Apparatus and method for laparaoscopic ligation

Abstract

A laparoscopic ligation device comprises an elongate hollow tube, having an open distal end. An arcuate finger, attached to the tube, has a tip that is distally spaced from the distal end of the tube. The finger includes structure adjacent its tip that releasably holds the tag end of a length of suture. A hollow mandrel is disposed within the tube, for movement between extended and withdrawn positions. The mandrel has an open distal end, carrying a plurality of loops formed in the standing part of the suture, that extends distally from the open end of the tube in the extended position. A rod having a hook at its distal end is disposed within the mandrel for movement between extended and withdrawn positions. In use, the finger is manipulated to engage a vessel or duct. The rod is moved to its extended position so that its hook snags the suture tag end from the finger tip. The rod is then moved toward its withdrawn position, carrying the tag end to form a ligature loop around the vessel or duct, and then into the distal end of the mandrel, and through the loops thereon. The mandrel is moved to its withdrawn position, thereby dropping the loops onto the tag end to form a loose knot that is tightened by the continued movement of the rod to its withdrawn position to constrict the ligature loop around the duct or vessel. The knot is then cut away from the rest of the suture.