Device for applying a rubber band in the human body

Abstract

The invention relates to a device for applying rubber bands, in particular in the human body and in other living beings. According to the invention, the device comprises: a) a mandrel body (1) with a first handle (34); b) a trigger (2) which is movably mounted on the mandrel body (1) and has at least one handle (35, 36) for moving the trigger (2) along the mandrel body (1), wherein the trigger (2) is used to pull a wire (14); and c) an assembly (19) with a spool (4) for winding the wire (14).

Description

Technical Field

[0001] The present invention relates to a device, particularly for applying rubber bands to the human body and other organisms, having a rubber band ligator with a manually controllable trigger. Background Technology

[0002] Rubber band ligation or rubber banding refers to a medical procedure used to treat various gastrointestinal conditions such as varicose veins (e.g., esophageal varices), arteriovenous cushions (e.g., hemorrhoids), or to protect against bleeding during polyp removal. In cases of esophageal varices, rubber band ligation is the preferred treatment, especially when there is active bleeding, existing bleeding, or a risk of bleeding.

[0003] For grade 1 hemorrhoids, this method is an alternative to sclerotherapy. It is ideal for treating grade 2 hemorrhoids, in particular. Due to the low success rate for grade 3 hemorrhoids, it is generally only used when there are compelling reasons against surgery.

[0004] In the case of rubber band ligation, the rubber band is applied to the base of the varicose vein, hemorrhoid, or polyp using an application tool. It tightens the prolapsed portion and restricts local blood flow. In the case of hemorrhoids or varicose veins, complete thrombosis of the vessel occurs after two to three days. A few days later, the ligated tissue necroses and is inconspicuously excreted with the rubber band in the feces.

[0005] Using up to 10 rubber bands at the tip of the endoscope, multiple varicose veins can be treated endoscopically, thus achieving complete ligation. Sometimes, it is necessary to ligate the remaining varicose veins during a second treatment.

[0006] This method is low-cost and, in some cases, relatively simple to perform on an outpatient basis. Typically, the treatment does not cause pain, so anesthesia is not required.

[0007] The modern rubber band ligature was first used by Blaisdell in the 1950s and was subsequently improved and refined by Barron, who used a mechanical instrument, namely the Barron ligature.

[0008] A ligator (US9693779B2) is also known, configured for use with an endoscope and mounted on the endoscope body. In currently known treatment methods, multiple elastic bands are sequentially applied to the intestinal tissue. An actuation mechanism is used for this, carried by the ligator body. The actuation mechanism includes a rotatable actuation button, a rotatable cord winding loop, an actuation cord, and a restraint that limits the rotation of the actuation button between a start position and an end position, beyond which further rotation is impossible. Instrument operation is time-consuming.

[0009] Other devices for applying rubber bands to the human body have been disclosed by DE 299 12 945 U1, DE 10 2004 002692 A1, US 2012 / 0095 507 A1, EP 1 484 077 A2 and US 2008 / 1 183 035 A1.

[0010] In the currently known rubber band ligators, the handle of the rubber band ligator is manually turned, which causes an adverse back force, resulting in instrument instability. Summary of the Invention

[0011] The objective of this invention is to simplify the operation of the rubber band ligator as much as possible and to automate it, by using the mechanism of this invention to release the rubber band from the rubber band ligator.

[0012] According to the present invention, this task is accomplished by a device for applying a rubber band having the following characteristics: a) A spindle body with a first handle; b) A trigger element movably mounted on a mandrel body and having at least one handle for moving a trigger element along the mandrel body, wherein the trigger element is used to pull a metal wire; c) An assembly having a winding spool for winding metal wire.

[0013] According to one embodiment of the invention, the winding reel is connected to the trigger via a transmission mechanism that converts the translational motion of the trigger into the rotational motion of the winding reel and is designed such that the winding reel is driven to rotate and wind the metal wire at least during a portion of the movement of the trigger along the mandrel. Preferably, the winding reel is not driven to rotate during another portion of the movement of the trigger.

[0014] Instead of the aforementioned transmission mechanism, a spring-controlled winding mechanism can be used, which drives the winding reel to rotate. The spring-controlled winding mechanism can be designed such that the metal wire is wound when the trigger returns from the proximal position to the distal initial position.

[0015] The transmission mechanism can be designed such that the winding reel is driven to rotate only when the trigger is pulled from the distal position (initial position) to the proximal position, but not when it returns to the initial position. Conversely, the transmission mechanism can also be designed such that the winding reel is driven to rotate when the trigger returns to the initial position, but not when the trigger is pulled from the distal position (initial position) to the proximal position.

