The present invention relates to an instrument for the ligation of hemorrhoids or the like.
Various methods for the therapy of hemorrhoids are currently used when said hemorrhoids no longer respond to strictly medical cures or when their size becomes such that any non-surgical therapy would produce no result or even negative results.
A first method is the strictly surgical one, which is irreplaceable in case of considerable internal and external prolapses.
This is a painful method which entails significant postoperative hospitalization and is also usually rather destructive as regards the muscles of the anal-proctorectal tract.
A second method is constituted by cryosurgery, which in practice consists in "freezing" the hemorrhoids at temperatures which can vary between -59 degrees Celsius and -89 degrees Celsius for cycles lasting a few minutes.
Another method is constituted by thermosurgery, which uses devices which emit flows of heat at preset temperatures and for limited periods of time.
A method which is currently having considerable success, since it is the easiest, quickest and most practical, as well as the least painful and least damaging, is the so-called "throttling" surgery.
This method consists in applying an elastic ring of adequate size on the "neck" of the hemorrhoid, leaving it in place until the hemorrhoid necrotizes and falls away spontaneously due to the occlusion of the blood supply pathways.
The time required in order to achieve this effect is relatively short, the results are extremely positive and the method, which is typically ambulatory, is not painful.
A cylindrical bush is used to apply the ligature to the "neck" of the hemorrhoid, and the elastic ring is arranged around said bush, dilating the ring considerably, by means of a conical applicator.
Once the hemorrhoid has been passed through said bush, the elastic ring is caused to slide, moving it so that it surrounds the "neck" of the hemorrhoid and, by pressing on it, performs the throttling action.
Two methods are currently used to make the hemorrhoids pass in the bush.
A first one of said methods consists in making a special instrument pass through the bush; said instrument is provided with a forceps at its end, which is suitable for gripping a portion of the hemorrhoid and for pulling it inside the bush.
This method has a series of problems, some of which are considerable; first of all, the need arises to use both hands, one for the bush and one for the instrument provided with the forceps.
It is furthermore rather traumatic, since the forceps can break the wall of the hemorrhoid.
Furthermore, it is not always possible to achieve the passage of the entire mass to be throttled.
In a second method, which is pneumatic, the bush constitutes the end of a duct which is connected to an aspirator which, when actuated, aspirates the hemorrhoid inside said bush.
Although this method has the advantage that it does not break the wall of the hemorrhoid and can be performed with one hand, it has the problem that during the operation the bush is constantly at negative pressure, so that the hemorrhoid cannot be disengaged in case of incorrect grip; furthermore, at the end of the operation it is necessary to disconnect the aspiration system from the instrument in order to be able to disengage the hemorrhoid.
For both "throttling" methods, the typically metallic material of which the instruments are made must be resterilized after each use and, since such materials are not transparent, it forces the operator to work practically blind.
The instruments themselves are furthermore considerably expensive.