Methods and Devices for Tissue Reconfiguration

• US 20090198254A1
• Filed: 03/18/2009
• Published: 08/06/2009
• Est. Priority Date: 06/22/1999
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Cerier, Jeffrey C., Laufer, Michael D., Cruz, Amos G.
• Granted Patent: US 8,057,494 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• 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 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• 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 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 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0474 Knot pushers
• CPC Class Codes: A61B 2017/0475 : using sutures having a slip knot
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/061 : hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 : Coils or spirals
• CPC Class Codes: A61B 2017/2905 : flexible
• CPC Class Codes: A61B 2017/2915 : arcuate shaped guiding means
• CPC Class Codes: A61B 2017/2916 : pins in guiding slots
• CPC Class Codes: A61B 2017/2917 : with flexible part
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61M 25/0133 : Tip steering devices

Abstract

Methods and devices are provided for reconfiguring a tissue within a hollow body organ using an entirely endoscopic approach in order to effectively reduce flow of fluid contents into a second hollow body organ in fluid communication with the first.

Claims

1. A device for tissue reconfiguration, comprising:

an elongate member having a body disposed on a distal portion thereof, the body having an opening configured for receiving tissue therein;

a tissue retrieving mechanism associated with the body and having at least one helical piercing member configured to retrieve a portion of tissue to be reconfigured and to position the portion of tissue within the opening of the body; and

a fastener configured for delivering a securing element through a portion of tissue positioned within the opening of the body to thereby reconfigure the portion of tissue.

2. The device of claim 1, wherein the opening is formed in a distal portion of the body and is configured to provide access to a space within the body for receiving tissue.

3. The device of claim 1, wherein the fastener is configured to deliver a securing element across the opening in the body into tissue positioned within the opening.

4. The device of claim 1, wherein the at least one helical piercing member is configured to be movable independently of the body to retrieve tissue and position the tissue within the opening of the body.

5. The device of claim 1, wherein the body includes opposed first and second members and at least one of the first and second members is configured to be movable relative to the other to grasp tissue therebetween.

6. The device of claim 5, wherein the first and second members define the opening of the body.

7. The device of claim 5, wherein the opposed first and second members are opposed pivotable jaws that are movable between an open position and a closed position.

8. The device of claim 1, wherein the tissue retrieving mechanism includes a plurality of helical piercing members configured to retrieve a plurality of portions of tissue and position the portions of tissue within the opening in the body.

9. The device of claim 1, wherein fastener is a stapling mechanism and the securing element is a staple.

10. The device of claim 1, wherein the securing element includes a piercing post configured to pierce and secure a portion of tissue within the opening in the body.

11. The device of claim 1, wherein the at least one helical piercing member is configured to retrieve a portion of tissue from inside a stomach.

12. A device for tissue reconfiguration, comprising:

an elongate member having a body disposed on a distal portion thereof, the body having an opening configured for receiving tissue therein;

a tissue retrieving mechanism having at least one vacuum suction member configured to retrieve a portion of tissue to be reconfigured using negative pressure and to position the portion of tissue within the opening in the body; and

a fastener delivery member configured to deliver a fastener into a portion of tissue positioned within the opening of the body to reconfigure the portion of tissue.

13. The device of claim 12, wherein the body includes first and second jaws defining the opening in the body.

14. The device of claim 13, wherein the first and second jaws are movable between an open, grasping configuration and a closed, fastening configuration.

15. The device of claim 14, wherein the at least one vacuum suction member is configured to retrieve and position tissue within the opening in the body when the first and second jaws are in the open, grasping configuration.

16. The device of claim 14, wherein the fastener delivery member is configured to deliver a fastener into tissue when the first and second jaws are in the closed, fastening configuration.

17. The device of claim 12, wherein the fastener delivery member is a stapler and the fastener is a staple.

18. The device of claim 12, wherein the fastener delivery member is configured to deliver a fastener across the opening in the body.

19. The device of claim 12, wherein the at least one vacuum suction member is configured to retrieve a portion of tissue from inside a stomach.

20. A device for tissue reconfiguration, comprising:

an elongate member having first and second grasping members positioned at a distal portion thereof and configured to be positioned substantially parallel to each other to receive tissue therebetween;

first and second tissue retrieving elements each having a plurality of tissue piercing elements formed thereon and configured to be movable relative to the first and second grasping members to position tissue between the first and second grasping members; and

a fastener configured to deliver a fastening element to tissue positioned between the first and second grasping members to reconfigure the tissue.

21. The device of claim 20, further comprising at least one helical piercing element configured to work with the first and second tissue retrieving elements to position tissue between the first and second grasping members.

22. The device of claim 20, wherein at least one of the first and second grasping members is configured to be positioned at an angle relative to the other to receive tissue therebetween.

23. The device of claim 20, wherein the plurality of tissue piercing elements are configured to pierce tissue to position the tissue between the first and second grasping members.

24. The device of claim 20, wherein the fastener is a stapler and the fastening element is a staple.

25. The device of claim 20, wherein the first and second tissue retrieving elements are configured to retrieve tissue from inside a stomach.

26. The device of claim 20, wherein the first and second tissue retrieving elements are configured to be movable independently of the first and second grasping members.