[0016] Regarding the arrangement of the assembly with the winding reel, various possibilities exist: In a first embodiment, the assembly with the winding reel is fixedly connected to the trigger. In this case, the transmission mechanism is preferably designed such that the winding reel is only moved when the trigger is pulled, but not driven to rotate, so that the metal wire is pulled accordingly and one or more rubber bands can be applied to the treatment site on the organism. When the trigger returns to its initial position, the winding reel is driven to rotate by the movement of the trigger, and the metal wire is wound onto the winding reel.

[0017] The selective function of the transmission mechanism during pulling or returning motion, i.e., the selective rotation drive of the winding reel, can be achieved, for example, by having the gear transmission mechanism mechanically engaged in one motion and mechanically disengaged in another. However, the transmission mechanism may also include a pawl mechanism that causes the pawl to act on the corresponding element and drive the winding reel to rotate when the trigger is operated in the first direction of motion, but to idle and not transmit force when the trigger is operated in the opposite direction of motion.

[0018] According to the second embodiment, the assembly with the winding reel is positioned at the mandrel body. In this case, the trigger is preferably designed such that it actuates the wire when the trigger is pulled from the distal position to the proximal position. The trigger may for this purpose, for example, have a hook or pin that acts on or deflects the wire. The transmission mechanism is preferably designed such that it drives the winding reel to rotate when the trigger returns from the proximal position to the initial position, but does not do so when the trigger is pulled. The foregoing applies to the selective function of the transmission mechanism.

[0019] The device for applying the rubber strip may include an automatic winding mechanism, which can automatically tighten the metal wire at the beginning of the application phase. This winding mechanism preferably includes a spring that drives the winding reel to rotate. Instead of a spring, other drive mechanisms, such as an electric motor, may be used.

[0020] The automatic winding mechanism is preferably locked in the initial position of the trigger, i.e., no tension is applied to the wire. The automatic winding mechanism can be activated by unlocking. Then, a spring or drive mechanism drives the winding reel to rotate, thereby pre-tensioning the wire.

[0021] A key advantage of this invention is that it enables automatic winding of the metal wire onto the winding spool using the rubber band tie of this invention. Automatic winding is achieved by pulling a trigger.

[0022] Thus, the rubber band is applied to the treatment site in the rubber band ligator of the present invention by the pulling (tension-compression principle) of the trigger element. Therefore, the work of the surgeon or physician is significantly simplified and can be performed more quickly. The device for applying the rubber band according to the present invention can be used with or without an endoscope.

[0023] The advantage here is that the rubber band ligator can be applied by applying pressure to the endoscope with the thumb and by using one hand, and the rubber band ligator remains fixed.

[0024] Advantageously, the mandrel body has an upper longitudinal groove and a lower longitudinal groove, which are connected by a connecting channel and serve as guide rails for the pin.

[0025] Another advantage is that the support is equipped with pins, which are components, and the pins are guided in the channels and connecting channels of the spindle body, wherein the rear pin is always guided in the upper longitudinal groove, while the other two pins are guided in the lower longitudinal groove and the upper longitudinal groove and connecting channel.

[0026] It is also advantageous that two parallel and spaced-apart receptacles are connected to each other, wherein one of the receptacles has a mandrel on which a winding spool is mounted, and the metal wire can be wound onto the winding spool by an automatic winding mechanism in the preparation stage and by a drive connection in the working stage.

[0027] Advantageously, the drive connection consists of a rack and pinion, with the pinion initially engaged with the rack after the assembly has moved. By returning the trigger to its initial position, the wire is wound onto the winding spool.

[0028] Advantageously, the spindle mounted on the support extends through an opening in the second support, wherein the disc spring connected to the bushing via the support is locked by means of a faceted shaft.

[0029] It is also advantageous that the catheter can be housed within the mandrel and moved, wherein the metal wire can be guided within the catheter, and the catheter is mounted in the endoscope and thus connected to the mandrel, i.e., the elastic element, especially the rubber band, can be applied to the desired site on the organism by means of the metal wire.

[0030] It is also advantageous that by activating the winding mechanism or gently pulling the trigger, the locking device of the winding reel is disengaged from the front bearing, wherein the winding reel is now rotated clockwise by means of a pre-tensioned winding reel spring and the metal wire is automatically wound onto the winding reel.

