Endoscopic ligation

Abstract

A ligature delivery device includes a control member, an elongated shaft, and an end effector attached to the distal end of the elongated shaft. An activation mechanism provides an user-operable connection between the control member and the end effector. In several embodiments, the end effector includes a reverse grasping mechanism. Several embodiments of ligature devices are adapted to be deployed endoscopically and/or translumenally using the reverse-grasping delivery device.

1 . Apparatus for ligating tissue comprising:
 an applicator having an elongate shaft;   an arcuate shaped track on a distal end of the elongate shaft, with a distal end of the arcuate shaped track spaced apart from a proximal end of the arcuate shaped track by a gap;   a flexible strip movable along the arcuate shaped track;   a retainer adjacent to the distal end of the elongate shaft, with a distal end of the flexible strip movable into the retainer.   
     
     
         2 . The apparatus of  claim 1  with the retainer comprising a row of teeth for preventing the flexible strip from pulling out of the retainer. 
     
     
         3 . The apparatus of  claim 1  with the arcuate shaped track causing the flexible strip to loop back on itself as the flexible strip is advanced forward along the arcuate shaped track 
     
     
         4 . The apparatus of  claim 1  with the arcuate shaped track comprising a circumferential track. 
     
     
         5 . The apparatus of  claim 1  with the flexible strip having a plurality of engagement features. 
     
     
         6 . The apparatus of  claim 1  with the arcuate shaped track adapted to partially encircle target tissue. 
     
     
         7 . The apparatus of  claim 1  with the retainer comprising an engagement block including a ratchet mechanism. 
     
     
         8 . The apparatus of  claim 1  with the arcuate shaped track comprising a C-shaped track. 
     
     
         9 . The apparatus of  claim 1  further comprising a grasper on the elongate shaft for grasping a distal end of the flexible strip. 
     
     
         10 . The apparatus of  claim 9  with the grasper movable from a first position wherein a distal end of the grasper extends at least partially across the gap, to a second position wherein the grasper is withdrawn proximal of the gap. 
     
     
         11 . Apparatus for ligating tissue comprising:
 an applicator having a shaft;   a curved track on a front end of the shaft, with a forward end of the curved track spaced apart from the front end of the shaft by a gap;   a flexible strip slidable in a forward direction on the curved track;   a retainer on the front end of the shaft having an opening for receiving and retaining a front end of the flexible strip;   with forward movement of the flexible strip causing the flexible strip to at least partially curve back on itself with the front end of the flexible strip engaging the retainer.   
     
     
         12 . The apparatus of  claim 11  with the flexible strip having a plurality of engagement features and the retainer comprising a row of teeth engageable with the engagement features, for preventing the flexible strip from pulling out of the retainer. 
     
     
         13 . A method for ligating tissue, comprising:
 positioning a curved track partially around tissue;   advancing a flexible strip along the curved track so that the flexible strip surrounds the tissue;   continuing to advance the flexible strip until a leading end of the flexible strip engages a retaining member; and   holding the leading end of the flexible strip in the retaining member.