Multiple ligating band dispenser

Abstract

Apparatus for dispensing a plurality of ligating bands individually and sequentially. A support, attached to the distal end of an endoscope, carries the plurality of ligating bands at axially spaced positions along an exterior surface. The distal ends of each set of independent displacement filaments each ligating band releasably attach to the distal edge of the dispenser. Each filament loops around the corresponding ligating band and returns past the distal edge of the dispenser and through the endoscope to the proximal end thereof. When a physician pulls a set of filaments proximally, the loop in each filament advances the corresponding ligating band off the distal edge of the dispenser.

What is claimed as new and desired to be secured by Letters Patent of the United States is: 
     
       1. A ligating band dispenser for attachment to the distal end of an endoscopic device further characterized by a proximal end and a lumen extending between the proximal and distal ends, said dispenser being adapted for supporting a given plurality of elastic ligating bands and comprising: A. support means for attachment to the distal end of the endoscopic device and for carrying the given plurality of ligating bands thereon, said support means having a passage therethrough for communication with the lumen, and   B. dispensing means including: i. a plurality of independent displacement means corresponding to the given plurality extending into the lumen of the endoscopic device, each said displacement means being attached to said support means and engaging a corresponding one of the ligating bands, and   ii. operator means extending from each of independent displacement means through the lumen of the endoscopic device thereby to be accessible at the proximal end thereof whereby proximal motion of said operator means from the proximal end of the endoscopic device transfers the most distal ligating band off the distal end of said support means.     
     
     
       2. A ligating band dispenser as recited in claim 1 wherein said support means includes tubular body means having an exterior cylindrical surface for carrying the ligating bands and having a proximal shoulder portion and includes connector means for connecting said shoulder portion to the proximal end of the endoscope. 
     
     
       3. A ligating band dispenser as recited in claim 1 wherein each of said plurality of independent displacement means includes a plurality of filaments having the distal end attached to a corresponding one of the ligating bands. 
     
     
       4. A ligating band dispenser as recited in claim 3 wherein said support means includes a distal edge portion and wherein each of said plurality of filaments extends distally of said distal edge portion from a corresponding one of said operator means, loops around a corresponding ligating band and releasably attaches to said support means at said distal edge portion. 
     
     
       5. A ligating band dispenser as recited in claim 4 wherein each said filament lies intermediate said support means and all ligating bands intermediate the corresponding ligating band and said distal edge portion. 
     
     
       6. A ligating band dispenser as recited in claim 4 wherein said filaments in each of said independent displacement means attach to said distal end and engage the corresponding ligating band substantially equiangularly. 
     
     
       7. A ligating band dispenser as recited in claim 4 wherein each of said independent displacement means comprises a pair of filaments that engage a corresponding ligating band and said distal edge portion at substantially diametrically opposed positions. 
     
     
       8. A ligating band dispenser as recited in claim 4 wherein each of said operator means comprises a grasping means formed in the proximal end of each said filaments for facilitating proximal displacement of said filaments and the corresponding ligating band from said dispenser. 
     
     
       9. A ligating band dispenser as recited in claim 4 wherein each of said operator means comprises a grasping means extending from the proximal end of the endoscope into said lumen and comprises bridle means for attaching said grasping means to the filaments in said corresponding independent displacement means for facilitating proximal displacement of said filaments and the corresponding ligating band from said dispenser. 
     
     
       10. A ligating band dispenser as recited in claim 4 wherein each of said operator means comprises a handle tied to the proximal end of each said filaments in a corresponding independent displacement means for facilitating proximal displacement of said filaments and the corresponding ligating band from said dispenser. 
     
     
       11. A ligating band dispenser as recited in claim 4 wherein said support means includes filament guide means located proximally of said distal edge portion for guiding said filaments proximally from said distal edge portion. 
     
     
       12. A ligating band dispenser as recited in claim 11 wherein said support means includes, proximally of said distal edge portion, a filament guide means for each of said plurality of filaments. 
     
     
       13. A ligating band dispenser as recited in claim 11 wherein said support means includes a filament guide means for directing each filament from the interior of said support means proximate said distal edge portion to the exterior of said support means over an intermediate portion thereof and to the interior of said support means at a proximal end thereof. 
     