[0031] Advantageously, by resetting the trigger to its initial position, the metal wire is wound onto the winding spool, while the two front pawls are pressed outward. The pin passes around the pawls, causing them to return to their initial state, thus ensuring that the pin does not move backward into the upper longitudinal slot, but instead moves through the connecting channel into the lower longitudinal slot.

[0032] It should be noted that the metal wire is designed in such a way that it protrudes from the endoscope.

[0033] Advantageously, a cap is placed at the end of the endoscope, and a large number of rubber bands are placed on the cap.

[0034] Another advantage is that the ejection of the rubber band at the end of the endoscope is achieved by means of a metal wire. In order to eject the rubber band, the metal wire retracts a distance of about 40mm, and is wound onto the winding spool as the trigger returns to its initial position.

[0035] It should be noted that during the preparation stage, the end of the metal wire is connected to the loop of the wire contained in the endoscope via a loop. The winding mechanism is operated by gently pulling the trigger, so that the metal wire is pulled into the endoscope and the cap is fitted onto the end of the endoscope.

[0036] The rubber band ligator of the present invention is characterized by an automatic winding mechanism, which ensures that the metal wire is quickly wound and placed in the preparation stage by means of a pre-tightened winding coil spring, which saves time and workload.

[0037] In the newly improved rubber band ligator, the rubber band can be continuously released via a rack and pinion mechanism using a metal wire.

[0038] Unlike existing rubber band ligators (where manual rotation of the handle generates an unfavorable backlash that causes instability), the rubber band is released by pulling the trigger, i.e., by the principle of tension and compression, through the rubber band ligator of this invention.

[0039] As described above, the length of the pull distance of the trigger (proximal direction) determines the length of the pulled-in metal wire. The length of the trigger pull distance is typically limited to a certain value, such as 35-45 mm, by a proximal stop. To allow the use of different types and sizes of rubber bands requiring different pull distances, a stop can be provided that limits the pull distance of the trigger during the return motion. In one embodiment, for example, a stop can be provided, which can be fixed along the mandrel body, for example, by insertion into the desired position. In another embodiment, for example, one or more elements, such as pins, provided on the mandrel body can be provided, which can be manually adjusted and prevent or allow the trigger to continue moving proximally.

[0040] To support practical applications using caps of different diameters, winding cores with multiple sections of varying diameters can be used. These different diameters can be color-coded for better allocation to specific caps. Alternatively, multiple different replaceable cores, each with only one specific diameter, can be provided, each color-coded to its corresponding application. Attached Figure Description

[0041] Other advantages and details of the invention are explained in the claims and description and are illustrated in the figures, wherein: Figure 1 A perspective view of a rubber band ligator is shown. Figure 1a An exploded view of the rubber band ligature is shown; Figure 2 The trigger for operating the automatic winding mechanism and pulling the metal wire is shown; Figure 3 A moving mandrel with an upper and lower rail is shown; Figure 4 The front section, i.e., the locking device with pawls, is shown; Figure 5 Show components; Figure 5a , 5b An exploded view of the components is shown; Figure 6 A perspective view showing a rubber band ligator in the preparation stage, along with an endoscope and the rubber band. Figure 6a A perspective view showing the rubber band ligator in its initial position during the working phase, along with the endoscope and the rubber band. Figure 6b A perspective view of a cap with threads but no rubber band is shown; Figure 7 A cross-sectional view of the rubber band ligator in its initial state is shown from a side perspective; Figure 7a A cross-sectional view of the rubber band ligature in its initial state is shown from an overhead perspective; Figure 8 A cross-sectional view of the rubber band ligator in its initial state is shown, along with the metal wire on the winding spool and the tension spring within the cavity. Figure 9 A cross-sectional view of the rubber band ligator is shown from an overhead perspective, and an elastic pawl is shown that prevents the pin from moving upward toward the longitudinal groove; Figure 10 A cross-sectional view of the rubber band ligator in its initial position during the pulling phase is shown from a side view, wherein the pin is guided from the inclined front connecting channel into the upper longitudinal groove. Figure 11 A cross-sectional view of the rubber band ligator in the pulling phase is shown from a side view, in which the pin is introduced from the upper longitudinal groove into the lower longitudinal groove; Figure 12 A cross-sectional view of the rubber band ligator is shown from an overhead perspective, in which the pin presses two laterally elastic pawls outward; Figure 13 A cross-sectional view of the rubber band ligator is shown from a side perspective, with the pin located within the connecting channel; Figure 14 A cross-sectional view of the rubber band ligator is shown from an overhead perspective, where the two lateral elastic pawls return to their initial state; Figure 15A cross-sectional view of the rubber band ligator is shown from a side perspective, showing the end of the wire pulling phase; Figure 16 , 17 A cross-sectional view of the rubber band ligator is shown, in which two lateral elastic pawls prevent the pins from returning to the lower longitudinal groove; Figure 17 A cross-sectional view of the rubber band ligator is shown from a side perspective, showing the start of the drive connection between the gear and the rack; Figure 18 , 19 A cross-sectional view of the rubber band ligator is shown from an overhead perspective, in which the pin presses two laterally elastic pawls outward; Figure 19 A cross-sectional view of the rubber band ligator is shown from a side perspective, showing the additional end of the drive connection between the gear and rack; Figure 20 A cross-sectional perspective view of the rubber band ligator is shown, here indicating the end of the wire pulling phase; Figure 21 A cross-sectional perspective view showing the configuration of the device, wherein the assembly with the winding spool is mounted on the mandrel body, and the trigger is located in a proximal position; Figure 22 A cross-sectional perspective view showing the configuration of the device, wherein the assembly with the winding spool is mounted on the mandrel body, and the trigger is located in the distal position. Detailed Implementation

