METHODS AND DEVICES FOR ENDOSCOPIC TREATMENT OF ORGANS

• US 20080208216A1
• Filed: 02/21/2008
• Published: 08/28/2008
• Est. Priority Date: 02/22/2007
• Status: Active Grant

• Current Assignee: Jeffrey C. Cerier
• Original Assignee: Jeffrey C. Cerier
• Inventors: Cerier, Jeffrey C.
• Granted Patent: US 8,092,472 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• 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 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/06095 pliable
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/4211 Diagnosing or evaluating reflux

Abstract

The present invention relates to devices and methods for the endoscopic treatment of hollow organs. The invention provides improved devices and methods for apposing and fixating multiple regions of the outer surface of a hollow organ. The invention is particularly useful for procedures in which multiple regions of the outer surface of the stomach are brought into apposition and fixated, for example procedures to treat gastroesophageal reflux disease (GERD) or procedures to treat obesity.

Claims

1. A system for creating and fixating a fold in the wall of a hollow organ by bringing multiple regions of the outer surface of the organ into apposition, comprising:

a first tube having a lumen, a proximal end and a distal end positionable within the organ;

a second tube having a lumen, a proximal end and a distal end, the second tube configured to pass through the lumen of the first tube into the organ;

a piercing element configured to pass through the lumen of the second tube to pierce the organ, position the distal end of the second tube outside of the organ, again pierce the organ, and position the distal end of the second tube back inside the organ;

a first tissue anchor having a first state configured to pass through the lumen of the second tube and a second state configured for tissue fixation;

a suture attached to the first tissue anchor;

a second tissue anchor having a first state configured to pass through the lumen of the first tube and slideably engaged with the suture, and a second state configured to fixate tissue and lock onto the suture;

a location indicator associated with the distal end of the second tube; and

an optical receiver associated with the distal end of the first tube for identifying the location of the distal end of the second tube when it is outside the organ.

2. The system of claim 1 wherein the location indicator includes a visible light source.

3. The system of claim 1 wherein the second tube has an outer diameter of 2.8 millimeters or less.

4. The system of claim 1 wherein the tissue piercing element is configured to apply electrical energy to the tissue, thereby cauterizing the tissue.

5. The system of claim 1 wherein the first tissue anchor includes a T-anchor.

6. A system for apposing and fixating tissue, comprising:

a tube having a lumen, a proximal end and a distal end;

a piercing element configured to pass through the lumen of the tube;

a first tissue anchor having a first state configured to pass through the lumen of the tube and a second state configured for tissue fixation;

a suture attached to the first tissue anchor; and

a second tissue anchor having a first state configured to pass through the lumen of a tube and slideably engaged with the suture, and a second state configured to fixate tissue and lock onto the suture.

7. The system of claim 6 wherein the outer diameter of the tube is 2.8 millimeters or less.

8. The system of claim 6 wherein the tissue piercing element is configured to apply electrical energy to the tissue, thereby cauterizing the tissue.

9. The system of claim 6 wherein the first tissue anchor includes a T-anchor.

10. The system of claim 6 wherein the second tissue anchor includes a T-anchor.

11. A system for apposing and fixating tissue, comprising:

a first tissue anchor having a first state configured to pass through a lumen of a tube and a second state configured to fixate tissue;

a suture attached to the first tissue anchor;

a second tissue anchor having a first state configured to pass through the lumen of a tube and slideably engaged with the suture, and a second state configured to fixate tissue and lock onto the suture.

12. The system of claim 11 wherein the first tissue anchor includes a T-anchor.

13. The system of claim 11 wherein the second tissue anchor includes a T-anchor.

14. A method of creating and fixating a fold in the wall of a hollow organ, the method comprising:

piercing the wall of a hollow organ at a first location from the inside of the organ to the outside of the organ to create a first hole in the wall of the organ;

advancing an elongated member through the first hole in the wall of the organ;

positioning the distal end of the elongated member near the outer wall of the organ at a second location;

detecting from within the organ the position of the distal end of the elongated member;

piercing the wall of the organ at the second location from the outside of the organ to the inside of the organ to create a second hole in the wall of the organ;

advancing the elongated member back into the organ through the second hole in the wall of the organ;

delivering a first tissue anchor and a suture through the first and second holes in the wall of the organ, the first tissue anchor being attached to the suture;

delivering a second tissue anchor over the suture and advancing the second tissue anchor over said suture, thereby moving the first and second holes in the wall of the organ towards one another and bringing multiple regions of the outer surface of the organ into apposition, and

locking the second tissue anchor onto the suture.

15. The method of claim 14 wherein piercing includes that application of electrical energy to cauterize the tissue.

16. The method of claim 14 wherein the elongated member includes a tube.

17. The method of claim 14 wherein the first tissue anchor is delivered through the elongated member.

18. The method of claim 14 wherein detecting from within the organ the position of the distal end of the elongated member is accomplished by viewing the wall of the organ using and endoscope within the organ.

19. A method of detecting the position of a medical device within the body, the method consisting of:

placing the medical device within the body and in proximity to tissue;

placing the distal end of an endoscope within the body on the opposite side of the tissue;

emitting light from the medical device;

viewing the tissue with the endoscope and observing the light shining through the tissue, thus detecting the position of the medical device.