     
       14. A ligating band dispenser as recited in claim 11 wherein each of said independent displacement means comprises a plurality of filaments at different angular positions for engaging a corresponding ligating band at spaced positions thereon and wherein a corresponding filament for each of said independent displacement means forms a filament group, said support means additionally including a filament group guide means for directing the filaments in each group from the distal to the proximal ends of said support means, each group of guide means at said distal end being spaced with respect to each other and being adjacent at said proximal end. 
     
     
       15. A ligating band dispenser as recited in claim 14 wherein each of said filament groups are substantially equiangularly displaced about said distal edge and wherein said guide means are grouped closely adjacent at said proximal end of said support means. 
     
     
       16. A ligating band dispenser as recited in claim 11 wherein each of said independent displacement means comprises a plurality of filaments at different angular positions for engaging a corresponding ligating band at spaced positions thereon and wherein a corresponding filament for each of said independent displacement means forms a filament group, said support means additionally including a filament group guide means for directing the filaments in each group from the distal to the proximal ends of said support means, each group of guide means at said distal end being spaced with respect to each other and said groups of guide means being adjacent at said proximal end. 
     
     
       17. A ligating band dispenser as recited in claim 16 wherein each of said groups are substantially equiangularly displaced about said distal edge and wherein said guide means are grouped closely adjacent at said proximal end of said support means. .Iadd. 
     
     
       18.  An apparatus for dispensing a flexible ligating band, wherein the device is coupleable to an endoscopic device having a distal end and a proximal end, the apparatus comprising: a support member selectively coupleable to the distal end of the endoscopic device, wherein the support member includes an outer support surface adapted to receive at least one ligating band thereon; and   a filament which, when the device is in an operative configuration, extends from the proximal end of the endoscopic device to the support surface to engage a ligating band so that, when the filament is drawn proximally from the endoscopic device, a ligating band is released from the support surface..Iaddend..Iadd.   
     