[0042] Figure 1 and Figure 6-8 A rubber band tie with an automatic winding mechanism is shown. The winding mechanism ensures that excessively long metal wires 14 and silk threads 53 can be wound up quickly during the preparation stage using a pre-tensioned coil spring 13. The winding mechanism is based on... Figure 5a , 5b It is specifically composed of a winding reel 4, a pre-tensioned coil spring 13, a locking device 25, receiving parts 3 and 5, a single-row needle roller bearing 12, a bearing seat 37 for the front part 10, and a bushing 6.

[0043] Figure 1 , 1a 2, 3 and Figure 20This is a perspective view of the rubber band ligator 20, which includes a mandrel body 1 with a circular handle 34 at one end. For example, an operator's thumb can be accommodated in the handle. Two additional circular handles 35 and 36 are provided on a movable trigger 2, which is movably mounted on the mandrel body 1. The operator's index and middle fingers can be accommodated in the two side-by-side handles 35 and 36, thereby actuating the trigger 2 and moving it on the mandrel body 1. Thus, the rubber band 18 is applied to the base of hemorrhoids, varicose veins, or polyps using the rubber band ligator 20, as further described below.

[0044] according to Figure 5-5b The perspective view and exploded view show that component 19 consists of interconnected receiving parts 3 and 5, one of which is equipped with a disc 48 and a spindle 26, and the other is equipped with a perforated disc 48b and an opening 33.

[0045] A single-row needle roller bearing 12 is locked onto the spindle 26, and a winding spool 4, which can only be rotated clockwise according to arrow 4b, is mounted on the needle roller bearing. A bushing 6 is mounted to the winding spool 4 by means of a polygonal facet 43. The bushing houses the wound coil spring and is installed and preloaded by means of a handle 7.

[0046] For this purpose, the winding reel 4 has a locking device 25 on its outer periphery, which prevents rotation when the automatic winding mechanism is not activated.

[0047] according to Figure 5a , 5b A gear 29 is disposed on the right side of the winding spool 4, extending through an opening 33 in the support 49b. Each of the two supports 49, 49b has two pins 21, 23 and 22, 24, which are received within channels 38, 40, as follows: Figure 9-20 As is known and will be explained in detail.

[0048] The two receiving parts 3 and 5 are fixedly connected to each other or, for example, glued together. Figure 5 , 5a 5b), in which a winding disc 4 is placed, in the guide tube 9 ( Figure 1 , 6 The metal wire 14 guided in the endoscope 15 is wound onto a spool, and the endoscope is equipped with a camera 27 at one end. Figure 6 ).

[0049] according to Figure 5 and 5a 5b, on the right side of the receiving part 5, there is a bushing 6 with an external gear 6b, the bushing housing a pre-tensioned disc spring 13 within its cavity. The disc spring 13 is capable of adjusting according to... Figure 5The spring 13 is wound or tightened by means of handle 7. The spring 13 is fixed in the bushing 6 by means of support 28 and locked to the inner part by means of a faceted spindle 26, which may be designed, for example, as a hexagonal connection structure. The spring 13 can be wound or tightened during the production stage by turning handle 7 according to arrow 30.

