CIRCUMFERENTIAL FULL THICKNESS RESECTIONING DEVICE

• US 20050145675A1
• Filed: 12/24/2003
• Published: 07/07/2005
• Est. Priority Date: 12/24/2003
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Hartwick, Darrell, Berndt, Malka, Nunez, George
• Granted Patent: US 8,590,764 B2
• Time in Patent Office: Days
• US Class Current: 227/180.100
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/1157 applying the staples radially

Abstract

An apparatus for performing endoluminal anastomosis of an organ comprises an operative head including an endoscope receiving lumen for slidably receiving a flexible endoscope therein, the operative head including an annular tissue receiving space extending around a circumference of a distal end thereof and a stapling mechanism for firing staples around an entire circumference of the tissue receiving space and a tissue gripping mechanism for drawing into the tissue receiving space a portion of tissue extending around an entire circumference of the organ.

Claims

8. A method of performing a circular anastomosis of a substantially tubular body organ, comprising the steps of:

inserting an operative head slidably coupled to an endoscope into a substantially tubular organ, wherein the operative head includes a stapling mechanism and a tissue receiving space extending around a distal end thereof;

drawing a portion of tissue from the organ into the tissue receiving space, wherein the portion of tissue extends around an entire circumference of the organ;

firing a plurality of staples through the tissue received in the tissue receiving space;

cutting away from the stapled portion of tissue, a portion of tissue to be resected.

9. The method according to claim 8, wherein the stapling mechanism is coupled to a controller which remains outside the body by at least one torsionally rigid, longitudinally flexible drive shaft.

10. The method according to claim 8, wherein the entire procedure is performed endoluminally.

11. The method according to claim 10, wherein the operative head is maneuvered into a desired position adjacent to the tissue to be resected by steering the flexible endoscope through the body organ to locate the tissue to be resectioned visually and then sliding the operative head along the endoscope to the desired position.

12. The method according to claim 11, wherein a longitudinally flexible sheath surrounds the endoscope and the drive shaft.

13. An apparatus for performing endoluminal anastomosis of an organ, comprising:

an operative head including an endoscope receiving lumen for slidably receiving a flexible endoscope therein, the operative head including a tissue receiving space and a stapling mechanism for firing staples around an entire circumference of the tissue receiving space; and

a tissue gripping mechanism for drawing into the tissue receiving space a portion of tissue extending around an entire circumference of the organ.

14. The apparatus according to claim 13, further comprising a control handle which remains outside a patient'"'"'s body while the apparatus is in use.

15. The apparatus according to claim 13, further comprising a flexible sheath extending between the operative head and the control handle and enclosing therein connections between the operative head and the control handle.

16. The apparatus according to claim 13, wherein the tissue gripping mechanism includes a plurality of graspers spaced from one another around the circumference of the tissue receiving space.

17. The apparatus according to claim 13, wherein the operative head further includes a tissue cutting mechanism for severing from the organ tissue received within the tissue receiving space.

18. The apparatus according to claim 17, wherein the operative head further includes a lockout mechanism preventing the tissue cutting mechanism from operating until operation of the tissue stapling mechanism has been completed.

19. The apparatus according to claim 13, wherein the operative head further includes a tissue clamping mechanism for holding the tissue within the tissue receiving space.

20. The apparatus according to claim 13, wherein the operative head further includes a distal cap moveable between an insertion position in which the distal cap covers the tissue receiving space and an operative position in which the distal cap is withdrawn to expose the tissue receiving space.

21. An apparatus for performing endoluminal anastomosis of an organ, comprising:

an operative head including an endoscope receiving lumen for slidably receiving a flexible endoscope therein, the operative head including a tissue receiving space formed in a distal end thereof and a stapling mechanism for driving staples radially outward from a longitudinal axis of the operative head through the tissue receiving space around an entire circumference thereof; and

a tissue gripping mechanism for drawing into the tissue receiving space a portion of tissue extending around an entire circumference of the organ.

