Apparatus and methods for rapid deployment of tissue anchors

• US 20050251177A1
• Filed: 04/28/2005
• 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, Lam, Cang C.
• Granted Patent: US 8,444,657 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• 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 17/06114 Packages or dispensers for needles or sutures packages for sharps A61B50/3001; for dental floss A61C15/043; packages for needles in general B65D85/24
• 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 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0416 Packages or dispensers for suture anchors or for anchor applicators
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• 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
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• 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
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like

Abstract

Apparatus and methods for rapid deployment of tissue anchors 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 pivotably coupled to the upper jaw member and is used to urge the jaw members from a low-profile configuration to an open configuration. A needle assembly can be advanced through the launch tube across tissue received between the jaw members of the tissue manipulation assembly. Tissue anchors can be advanced through the needle assembly for securing received tissue. The tissue anchors can be positioned within a reloadable chamber of a control handle disposed outside the patient, then advanced through the needle assembly.

Claims

1. A tissue manipulation apparatus, comprising:

a tissue grasping and securing tool coupled to a distal end of an elongate member and adapted to be advanced endoluminally into a body lumen; and

a control handle coupled to a proximal end of the elongate member,

wherein the control handle is adapted to advance tissue anchors through the elongate member to the tissue grasping and securing tool while the tool is disposed within the body lumen.

2. The apparatus of claim 1, wherein the control handle is adapted to advance a plurality of tissue anchors to the tissue grasping and securing tool while the tool is disposed within the body lumen.

3. The apparatus of claim 2, wherein the control handle comprises a chamber configured for loading tissue anchors into the control handle for advancement to the tool.

4. The apparatus of claim 3, wherein the chamber comprises a reloadable chamber.

5. The apparatus of claim 4, wherein the control handle comprises a pusher for advancing tissue anchors from the reloadable chamber through the elongate member to the tissue grasping and securing tool.

6. The apparatus of claim 5, wherein the control handle further comprises a ratchet mechanism for advancing the pusher.

7. The apparatus of claim 5, wherein the control handle further comprises motorized mechanism for advancing the pusher.

8. The apparatus of claim 5, wherein the control handle comprises a geared mechanism for advancing the pusher.

9. The apparatus of claim 8, wherein the geared mechanism comprises a variable gearing ratio.

10. The apparatus of claim 1 wherein the tissue grasping and securing tool comprises 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 member adapted to urge the first and second jaw members between a low-profile delivery configuration and an expanded grasping configuration.

11. The apparatus of claim 10 further comprising a needle assembly having a piercing tip which is adapted to be advanced through the launch tube.

12. The apparatus of claim 11 further comprising at least two tissue anchors adapted to be ejected from the needle assembly for securing the engaged tissue therebetween.

13. The apparatus of claim 1 further comprising a tissue engagement device having a distal end effector adapted to reversibly engage tissue and further adapted to be positioned endoluminally within the body lumen adjacent to the tissue grasping and securing tool.

14. The apparatus of claim 1 further comprising an endoscopic device having a flexible body with a steerable distal section,

wherein the flexible body is adapted to be rigidized to maintain an arbitrary shape, and

wherein the tissue grasping and securing tool is adapted to be advanced into the body lumen through the endoscopic device.

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

endoluminally advancing a tissue grasping tool into the hollow body organ;

engaging tissue with the tissue grasping tool; and

securing the engaged tissue with a tissue anchor advanced to the tissue grasping tool from a control handle positioned outside of the hollow body organ.

16. The method of claim 15 further comprising advancing an additional tissue anchor from the control handle to the tissue grasping tool.

17. The method of claim 15, wherein securing the engaged tissue with a tissue anchor advanced to the tissue grasping tool from a control handle positioned outside of the hollow body organ further comprises:

loading a chamber of the control handle with the tissue anchor; and

advancing the tissue anchor to the tissue grasping tool with a pusher.

18. The method of claim 17, wherein advancing the tissue anchor with a pusher further comprises advancing the pusher via a ratchet mechanism.

19. The method of claim 17, wherein advancing the tissue anchor with a pusher further comprises advancing the pusher via a motorized mechanism.

20. The method of claim 17, wherein advancing the tissue anchor with a pusher further comprises advancing the pusher via a geared mechanism.

21. The method of claim 20, wherein advancing the tissue anchor via a geared mechanism further comprises advancing the pusher via a geared mechanism having a variable gearing ratio.

22. The method of claim 17 further comprising:

retracting the pusher; and

reloading the chamber.

23. The method of claim 17 further comprising retracting the pusher with a spring-loaded mechanism.

24. The method of claim 15 wherein endoluminally advancing comprises advancing the tissue grasping tool transesophageally into a stomach.

25. Tissue manipulation apparatus, the apparatus comprising:

a tissue securement tool adapted to be advanced endoluminally into a body lumen; and

a control handle having a reloadable chamber,

wherein the control handle is adapted to advance tissue anchors positioned within the reloadable chamber to the tissue securing tool while the tool is disposed within the body lumen.