[0050] according to Figure 6 and 8 One end of the metal wire 14 is mounted on the winding spool 4, and the other end is guided in the catheter 9, which is supported in the endoscope 15.

[0051] Mandrel 1 ( Figure 3 , 20 The channel 38, 40 has an upper longitudinal groove 38 and a second longitudinal groove 40 spaced apart therefrom or below it. The two front ends of the channels 38, 40 are connected to each other by a connecting channel 54 extending obliquely in the direction of the conduit 9. The two channels 38, 40 are connected by a rear connecting channel 55 extending obliquely relative to the handles 35, 36.

[0052] The metal wire 14 is designed to be long enough to protrude a portion onto the endoscope 15. During the preparation stage ( Figure 6-8 A cap 50 should be placed at the end of the endoscope 15, and a large number of rubber bands 18 should be fitted on the cap. The end of the metal wire 14 is connected to the loop 51 of the wire 53 via a ring 52. The wire is contained inside the endoscope 15 and connected to the winding reel 4. By gently pulling the trigger 2 by 2~3mm, the winding mechanism is actuated, so the metal wire 14 is pulled into the endoscope 15 and the cap 50 is fitted onto the end of the endoscope 15. Figure 6a , 9 10).

[0053] The winding reel 4 is equipped with a locking device 25. Figure 5a , 5b 7, 8), which continuously locks the rotational movement of the winding reel 4 until the locking device 25 moves backward toward the handle 34 by slightly pulling the trigger 2 by 2~3mm, so that pins 23 and 24 are in the preparation stage ( Figure 6-10 First, it moves upward and backward to the inclined connecting channel section 45. Figure 7-10 In this configuration, pins 21 and 22 are accommodated in holes 16 and thus retained within the upper longitudinal groove 38. During the preparation stage, the trigger element 2 is pulled and, consequently, moved along the spindle body 1. Figure 6-10 In this process, the metal wire 14 is automatically wound onto the winding reel 4 by means of the coil spring 13 through the release of the bearing 37 located at the front part 10. Figure 6a , 9 (10). It should be noted that the disc spring 13 is housed in the bushing 6 in the pre-tensioned state.

[0054] By continuing to pull, the trigger 2, together with the receiving part 3 and the fixed cover 5, and the entire assembly 19 ( Figure 5-5b Pins 21 and 22 are pulled together toward handle 34, while pins 21 and 22 are moved backward, passing through connecting channel 54. Figure 10-11 ), and then are guided in the lower longitudinal groove 40, thus allowing pins 23, 24 to enter the extended connecting channel 55 ( Figure 12-13 Then it enters the upper longitudinal groove 38 ( Figure 14-15 ).

[0055] according to Figure 4 The front part 10 of the rubber band ligator has an elastic [feature] in the outer region, as shown in the top view. Figure 1a , 9 Two laterally resilient pawls 42 prevent pins 23 and 24 from moving backward along the upper longitudinal groove 38 in the direction of the handle 34 due to the pulling of the trigger 2. Instead, they pass through the connecting channel 54 connecting the upper and lower longitudinal grooves 38 and 40. This ensures that pins 23 and 24 are guided within the lower longitudinal groove 40 and thus enter the extending connecting channel 55 that connects the lower longitudinal groove 40 to the upper longitudinal groove 38, and are pressed outward by the resilient pawls 41 of the front part 10. Figure 12 , 13 After pins 23 and 24 pass by pawl 41, pawl 41 returns to its initial state. Figure 14 , 15 Therefore, it is ensured that pins 23 and 24 do not return to the lower longitudinal groove 40, but can instead move into the upper longitudinal groove 38.

[0056] according to Figure 8 A tension spring 11 is disposed in the cavity 56 between the front part 10 and the spindle body 1. One end of the tension spring 11 is fixed to the front part 10 by a fixing part 32, and the other end is fixed to the trigger member 2 by a fixing part 31. The tension spring 11 continuously applies tension to the trigger member 2 and the assembly 19, causing the trigger member 2 to move forward toward the endoscope 15 until the end of the upper longitudinal groove 38, so that the pins 23 and 24 can no longer move along the extended channel 45 because the locking device 39 ( Figure 9 , 10 This prevents it from doing so. The locking device 39 is fixed to the spindle body 1 and according to... Figure 3 It is located inside the front part of the mandrel body 1.

