Tissue manipulation and securement system

• US 20050251165A1
• Filed: 03/01/2005
• Published: 11/10/2005
• Est. Priority Date: 05/07/2004
• 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.
• Granted Patent: US 7,736,374 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• 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 17/0487 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• 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 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0464 for soft tissue
• 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 hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled for sutures A61B2017/06171
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

Tissue manipulation and securement systems are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member and has a lower jaw member and an upper jaw member pivotably coupled to the lower jaw member. A reconfigurable launch tube is also pivotably coupled to the upper jaw member and is used to urge the jaw members from a low-profile configuration to an open configuration for receiving tissue. The tissue manipulation assembly may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly.

Claims

1. A tissue securement apparatus, comprising:

an elongate body having a proximal end, a distal end, and a flexible length therebetween;

a first jaw member pivotably coupled to the distal end of the elongate member;

a second jaw member pivotably coupled along the first jaw member; and

a launch tube defining a lumen therethrough, the launch tube being slidably positioned along the elongate body and pivotably coupled to the second jaw member.

2. The apparatus of claim 1 wherein at least one of the first and second jaw members comprise protrusions for facilitating engagement onto the tissue.

3. The apparatus of claim 1 wherein a distal end of the launch tube member is pivotably coupled to the second jaw member.

4. The apparatus of claim 1 wherein the launch tube member comprises a distally located flexible portion.

5. The apparatus of claim 4 wherein the launch tube member further comprises a rigid portion proximally of the flexible portion.

6. The apparatus of claim 1 wherein the first and second jaw members are adapted to configure into an expanded configuration when the launch tube is urged proximally.

7. The apparatus of claim 1 wherein the first and second jaw members are adapted to configure into a grasping configuration when the launch tube is urged distally.

8. The apparatus of claim 1 wherein the first jaw member defines an opening for passage of a needle assembly therethrough.

9. The apparatus of claim 1 further comprising a needle assembly slidably positioned within the launch tube, the needle assembly having a needle body and an anchor assembly for securing tissue therebetween.

10. The apparatus of claim 1 further comprising a pull wire connected to a portion of the launch tube for articulating the apparatus about the distal end of the elongate member.

11. A method of securing tissue within a hollow body organ, comprising:

endoluminally advancing into a hollow body organ an elongate flexible member having a first jaw member and a second jaw member in a low-profile configuration positioned on a distal end of the elongate flexible member;

urging the first jaw member to pivot about the elongate member distal end by proximally translating a launch tube;

urging the second jaw member to pivot into contact against the first jaw member by distally translating the launch tube.

12. The method of claim 11 wherein endoluminally advancing comprises advancing the elongate flexible member transesophageally into a stomach.

13. The method of claim 11 wherein endoluminally advancing comprises advancing the elongate flexible member through an endoscopic device into the hollow body organ.

14. The method of claim 13 further comprising rigidizing a length of the endoscopic device when positioned within the hollow body organ.

15. The method of claim 11 wherein urging the first jaw member to pivot comprises pivoting the first jaw member such that the first jaw member is angled relative to a longitudinal axis of the elongate flexible member.

16. The method of claim 11 wherein urging the second jaw member to pivot comprises rotating the second jaw member against the first jaw member into a clamping configuration.

17. The method of claim 11 further comprising positioning a portion of tissue to be secured between the first and second jaw members prior to urging the second jaw member to pivot into contact.

18. The method of claim 11 further comprising advancing a needle assembly through the launch tube such that the needle assembly exits the launch tube and passes through the first jaw member.

19. The method of claim 18 further comprising deploying a first tissue anchor from the needle assembly.

20. The method of claim 19 further comprising deploying a second tissue anchor from the needle assembly after disengaging the second jaw member from the first jaw member.

21. The method of claim 11 further comprising proximally translating the launch tube to urge the second jaw member away from the first jaw member.