22. An operative head for an apparatus for performing endoluminal anastomosis of an organ, comprising:

an endoscope receiving lumen for slidably receiving a flexible endoscope therein;

a tissue receiving space formed in a distal end thereof;

a stapling mechanism for stapling an entire perimeter of a closed space;

an anvil moveable with respect to the stapling mechanism to vary in size a gap therebetween between a tissue receiving position in which tissue may be drawn is into the gap and a stapling position in which the tissue is gripped between the anvil and stapling mechanism; and

a tissue gripping mechanism for drawing into the tissue receiving space a resection portion of tissue so that, when the resection portion of tissue is drawn into the tissue receiving space, a stapling portion of tissue is positioned between the anvil and the stapling mechanism, wherein the stapling portion of tissue extends around an entire circumference of the organ.

1. A system for endoluminally performing an anastomosis of a substantially tubular organ, the system comprising:

a flexible endoscope;

an operative head slidably mountable on the endoscope, the operative head including a tissue receiving space formed at a distal end thereof, a stapling mechanism and a tissue cutting mechanism; and

a tissue gripping mechanism for drawing tissue from the organ into the tissue receiving space, wherein the portion of tissue drawn into the tissue receiving space extends around a complete circumference of the organ;

wherein, operation of the stapling mechanism drives staples through a portion of tissue received within the tissue receiving space around the entire circumference thereof and, operation of the tissue cutting mechanism severs from the tissue through which the staples were driven a portion of tissue located within the tissue receiving space separated proximally therefrom.

3. The system according to claim 1, wherein the control unit further includes a rotatable control member coupled to the stapling mechanism by a longitudinally flexible, torsionally stiff drive shaft.

4. The system according to claim 1, wherein the stapling mechanism rotates about a longitudinal axis of the operative head so that the stapling of the tissue is performed sequentially around a circumference thereof.

5. The system according to claim 4, wherein the anvil is coupled to the stapling mechanism and rotates therewith.

6. The system according to claim 1, wherein the tissue gripping mechanism includes a plurality of gripping jaws spaced from one another around a circumference of the tissue receiving space.

7. The system according to claim 1, wherein the tissue gripping mechanism includes a suction gripper.

23. The operative head according to claim 22, wherein the stapling mechanism includes a plurality of staple openings extending around the entire perimeter of the closed space, wherein the staple openings are formed in a surface located in a plane substantially perpendicular to an axis of the operative head.

24. The operative head according to claim 23, wherein the anvil is moveable relative to the stapling mechanism substantially parallel to the axis.

25. The operative head according to claim 22, further comprising a tissue cutting mechanism for severing a portion of tissue located within the closed space.

26. The operative head according to claim 25, wherein the tissue cutting mechanism includes a blade located radially within the stapling apparatus substantially parallel to an inner surface of the stapling apparatus.

27. The operative head according to claim 26, wherein the closed space is substantially circular and wherein the tissue cutting mechanism is substantially concentric with the closed space.

28. The operative head according to claim 26, wherein the stapling mechanism includes a plurality of staple openings adapted to hold a corresponding plurality of staples and a staple driver member slidably received in the operative head for movement relative to the staple openings so that the staple driver member drives staples out of the staple openings against the anvil member and through any tissue received therebetween.

29. The operative head according to claim 28, further comprising a first balloon coupled to a source of inflation fluid wherein, when inflated, the first balloon drives the staple driver member relative to the staple openings to drive the staples out of the staple openings.

29-1. The operative head according to claim 28, further comprising a second balloon coupled to a source of inflation fluid wherein, when inflated, the second balloon drives the tissue cutting mechanism to sever tissue radially within the closed space.

30-2. The operative head according to claim 30, further comprising a second balloon coupled to a source of inflation fluid wherein, when inflated, the second balloon drives the tissue cutting mechanism from the ready position, across the gap between the staple mechanism and the anvil to sever tissue radially within the closed space from the stapled tissue.