[0057] The reset of trigger 2 and its connected components will also generate a drive connection between gear 29 and rack 47. Figure 17 , 19 The rack is located at the lower part of the spindle body 1. Figure 3 ).

[0058] Through the gear 29 and the rack 47 located on the bottom side of the spindle body 1 ( Figure 3 , 17 The drive connection between -19) and the reset of the trigger 2 causes the metal wire 14 to be wound onto the winding reel 4, while the two pawls 42 of the front part 10 ( Figure 18 The trigger element 2 is pressed outward, preventing pins 23 and 24 from moving further backward in the upper rail 38. Instead, they move downward into the lower longitudinal groove 40 via the connecting channel 54. Each time the trigger element 2 moves backward, a rubber band on the endoscope 15 is released and applied to the corresponding area of ​​the patient to be treated.

[0059] according to Figure 6 The thread 53 is connected to a large number of rubber strips 18 arranged side by side on the cover 50, so that new rubber strips can be applied to the desired location by pulling the trigger 2 individually. Thus, the operation of the trigger 2 and the assembly 19 is repeated as already described.

[0060] The procedure for applying a rubber ring 18 to a desired site, such as a hemorrhoid, using a rubber band ligator 20 is summarized below.

[0061] The operation consists of two stages: 1. Preparation stage During the preparation phase, the rubber band ligator 20 and the rubber band 18 are installed on the endoscope 15 along with the cover 50. Figure 6-10 The excessively long metal wire 14 and silk wire 53 are wound onto the winding reel 4 by activating the winding mechanism.

[0062] 2. Work Phase a) During the pulling phase, the metal wire 14 pulls the trigger element 2 ( Figure 9-15 The rubber band 18 is pulled out and thus released.

[0063] b) By resetting trigger 2 ( Figure 14-19 10) to the starting position, the metal wire 14 is wound onto the winding reel 4 by means of the drive connection.

[0064] During the preparation phase, according to Figure 6-8 The metal wire 14 is guided through the endoscope 15, and then the rubber band ligator 20 is installed on the endoscope 15 by inserting the catheter 9 into the endoscope 15.

[0065] After passing through endoscope 15, metal wire 14 according to Figure 6 The loops 51 and 52 are connected to the wire 53, which is connected to a large number of rubber bands 18 applied to the endoscope tip.

[0066] Next, the winding mechanism is activated by operating the trigger 2, that is, by slightly pulling the trigger 2 by 2~3mm, and the locking device 25 of the winding reel 4 disengages from the bearing 37 of the front part 10. Figure 10 The winding reel 4 is now rotated clockwise by means of the pre-tensioned winding spring 13, thereby automatically winding the metal wire 14 onto the winding reel 4.

[0067] At the same time, pins 23 and 24 are from the initial state ( Figure 7 , 8 ) moves upward and backward into the inclined extending connecting channel 45, until the initial position ( Figure 6a , 10 As a result, the locking device 39 is forced to move upward and then return to its initial state. This process produces a ticking sound, indicating that automatic winding is about to begin.

[0068] Therefore, the excessively long metal wire 14 and silk thread 53 are automatically pulled into the endoscope 15. Figure 6 The cover 50 is fitted onto the end of the flexible tube of the endoscope 15. Figure 6a , 10 This allows the rubber band ligator 20 to be used during the working phase. A rubber band on the endoscope 15 is now released at the desired site and applied to the corresponding site on the patient to be treated.

[0069] The working phase begins with pulling the trigger 2 approximately 40mm. This pulls pins 23 and 24 backward toward the handle 34. Because the two laterally elastic pawls 42 of the front part 10 prevent pins 23 and 24 from entering the upper longitudinal groove 38, pins 23 and 24 are guided into the lower longitudinal groove 40 through the connecting channel 54. Furthermore, pins 23 and 24 enter the upper longitudinal groove 38 through the extended connecting channel 55, where they are pressed outward by the elastic pawls 41 of the front part 10. Figure 12 , 13 After pins 23 and 24 pass by pawl 41, pawl 41 returns to its initial state. Figure 14 , 15 (20), so as to ensure that pins 23 and 24 do not return to the lower longitudinal groove 40, but remain in the upper longitudinal groove 38. Now, the metal wire can be pulled and thereby apply the rubber band 18 to the treatment site, such as varicose veins, and the pulling phase ends here.

[0070] It must be noted that there is no gear meshing between rack 47 and gear 29 during the pulling phase, because pins 23 and 24 are located in the lower longitudinal groove 40 during this phase.

