Endoscopic tissue apposition device and method of use

• US 20060047289A1
• Filed: 03/09/2005
• Published: 03/02/2006
• Est. Priority Date: 08/27/2004
• Status: Active Grant

• Current Assignee: Davol Incorporated (Becton, Dickinson & Co)
• Original Assignee: Davol Incorporated (Becton, Dickinson & Co)
• Inventors: Fogel, Roberto
• Granted Patent: US 8,172,857 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• 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 17/0625 the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator A61B17/06109 takes precedence
• 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 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• 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 2017/06028 by means of a cylindrical longitudinal blind bore machined at the suture-receiving end of the needle, e.g. opposite to needle tip
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2217/005 with suction drainage system

Abstract

An endoscopic tissue apposition device that includes a vacuum chamber configured to securely hold a portion of tissue therein, the vacuum chamber being defined by a proximal wall and a distal wall opposite to the proximal wall. Working and vacuum channels are provided in communication with the vacuum chamber. A portion of tissue is held in the vacuum chamber when vacuum is applied in the vacuum chamber through the vacuum channel. A carrier needle is disposed on a proximal side of the vacuum chamber and is longitudinally advanceable into and across the vacuum chamber, while a punch needle is disposed on a distal side of the vacuum chamber and is configured to receive the carrier needle therein. A hold and release mechanism holds and releases the punch needle to facilitate joining portions of tissue together.

Claims

1. An endoscopic tissue apposition device, comprising:

a device body having a first end portion and a second end portion;

a vacuum chamber within the device body for receiving tissue drawn thereinto, the vacuum chamber being located between the first end portion and the second end portion;

a vacuum line communicating with the vacuum chamber for applying a vacuum to the vacuum chamber;

a carrier needle retractable within the first end portion of the device body and traverseable across the vacuum chamber to the second end portion of the device body;

a punch needle engageable with the second end portion of the device body, wherein the punch needle is configured to receive the carrier needle; and

a hold and release mechanism for intermittently retaining the punch needle in the second end portion of the device body,

wherein a suture is attachable to the punch needle, and

wherein the punch needle with the attached suture is traverseable across the vacuum chamber upon the carrier needle being received within the punchy needle.

2. The apposition device according to claim 1, wherein the carrier and punch needles each have a beveled tip, and wherein the punch needle is hollow.

3. The apposition device according to claim 1, wherein the hold and release mechanism comprises:

a holding channel which releasably holds the punch needle therein; and

a release channel which includes a holding mechanism therein.

4. The apposition device according to claim 3, wherein the release channel has a longitudinal length greater than a longitudinal length of the holding channel.

5. The apposition device according to claim 3, wherein the holding mechanism comprises:

a key having a pivot end;

a slotted member having a vertically extending slot configured to slidably receive the pivot end of the key therein; and

a biasing member.

6. The apposition device according to claim 5, wherein the punch needle further comprises:

a notch configured to receive the key therein to prevent the punch needle from sliding out of the holding channel; and

a suture aperture.

7. The apposition device according to claim 6, wherein a suture passes through the suture aperture of the punch needle.

8. The apposition device according to claim 7, further comprising:

a tag attached to a free end of the suture, the tag being configured to be larger than the suture aperture to prevent the suture from falling out of the punch needle.

9. The apposition device according to claim 8, wherein the biasing member comprises:

a cylinder having a stop protruding radially away from an outer surface of the cylinder;

at least one support strut having a through-hole formed therein through which the cylinder is longitudinally advanced; and

a coil wound around the outer surface of the cylinder.

10. The apposition device according to claim 9, wherein a first end of the coil engages the stop and a second end of the coil engages the second support strut.

11. The apposition device according to claim 10, wherein the key further includes a cam which urges the cylinder toward a distal end of the device when the key slides vertically upward as the punch needle is being removed from the holding channel and as the carrier needle is retracted back toward the working channel, and wherein the coil is compressed between the stop and second support strut.

12. A method of joining internal body tissue endoscopically, comprising:

navigating a distal end of an endoscopic apposition device to a treatment site, the apposition device having a vacuum chamber configured to securely hold a U-shaped portion of tissue therein, a carrier needle retractably disposed on a first end portion of the vacuum chamber and traverseable across the vacuum chamber, a punch needle disposed on a second end portion of the vacuum chamber opposite the first end portion and configured to receive the carrier needle therein, and a hold and release mechanism which holds and releases the punch needle;

advancing the carrier needle across the vacuum chamber and into the punch needle;

retracting the carrier and punch needles to the first end portion proximal of the vacuum chamber;

applying the vacuum to the vacuum chamber; and

advancing the carrier and punch needles toward the second end portion of the vacuum chamber to secure the U-shaped portion of tissue together.

13. The method according to claim 12, wherein advancing the carrier and punch needles toward the second end portion of the vacuum chamber further comprises:

passing the punch needle through the U-shaped portion of tissue with a suture securably retained by the punch needle.

14. The method according to claim 13, further comprising:

holding the punch needle, via the hold and release mechanism, after the punch needle and suture have passed through the U-shaped portion of tissue;

retracting the carrier needle to the proximal side of the vacuum chamber; and

discontinuing the vacuum to release the U-shaped portion of tissue.

15. The method according to claim 14, further comprising:

relocating the apposition device to a new area of tissue and capturing the new area of tissue in the apposition device by reapplying the vacuum.

16. An endoscopic tissue apposition device, comprising:

tissue retaining means for securely retaining a portion of tissue therein, the tissue retaining means having first and second ends, wherein the second end opposes the first end;

vacuum means for supplying a vacuum pressure to the tissue retaining means;

a carrier needle longitudinally advanceable across the tissue retaining means;

a punch needle configured to receive the carrier needle; and

a hold a release means for holding and releasing the punch needle, the hold and release means being in communication with the tissue retaining means,

wherein a suture is attacheable to the punch needle.

17. The apposition device according to claim 16, wherein the first end of the tissue retaining means comprises a first wall and the second end of the tissue retaining means comprises a second wall, and wherein the tissue retaining means communicates with the vacuum means via an aperture formed in the first wall.

18. The apposition device according to claim 17, wherein the carrier needle is disposed in the first end of the tissue retaining means and the punch needle is disposed in the second end of the tissue retaining means.

19. The apposition device according to claim 18, wherein the hold and release means is disposed in the second end of the tissue retaining means.

20. The apposition device according to claim 16, wherein the carrier and punch needles are coaxial.