Apparatus for manipulating and securing tissue

• US 10,045,871 B2
• Filed: 11/11/2016
• Issued: 08/14/2018
• Est. Priority Date: 12/12/2003
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Saadat, Vahid, Ewers, Richard C., Lam, Cang C., Vaughan, Robert A., Rothe, Chris, Michlitsch, Kenneth H.
• Primary Examiner(s): YABUT, DIANE D
• Application Number:
  US15/349,127
• Publication Number:
  US 20170056228A1
• Time in Patent Office: 641 Days
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06 Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials puncturing needles A61B17/34; hypodermic needles A61M5/32 ; sewing needles D05B85/00
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• CPC Class Codes: A61B 2017/045 : snug fit within the anchor
• CPC Class Codes: A61B 2017/0451 : Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 : the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 : Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0459 : Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• CPC Class Codes: A61B 2017/0461 : with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0475 : using sutures having a slip knot
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/081 : Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like

Abstract

Apparatus for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to a longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

Claims

1. An apparatus for forming a tissue fold, comprising:

a flexible elongate body;

first and second extension members attached at a distal end of the flexible elongate body with an open space between the first and second extension members;

a tissue engager extendible along a first axis out of the distal end of the flexible elongate body and through the open space; and

a launch tube pivotably attached to the first extension member to allow a distal tip of the launch tube to pivot to a launch position substantially perpendicular to the first axis.

2. The apparatus of claim 1 further comprising a needle assembly slidably disposed within the launch tube.

3. The apparatus of claim 2 further comprising at least one expandable anchor slidably disposed within the needle assembly.

4. The apparatus of claim 3 with the flexible elongate body extending through a shape-lockable overtube.

5. The apparatus of claim 3 wherein the tissue engager comprises a helically-shaped member.

6. The apparatus of claim 3 wherein the launch tube is movable from a low-profile position into the launch position.

7. The apparatus of claim 6 wherein the launch tube is straightened relative to the flexible elongate member when in the low profile position.

8. The apparatus of claim 2 with the needle assembly having a needle extendible through an opening in the second extension member.

9. The apparatus of claim 1 wherein the extension members are solid.

10. The apparatus of claim 9 wherein the first extension member comprises an open looped member.

11. An apparatus for forming a tissue told, comprising:

a flexible tubular body;

a tissue engager having helical distal end;

a first bail and a second bail on a distal end of the flexible tubular body;

a launch tube having a distal end pivotably attached to the first bail;

a needle assembly slidably disposed within the launch tube; and

at least one expandable anchor within the needle assembly.

12. The apparatus of claim 11 wherein the first and second bails are solid.

13. The apparatus of claim 11 wherein the first bail comprises an open looped member.

14. The apparatus of claim 11 with the flexible elongate body extending through a shape-lockable overtube.

15. An apparatus for forming a tissue told, comprising:

a flexible tubular body;

a tissue engager having helical distal end, with the tissue engager rotatable to engage tissue via the helical distal end;

a first solid bail and a second solid bail on a distal end of the flexible tubular body, with the first solid bail spaced apart from the second solid bail;

a launch tube extending through the flexible tubular body, with a distal end of the launch tube pivotably attached to the first bail;

with the launch tube movable from a low-profile position wherein a distal end of the launch tube is straightened relative to the flexible elongate member, into a launch position wherein the distal end of the launch tube is curved relative to the flexible elongate member;

a needle assembly within the launch tube, the needle assembly including a needle and at least one expandable anchor within the needle; and

within the needle extendible out of the launch tube and through an opening in the second solid bail, when the launch tube is in the launch position.

16. The apparatus of claim 15 wherein a distal tip of the launch tube is perpendicular to the second bail when the launch tube is in the launch position, and the needle is extendible through the opening in the second bail in a direction perpendicular to the second bail.

17. The apparatus of claim 15 with the flexible tubular body extending through a shape-lockable overtube.