     
       19.  An apparatus according to claim 18, wherein the filament includes a proximal portion coupled to a distal portion so that, when the device is in the operative configuration, the proximal portion extends from the proximal end of the endoscopic device to an intermediate location within the lumen and the distal portion extends from the intermediate location to the support surface, and wherein the distal portion includes a plurality of lines, each line extending to a corresponding location on the support surface..Iaddend..Iadd.20. An apparatus according to claim 18, wherein the support surface is substantially cylindrical and wherein the circumference of the support surface is selected so that it is greater than an unstretched diameter of the ligating bands which are flexible and are stretched to be placed on the support surface..Iaddend..Iadd.21. An apparatus according to claim 18, wherein the endoscope includes a lumen extending from the distal end to the proximal end thereof and wherein, when the support surface is coupled to the endoscope, the lumen communicates with a passage extending through the support surface and the filaments extend from the proximal end, through the lumen to the distal end, through the passage to the support surface..Iaddend..Iadd.22. An apparatus according to claim 18, wherein the support surface includes a guideway for receiving the filament therein so that the filament is maintained in a desired position on the support surface..Iaddend..Iadd.23. An apparatus for dispensing a plurality of ligating bands, wherein the apparatus is adapted to be coupled to an endoscopic device having a distal end and a proximal end, the apparatus comprising: a support member selectively coupleable to the distal end of the endoscopic device, wherein the support member includes an outer support surface adapted to receive a plurality of ligating bands thereon; and   a plurality of filaments, each of which, when the device is in an operative configuration, contacts a respective ligating band so that, when each filament is drawn proximally, the respective ligating band is released from the support surface..Iaddend..Iadd.24. An apparatus according to claim 23, wherein the support surface includes a plurality of guideways, each of the guideways corresponding to a respective filament to maintain each filament in a desired position on the support surface..Iaddend..Iadd.25. A system for dispensing ligating bands comprising:   an endoscopic device having a distal end and a proximal end;   a support member coupled to the distal end of the endoscopic device, wherein the support member includes an outer support surface adapted to receive at least one ligating band thereon; and   a filament which, when the device is in an operative configuration, extends from the proximal end of the endoscopic device to the support surface to engage a ligating band so that, when the filament is drawn proximally from the endoscopic device, a ligating band is released from the support surface..Iaddend..Iadd.26. A system according to claim 25, wherein the endoscope includes a lumen extending therethrough from the proximal end to the distal end and wherein, when the support surface is coupled to the endoscopic device, the filament extends through the lumen to a passage extending through the support surface..Iaddend..Iadd.27. A system according to claim 25, wherein the ligating band is flexible and wherein an unstretched diameter of the ligating band is smaller than a diameter of the support surface..Iaddend..Iadd.28. A system according to claim 25, wherein the support surface is adapted to receive a plurality of ligating bands thereon..Iaddend..Iadd.29. A system for dispensing a ligating band comprising:   a support surface for holding a plurality of ligating bands thereon, the support surface being sized so that the ligating bands received thereon are stretched beyond an unstretched diameter, wherein, when the device is in a desired position inside a living body, the support surface is located adjacent to a portion of tissue to be ligated; and   a filament which, when the device is in the operative position, extends from a proximal end outside the living body to a distal end coupled to at least one ligating band received on the support surface so that, when the filament is pulled axially, the at least one ligating band is released from the support surface..Iaddend..Iadd.30. An apparatus according to claim 29, wherein the support surface includes at least one guideway for maintaining the filament in a desired position on the support surface..Iaddend..Iadd.31. The apparatus according to claim 30, wherein the at least one guideway includes a notch extending from a distal end of the support surface toward a proximal end thereof..Iaddend..Iadd.32. An apparatus for dispensing a plurality of flexible ligating bands to tissue within a living body, comprising:   a support member selectively coupled to a distal end of an endoscopic device, wherein the support member includes a passage therethrough and an outer support surface adapted to receive at least one ligating band thereon; and   at least one filament coupled to the at least one ligating band so that, when the at least one filament is drawn proximally, the at least one ligating band is released from the support surface..Iaddend..Iadd.33. An apparatus according to claim 32, wherein the support member is substantially cylindrical and includes at least one guiding notch formed in a distal end thereof and wherein the at least one filament is slidably received within the notch so that the filament is maintained at a desired location on the support surface..Iaddend..Iadd.34. An apparatus according to claim 32, wherein the support surface includes a passage therethrough and the filament extends therethrough..Iaddend..Iadd.35. An apparatus according to claim 32, wherein the ligating bands are flexible..Iaddend..Iadd.36. An apparatus according to claim 32, wherein the support surface is adapted to receive a plurality of ligating bands   
     
     
        thereon..Iaddend..Iadd.37.  A method for ligating tissue within a living body comprising the steps of: positioning a support surface adjacent to a first portion of tissue to be ligated, wherein the support surface includes at least one ligating band received on an outer surface thereof and wherein a filament coupled to the at least one ligating band extends from the support surface to a proximal end;   drawing the tissue to be ligated into a passage extending through the support surface;   pulling the proximal end of the filament to release the at least one ligating band from the support surface so that the at least one ligating band encircles and grips the first portion of tissue..Iaddend..Iadd.38. A method according to claim 37, wherein the at least one ligating band includes a first ligating band and a second ligating band and wherein the first ligating band encircles and grips the first portion of tissue, further comprising the steps of:   positioning the support surface adjacent to a second portion of tissue to be ligated;   drawing the second portion of tissue into the passage; and   releasing the second ligating band so that the second ligating band encircles and grips the second portion of tissue..Iaddend..Iadd.39. A method according to claim 37, wherein the steps of drawing the first and second portions of tissue into the passage include the step of applying suction to the tissue via the passage..Iaddend..Iadd.40. A method according to claim 37, wherein the steps of positioning the support surface adjacent to the first portion of tissue includes the step of coupling the support surface to the distal end of an endoscope and guiding the endoscope through a body lumen so that the support surface is adjacent   
     
     
        to the first portion of tissue..Iaddend..Iadd.41.  An apparatus for ligating tissue within a living body comprising: a support member for receiving a plurality of elastic ligating bands on a support surface thereof, wherein the support member includes means for selectively coupling to and decoupling from a distal end of an endoscopic device;   means for drawing tissue to be ligated into the support member; and   means for selectively releasing the ligating bands individually to encircle and elastically grip tissue received within the support member to cut off varices..Iaddend.