[0071] After the first rubber band 18 is applied, the trigger 2 returns to its original position by means of the tension spring 11. Figure 10 The initial position.

[0072] By resetting the trigger 2 to its initial position, a drive connection is established between the gear 29 and the rack 47. Figure 17-19 This causes the metal wire 14 to wind onto the winding reel 4. At the stop end, the two pawls 42 of the front part 10 ( Figure 18-19 The pins 23 and 24 are pressed outwards and return to their initial state after passing around the pawl 42. Figure 9 , 10 Therefore, pins 23 and 24 are no longer guided backward in the upper longitudinal groove 38, but are instead guided in the lower longitudinal groove 40 via the connecting channel 54.

[0073] Now, the first working process is complete and can now be repeated at will without the operator having to make any structural changes to the rubber band ligator 20.

[0074] Figure 21 A cross-sectional perspective view showing the configuration of the device is provided, in which assembly 19, including the winding spool 4, is mounted on the mandrel body 1, with the trigger element in a proximal position. The trigger element 2 in this case has a pin to deflect the metal wire 14. One end of the metal wire is fixed to the winding spool.

[0075] Figure 22 Show Figure 21 A cross-sectional perspective view of the configuration, but in this case, the trigger 2 is in the distal position. The winding reel 4 is driven by a spring, for example, which may be located inside or on one side of the winding reel 4. In this embodiment, the winding mechanism is designed to automatically wind the metal wire 4 as the trigger 2 moves from the proximal position to the distal position and the metal wire thus slackens. When the trigger 2 is pulled proximally, the winding reel 4 is locked by a locking device, for example, by a pawl acting on the winding reel 4. In this case, a transmission mechanism is not needed to convert the forward and backward movement of the trigger 2 into the rotational movement of the winding reel 14. However… Figure 21 , 22 Another embodiment of the device shown, which has a winding disc mounted on the mandrel body 1, can be equipped with such a transmission mechanism as an alternative.

[0076] Figure label: 1-Mandrel 2-Trigger 3-Containing section 4-Winding Reel 4b-arrow 5- Receiving part, fixed cover 6- Bushing with external gear 6b ​​for disc spring 13 6b-External Gear 7-Rotating handle 8-Seals 9-catheter 10-Front, locking device 11-Tension Spring 12-Single row needle roller bearing (single row bearing) 13-Pre-tensioned coil spring, spring 14-Metal Wire 15-Endoscope 16-Two holes inside trigger element 2 Multiple side-by-side rubber strips on the 18-cover 50 19-Components 20-Rubber band ligature 21-sales 22-Pin 23-Pin 24-pin 25-Locking device 26-The mandrel in the receiving part 3 27 - Camera at the end of endoscope 15 Support in bushing 6 (28) 29-Gear 30 - Arrow in handle 7 31 - Fixing part for tension spring 11 32 - Fixing part for tension spring 11 Opening in 33-hole plate 48b 34 - Circular handle inside spindle body 1 35 - Circular handle inside trigger 2 36 - Circular handle inside trigger 2 37-Support 38-Upper longitudinal groove, channel 39-Locking device 40-Lower longitudinal groove, channel 41-Flexible Pawl 42-Flexible Pawl 43-Multifaceted 45-Angled front connecting channel, at the end of channels 38 and 40 47-Rack 48-disc 48b-hole plate 49 - Support for accommodating pins 21 and 23, housing part 49b - Support for accommodating pins 22 and 24, housing part 50-cap 51-Silk thread 53 loop, loop 52- The loop at the end of the metal wire 14, the loop 53 - The thread inside the end of the cap 50 54-Front Connection Channel 55-Rear Connection Channel 56-Cavity

Claims

1. A device for applying a rubber band to the human body and other organisms, comprising: a) A spindle body (1) having a first handle (34); b) A trigger (2) movably mounted on the spindle body (1) and having at least one handle (35, 36) for moving the trigger (2) along the spindle body (1), wherein, The trigger (2) is used to pull the metal wire (14); and c) An assembly (19) having a winding spool (4) for winding the metal wire (14). Its characteristics are, The winding reel (4) is fixedly connected to the trigger (2), and the transmission mechanism is designed such that when the trigger (2) is pulled, the winding reel (4) is not driven to rotate, and the metal wire (14) is driven by the pulling motion of the trigger (2), so that one or more rubber bands (18) can be applied to the treatment site of the organism, and when the trigger (2) is reset to the initial position, the metal wire (14) is wound onto the winding reel (4).

