Application of a Remodeled Stiegmann-ligator to Esophageal Varix

Abstract: The Stiegmann-ligator has been recently proved to be useful for the treatment of esophageal varices. With those ligators, however, we found difficulty in performing ligation when the pathological change was on the tangent line or relatively large, such as F₃, or associated with concentrated RC signs. To overcome these problems, we modified the Stiegmann O-ring ligator by diagonally cutting the tip of the inner sleeve. Using this ligator, we conducted some animal-model experiments and clinical trials. In all cases, the remodeled ligator covered a wider range of lesions. We no longer encountered difficulties in performing ligation with the remodeled ligator when pathological changes were on the tangent line. The procedure did not cause any complications apart from temporary chest discomfort after surgery.