this tools enables laparoscopic surgeon to apply very secure conventional surgeons knot easily during laparoscopic surgeries even in a very limited surgical space. Cleaning and the sterilization of the instrument which is essential in surgical procedures is very easy as there are no electronic parts incorporated.

Claims

1. A device for making knots in laparoscopic surgery wherein the said device is comprising: a. a pair of grasping jaws[1] to grasp and manipulate tissues and surgical thread, b. a thread holding groove[2] placed proximal to the said grasping jaws assists in holding thread during loop formation of knot application, c. a shaft [3] rotatable in either direction totally independent from the controlling handle [5] to which said grasping jaws [1] and the thread holding groove [2] are attached, d. a jaw controller[4] at the controlling handle[5] operating said grasping jaws[1] open and close, e. a controlling handle[5] to which the shaft[3] of the instrument is attached independently rotatable, f. a rotation controller[6], connected to the shaft [3] at the handle end of the device assisting rotation in either direction, g. bearings for rotation[7] connecting the said shaft[3] to the controlling handle, h. tension springs[8] connected to the release knob for thread holding groove[9] to keep the said thread holding groove [2] at closed position, i. a release knob for thread holding groove[9] permitting opening of the said thread holding groove[2] to load and release the thread.

2. The device claimed in claim 1 comprising a thread holding groove wherein the said thread holding grove [FIG. 1-2] is an adjustable groove placed proximal to the grasping jaws [FIG. 1-1] of the instrument and the thread holding groove [FIG. 1-2] is kept closed position normally and opened using the release knob[FIG. 1-9] to load and release the thread.

3. The device claimed in claim 1 comprising a thread holding groove where in the said holding groove [FIG. 1-2] is an adjustable gap around the whole circumference of the shaft of the tool [FIG. 1-3]

4. The device claimed in claim 1 comprising a thread holding groove wherein the said holding groove[FIG. 1-2] is any type of second grasping area or grasping jaws in addition to the main grasping jaws [FIG. 1-1].

5. The device claimed in claim 1 comprising a thread holding groove wherein the said holding grove [FIG. 1-2] is capable of rotating in either direction with the aid of the rotation controller [6] at the handle end without rotating the controlling handle [5].

6. A method for applying instrumental surgeons knot [FIG. 2] comprising a rotatable thread holding groove[FIG. 1-2] which can hold and wrap the surgical thread around the independently rotatable shaft to any degree of rotation to form loops in the process of knot application.

7. A method of applying intracorporeal surgeons knot in laparoscopic procedure involving making a loop at one end of the thread where other end is passed through to form a knot. Method described herein is performed by holding one end of the thread using said thread holding groove and wrapping it around the independently rotating shaft of the tool making necessary number of loops. Once the said loop is formed around the shaft, the free end of the same thread is tightly held by the grasping jaws while wrapped end is released and dragged apart using second tool making the first knot.

Description

BRIEF DESCRIPTION OF DRAWINGS

[0020] Diagrams and the illustrations shown here will help to understand the structure of the preferred embodiment of the invention and its functional capabilities.

[0021] FIG. 1. conventional surgeons knot basic configuration.

[0022] FIG. 2. laparoscopic knot applicator structure and components.

[0023] FIG. 3. step by step illustration showing ligation procedure using laparoscopic knot applicator.

DESCRIPTION OF EMBODIMENTS

[0024] Laparoscopic knot applicator is a tool designed to facilitate easy application of surgeons knot in laparoscopic surgeries. Before going in to detailed description of the instrument it is essential to have an idea of basic configuration of surgeons knot [FIG. 1] and its unique knotting properties.

[0025] During any kind of surgical practice application of secure surgeons knot plays a very vital life saving role. Surgeons knot is a type of modified reef knot. As illustrated in FIG. 1, typical surgeons knot has double loops (twists) in its first throw[FIG. 1-1] and two subsequent throws having only one loop[FIG. 1-2]. The significance of this configuration is, double looped first throw ensures good friction and tethering to the ligated tissue which prevents slip ligature. Double twisted first throw also helps to maintain the tension of the first throw while applying the subsequent knots. Second and third throws of the knot prevents unfastening of the knot due to tension, pressure inside vessels etc. Due to this reliable and tissue friendly characteristics of this knot surgeons preferred to use it where ever necessary.

