ENDOSCOPIC TISSUE APPROXIMATION METHOD

• US 20080228199A1
• Filed: 03/16/2007
• Published: 09/18/2008
• Est. Priority Date: 03/16/2007
• Status: Abandoned Application

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Schwemberger, Richard F., Andreyko, Michael J., Cropper, Michael S.
• Application Number:
  US11/687,477
• Publication Number:
  US 20080228199A1
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/1285 for 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 2017/0645 being elastically deformed for insertion
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks

Abstract

The present invention generally provides methods and devices for approximating tissue. The methods and devices utilize a device for applying an implantable tissue fastener and a variety of implantable tissue fasteners. The tissue-fastening device can be delivered endoscopically and can be adapted to function along side or in conjunction with a flexible endoscope. In general, the device can include a flexible shaft having an implantable tissue fastener applier disposed at a distal end thereof and a handle for operating the implantable tissue fastener applier disposed at a proximal end thereof. A variety of implantable tissue fasteners can be used with the tissue fastener applier device including single and multi-anchor embodiments.

Claims

1. A method for approximating tissue, comprising:

inserting to a target site a device for applying an implantable tissue fastener, the device having an elongate sheath, a hollow needle slidably disposed within the sheath, and at least one selectively deployable tissue fastener;

positioning the device adjacent the targeted tissue;

actuating the device to extend the hollow needle from the elongate sheath and penetrate the targeted tissue;

reconfiguring the targeted tissue in a desired orientation; and

actuating the device to deploy the tissue fastener to penetrate the reconfigured tissue to secure the reconfigured tissue in the desired orientation.

2. The method of claim 1, wherein actuating the device includes partially deploying the tissue fastener so as to engage the targeted tissue with the tissue fastener in a partially deployed configuration.

3. The method of claim 2, wherein reconfiguring the targeted tissue comprises manipulating the engaged tissue with the partially deployed tissue fastener.

4. The method of claim 1, further comprising actuating the device to deploy a tissue backstop disposed on a distal portion of the hollow needle.

5. The method of claim 4, wherein reconfiguring the targeted tissue comprises compressing the engaged tissue between a proximal surface of the tissue backstop and a distal surface of the elongate sheath.

6. The method of claim 2, further comprising actuating the device to fully deploy the tissue fastener.

7. The method of claim 1, further comprising repeating the steps of reconfiguring the targeted tissue and actuating the device to deploy the tissue fastener.

8. The method of claim 1, wherein reconfiguring the targeted tissue comprises engaging and manipulating an inner surface of the targeted tissue to change the shape of the targeted tissue.

9. The method of claim 8, wherein the targeted tissue is reconfigured to be in the shape selected from the group consisting of a fold, a bulge, a mound, a plication, a ridge, a tube, a cone, and a horn.

10. The method of claim 1, wherein reconfiguring and approximating the targeted tissue are performed using only the tissue fastener delivery device.

11. The method of claim 1, wherein inserting the device comprises inserting the device translumenally.

12. The method of claim 1, wherein inserting the device comprises inserting the device laparoscopically.

13. The method of claim 1, further comprising endoscopically viewing at least a portion of the method for approximating.

14. The method of claim 1, wherein the tissue fastener is a one piece fastener.

15. The method of claim 1, wherein the tissue fastener comprises first and second anchor members.

16. The method of claim 1, wherein the tissue fastener comprises first, second, and third anchor members.

17. The method of claim 1, wherein inserting the device for applying an implantable tissue fastener comprises inserting the device through a working channel of an endoscope.

18. The method of claim 1, wherein inserting the device for applying an implantable tissue fastener comprises inserting the device through an accessory channel mated to an endoscope.

19. The method of claim 1, wherein the targeted tissue is an internal organ that is endscopically accessed.