Dissection and ligation cartridge

Abstract

Cartridges and methods for ligation or dissection and ligation of tubular tissue structures are described. The cartridges and methods provide a means for efficient dissection and application of one or more ligatures by a single user using a single cartridge resulting in effective closure of a vessel or other tubular tissue structure by placement of a ligature at the desired location resulting in the desired tissue margin or stump.

1 - 28 . (canceled) 
     
     
         29 . A device for cutting and ligating tissue, the device comprising:
 an elongate cartridge body having a radial periphery, and a proximal end and an opposite distal end, the proximal end and the distal end defining a cartridge axis;   a cartridge-base interface at the proximal end, the cartridge-base interface arranged to couple the device to a base that includes an actuator operative to move the device from a non-deployed configuration to a deployed configuration;   a deployable grasping or clamping implement housed within the cartridge body when the device is in the non-deployed configuration, the deployable grasping or clamping implement having jaws situated proximate the distal end;   a deployable cutter assembly housed within the cartridge body when the device is in the non-deployed configuration, the deployable cutter assembly including a blade movable relative to the cartridge body along a guide or channel that is arranged along the cartridge axis;   a first ligature loop holder fixed to the cartridge body and arranged to retain a first section of a ligature loop to extend along a portion of the radial periphery; and   a second ligature loop holder fixed to the cutter assembly and arranged to retain a second section of the ligature loop to pass through an interior of the cartridge body and to be movable relative to the first section along the cartridge axis;   wherein the deployable grasping or clamping implement is actuatable to grasp or clamp the tissue, and the deployable cutter assembly is actuatable to move the blade relative to the cartridge body to cut the tissue to thereby form a pair of cut ends, and to extend the ligature loop between the cut ends.   
     
     
         30 . The device of  claim 29 , wherein the ligature loop further includes a proximal tail and a partially tightened slidable knot, and wherein the device further comprises:
 a tensioner operative to tighten the ligature loop by pulling the proximal tail through the partially tightened slidable knot.   
     
     
         31 . The device of  claim 29 , wherein the non-deployed configuration comprises a proximal locked position wherein the ligature loop is non-tightenable, and the deployed configuration comprises an unlocked position wherein the ligature loop is tightenable. 
     
     
         32 . The device of  claim 29 , wherein the deployable grasping or clamping implement and the deployable cutter assembly are each actuatable via the cartridge-base interface. 
     
     
         33 . The device of  claim 29 , wherein the first ligature loop holder includes a groove recessed in an exterior surface of the cartridge body and elongated along a circumferential direction. 
     
     
         34 . The device of  claim 29 , further comprising:
 a third ligature loop holder fixed to the cartridge body and arranged to retain a third section of a second ligature loop to extend along a portion of the radial periphery; and   wherein the second ligature loop holder is further arranged to retain a fourth section of the second ligature loop to pass through an interior of the cartridge body and to be movable relative to the third section along the cartridge axis.   
     
     
         35 . The device of  claim 29 , wherein the first and the second loop holders are each arranged to hold a plurality of sections of a corresponding plurality of ligature loops. 
     
     
         36 . The device of  claim 29 , further comprising:
 a knot holder operative to prevent the ligature loop having a partially tightened slidable knot from being pulled when the device is in the non-deployed configuration.   
     
     
         37 . The device of  claim 29 , further comprising a plurality of ligature loops installed in the first ligature loop holder and the second ligature loop holder. 
     
     
         38 . The device of  claim 37 , wherein each ligature loop of the plurality of ligature loops is independently tightenable. 
     
     
         39 . A device for dissecting and ligating a tubular tissue structure comprising the device according to  claim 29 , and further comprising the base. 
     
     
         40 . The device of  claim 39 , wherein the base comprises a handle and a trigger.