[0026] In contrast to open surgeries, it is not an easy task to perform the knot in laparoscopic procedures as surgeons have to use long instruments within a limited space. When laparoscopic ligating instruments parallel to each other (or narrow manipulation angle is used) it is extremely difficult to negotiate the loops of the knot. The new instrument described here helps to overcome these problems easily.

[0027] As illustrated in FIG. 1.1 double twist of first throw needs rotation of 720 degrees rotation of one thread around the other. performing these rotations inside body using long instruments, while watching on a two dimensional monitor in a small space is extremely difficult and needs lot of practice and coordination. Invention described here significantly reduce the effort and time necessary to apply knots during Laparoscopy.

[0028] preferred embodiment of the invention as shown in FIG. 2. comprised of a pair of grasping jaws[1], thread holding groove[2], shaft of the tool[3], jaw controller[4], controlling handle[5], rotation controller[6], bearings for rotation[7], tension springs[8], release knob for thread holding groove[9] and a inner shaft with stoppers.

[0029] Basic structure of the instrument can be described as a standard laparoscopic needle holder (or a grasper) with improvements comprising of a thread holding groove[2] and a release knob for the thread holder[9].

[0030] Grasping jaws[1] can be opened and closed using the jaw controller[4] to catch tissues and thread. whole shaft[3] of the instrument including grasping jaws[1] and thread holding groove[2] is rotatable in either direction using the rotation controller knob[6]. Thread holding groove[2] is kept closed position using tension spring[8] and opened only by pressing the release knob [9]. During ligation procedure once the thread is fed to the thread holding groove[2] it retains inside the groove[2] till released by the release knob[9]. This self retaining property of thread holding groove[2] is essential for the proper functioning of the knot applicator.

[0031] As illustrated on drawings present invention is entirely a mechanical device which contains no electronics or batteries. This is an important property of reusable surgical tools as these instruments need regular cleaning and sterilization using liquid disinfectants etc.

Operation of the Instrument.

[0032] Laparoscopy is a surgical technique developed to perform operations in side the body cavity using keyhole incisions. Carbon dioxide gas is pumped in to the abdominal cavity of anesthetized patient to achieve operating space. Then laparoscopic camera is inserted through a small incision at umbilicus to visualize intra abdominal structures on a TV screen. Instruments necessaryto perform operation are inserted through several other ports created on abdominal wall.

[0033] Invention described here is a laparoscopic tool to perform litigation in side the abdominal cavity. Once the vessel or the structure to be ligated is defined, suitable type of surgical suture material is inserted in to the body cavity via one of the ports. Then the thread is placed behind the vessel and one free end of thread is fed to the thread holding groove[FIG. 1-2] of the knot applicator after opening the groove by pressing thread release knob[FIG. 1-9]. Once caught by the thread holding groove thread will retain there due to the action of the tension spring. Next as illustrated on FIG. 3 thread is twisted around the shaft of the instrument 720 degrees using the rotation controller knob [FIG. 1-6] in clockwise direction. Now the other end of the thread is caught by the grasping jaws of the same instrument while the vessel/structure is encircled as demonstrated in FIG. 3-b. Now use a second instrument to catch the end of the thread held by the thread holding groove and drag it away to release the thread from the groove. While holding both ends of the string tightly, pull both instruments apart making the double twisted first throw of the surgeons knot successfully. Subsequent throws of the knot can be performed easily repeating the same sequence as described above.

[0034] Current invention can be used in a different way to apply the first throw of the surgeons knot as follows. Here the suture thread is fed to the thread holding groove and twist it around the shaft of the knot applicator 270 degrees, before inserting into the body cavity. Now the knot applicator with the twisted thread is introduced in to the abdominal cavity through a port. Then using a second grasping instrument pass the free end of the thread around the structure to be ligated and feed that end of the thread to the knot applicator grasping jaws. Next pull the end of the thread at the thread holding groove using the second instrument to release it. Now drag both ends of the thread apart to apply the first throw of the surgeons knot.