2. The apparatus according to claim 1, characterized in that, The winding spool (4) is connected to the trigger (2) via a transmission mechanism that converts the translational motion of the trigger (2) into the rotational motion of the winding spool (4) and is designed such that the winding spool (4) is driven to rotate and wind the metal wire (14) for at least a portion of the time during which the trigger (2) moves along the mandrel (1).

3. The apparatus according to claim 1, characterized in that, A spring-driven winding mechanism is provided to drive the winding disc (4) to rotate.

4. The apparatus according to claim 1, characterized in that, An automatic winding mechanism is provided that can automatically tighten the metal wire (14), wherein the winding mechanism includes a spring (13) that drives the winding reel (4) to rotate.

5. The apparatus according to claim 1, characterized in that, The mandrel body (1) has an upper longitudinal groove (38) and a lower longitudinal groove (40), which are connected by connecting channels (54, 55) and serve as guides for the first pin (21, 22) and the second pin (23, 24).

6. The apparatus according to claim 5, characterized in that, The first support (49) and the second support (49b) are equipped with the first pin (21, 22) and the second pin (23, 24) belonging to the component (19), wherein the second pin (23, 24) is guided within the channel and the connecting channel (54, 55) of the mandrel body (1).

7. The apparatus according to claim 6, characterized in that, The first pin (21, 22) is continuously guided in the upper longitudinal groove (38), and the two second pins (23, 24) are guided in the upper and lower longitudinal grooves (38, 40) and the connecting channel (54, 55).

8. The apparatus according to any one of the preceding claims, characterized in that, Two parallel and spaced-apart receptacles (3, 5) are connected to each other, wherein one of the receptacles (3) has a mandrel (26) on which the winding spool (4) is mounted, and the metal wire (14) can be wound onto the winding spool by an automatic winding mechanism in the preparation stage and by a drive connection in the working stage.

9. The apparatus according to any one of claims 1-7, characterized in that, By resetting the trigger (2) to the initial position, the rack (47) and gear (29) are placed in the drive connection, wherein the metal wire (14) is wound onto the winding spool (4).

10. The apparatus according to claim 6, characterized in that, The spindle (26) mounted on the first support (49) extends through an opening (33) provided in the second support (49b), wherein the multifaceted spindle (26) is used to lock the disc spring (13) connected to the bushing (6) by means of the third support (28).

11. The apparatus according to claim 3 or 4, characterized in that, The catheter (9) can be received and moved in the mandrel (1), wherein the metal wire (14) can be guided in the catheter (9) and the catheter (9) is supported in the endoscope (15) and thus connected to the mandrel (1), that is, the elastic element can be applied to the desired site of the organism by means of the metal wire.

12. The apparatus according to claim 3 or 4, characterized in that, By activating the winding mechanism or slightly pulling the trigger (2), the locking device (25) of the winding spool (4) is moved away from the bearing (37) of the front (10), wherein the winding spool (4) is rotated by means of the pre-tightened winding spring (13) and the metal wire (14) is automatically wound onto the winding spool (4).

13. The apparatus according to claim 5, characterized in that, The metal wire (14) is wound onto the winding spool (4) by resetting the trigger (2) to its initial position, and at the stop end, the two pawls (42) of the front (10) are pressed outward, wherein the second pin (23, 24) returns the pawl (42) to its initial state after passing by it and thus ensures that the second pin (23, 24) cannot move backward into the upper longitudinal groove (38), but can move into the lower longitudinal groove (40) via the connecting channel (54).

14. The apparatus according to claim 11, characterized in that, A cover (50) is placed at the far end of the device, and a large number of rubber strips (18) are fitted on the cover.

15. The apparatus according to claim 11, characterized in that, in The rubber band (18) at the end of the endoscope (15) is ejected by the metal wire (14), wherein, in order to eject the rubber band (18), the metal wire (14) is retracted to a distance of 30 to 50 mm and is wound onto the winding spool (4) by resetting the trigger (2) to the initial position.

16. The apparatus according to claim 14, characterized in that, in During the preparation phase, the end of the metal wire (14) is connected to the loop (51) of the wire (53) contained in the endoscope (15) via a loop (52), wherein the winding mechanism is actuated by slightly pulling the trigger (2) and thus the metal wire (14) is pulled into the endoscope (15), and the cover (50) is fitted onto the end of the endoscope (15).

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