Methods and apparatus for securing and deploying tissue anchors

• US 20060271073A1
• Filed: 05/26/2005
• Published: 11/30/2006
• Est. Priority Date: 05/26/2005
• 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 9,585,651 B2
• Time in Patent Office: Days
• US Class Current: 606/148
• 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 17/0487 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 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/003 Steerable
• 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
• 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 2017/2927 the angular position of the head being adjustable with respect to the shaft

Abstract

Methods and apparatus for securing and deploying tissue anchors are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member. A reconfigurable launch tube is also pivotably coupled to the tissue manipulation assembly, which 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. A deployment assembly is provided for securing engaged tissue via one or more tissue anchors, the deployment assembly also being configured to disengage the anchors endoluminally or laparoscopically.

Claims

1. An anchor deployment assembly comprising:

at least one tissue anchor having a length of suture depending therefrom; and

an elongate member configured for advancement within a body lumen,

wherein the elongate member is configured to deploy the at least one tissue anchor, and

wherein the elongate member is further configured to disengage the suture at a location proximal to the at least one tissue anchor upon deployment of the at least one tissue anchor.

2. The anchor deployment assembly of claim 1, wherein the elongate member is configured to sever the suture at the proximal location upon deployment of the at least one tissue anchor.

3. The anchor deployment assembly of claim 2, wherein the elongate member comprises a needle assembly having a piercing tip, the piercing tip configured to sever the suture.

4. The anchor deployment assembly of claim 3, wherein the needle assembly defines at least one cut-out having sharpened edges for severing the suture.

5. The anchor deployment assembly of claim 1 further comprising a tissue grasping tool adapted to be advanced endoluminally into a body lumen, wherein the anchor deployment assembly is configured for advancement through the tissue grasping tool.

6. The anchor deployment assembly of claim 5, wherein the tissue grasping tool further comprises a first jaw 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.

7. The anchor deployment assembly of claim 6, wherein the anchor deployment assembly is configured for advancement through the launch tube member.

8. The anchor deployment assembly of claim 6 wherein a distal end of the launch tube member is pivotably coupled to the second jaw member.

9. The anchor deployment assembly of claim 5 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 tool.

10. The anchor deployment assembly of claim 9 wherein the distal end effector comprises a helical member having a tissue piercing tip.

11. The anchor deployment assembly of claim 9 wherein the distal end effector comprises a grasper for reversibly engaging the tissue.

12. The anchor deployment assembly of claim 1 further comprising an endoscopic device having a flexible body, the flexible body adapted to be rigidized to maintain an arbitrary shape, wherein the anchor deployment assembly is configured for advancement through the endoscopic device.

13. The anchor deployment assembly of claim 12, wherein the endoscopic device comprises a steerable distal section.

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

advancing a needle of an anchor deployment assembly through engaged tissue;

deploying a distal tissue anchor through the needle on a distal side of the engaged tissue;

retracting the needle to a proximal side of the engaged tissue;

deploying a proximal tissue anchor through the needle on the proximal side of the engaged tissue; and

severing a suture element connecting the proximal and distal tissue anchors with the needle proximal of the proximal anchor, thereby releasing the proximal and distal anchors from the anchor deployment assembly.

15. The method of claim 14 further comprising cinching the proximal and distal anchors to secure the engaged tissue prior to severing the suture element.

16. The method of claim 14, wherein severing the suture element with the needle further comprises severing the suture element via sharpened cut-outs defined in the needle.

17. The method of claim 14 wherein deploying the proximal and distal anchors through the needle further comprises advancing a pusher through the needle.

18. The method of claim 14 further comprising, prior to advancing the needle through the engaged tissue, endoluminally advancing a tissue grasping tool pivotably coupled to a distal end of an elongate member into the hollow body organ;

reversibly engaging the tissue within the hollow body organ with a distal end effector positioned adjacently to the tissue grasping tool; and

clamping the engaged tissue with the tissue grasping tool.

19. The method of claim 18 wherein endoluminally advancing comprises advancing the tissue grasping tool transesophageally into a stomach.

20. The method of claim 18 further comprising, prior to advancing the needle through the engaged tissue, positioning the anchor deployment assembly at least partially within the tissue grasping tool.

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

deploying a tissue anchor assembly through a needle of an anchor deployment assembly, thereby securing engaged tissue; and

severing a suture element attached to the tissue anchor assembly with the needle proximal of the proximal anchor, thereby releasing the tissue anchor assembly from the anchor deployment assembly.