ENDOSCOPIC STAPLING DEVICES AND METHODS

• US 20090236391A1
• Filed: 03/21/2008
• Published: 09/24/2009
• Est. Priority Date: 03/18/2008
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Barosense, Inc. (Boston Scientific Scimed Incorporated)
• Inventors: Cole, David, Smith, Andrew
• Granted Patent: US 7,913,892 B2
• Time in Patent Office: Days
• US Class Current: 227/175.100
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/07271 characterised by its cartridge
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61F 5/0013 Implantable devices or invasive measures
• CPC Class Codes: A61F 5/0083 Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00

Abstract

Described herein are endoscopic staplers used to apply one or more fasteners to body tissue. In one embodiment, a fastener-applying device, which is preferably a stapler, is passed transorally into the stomach and used to plicate stomach tissue by engaging tissue from inside of the stomach and drawing it inwardly. In the disclosed embodiments, the tissue is drawn inwardly into a vacuum chamber, causing sections of serosal tissue on the exterior of the stomach to be positioned facing one another. The disclosed staplers allow the opposed sections of tissue to be moved into contact with one another, and preferably deliver staples for maintaining contact between the tissue sections at least until serosal bonds form between them. Each of these steps may be performed wholly from the inside of the stomach and thus can eliminate the need for any surgical or laparoscopic intervention. After one or more plications are formed, medical devices may optionally be coupled to the plication(s) for retention within the stomach.

Claims

1-163. -163. (canceled)

164. A medical instrument for applying tissue fasteners, comprising:

a shaft having a distal end;

a head having a proximal end;

a first face on a first one of the distal end or the proximal end;

a second face on the other one of the distal end or the proximal end;

a latch having a first feature on the first face and a second feature on the second face, the first and second features engageable with one another to removably couple the stapler head to the shaft.

165. The medical instrument according to claim 164, further including:

a fluid line in the shaft; and

a fluid port in the head, wherein the fluid line and fluid port are fluidly coupled to one another when the stapler head is coupled to the shaft.

166. The medical instrument of claim 164, wherein:

the medical instrument further includes an alignment pin on the first face and an opening on the second face, the alignment pin insertable into the hole; and

wherein

the first and second faces are rotatable relative to the alignment pin to a latched position in which the first and second features engage with one another.

167. The medical instrument of claim 166, wherein the first feature is a boss having an undercut, and the second feature is a member rotatable into an engaged positioned beneath the undercut.

168. The medical instrument of claim 166, wherein the first feature is a second pin and the second feature is an opening positioned such that relative rotation of the first and second faces causes the pin to engage with the opening.

169. The medical instrument of claim 166, wherein the first plate includes a first drive fluid throughhole and the second plate includes a second drive fluid throughhole, and wherein the first and second throughholes are positioned such that rotation of the first and second plates to the latched position moves the first and second throughholes in alignment with one another.

170. The medical instrument of claim 169, wherein the first plate is on the distal end of the elongate shaft, and wherein the medical instrument further includes a drive fluid line extending through the shaft, the drive fluid line positioned on the first plate to direct drive fluid into the first drive fluid throughhole.

171. The medical instrument of claim 164, wherein the distal end of the shaft includes an articulating section.

172. The medical instrument of claim 171, wherein the articulating segment includes an elongate spine formed of a plurality of spine segments threaded over at least one cable, and wherein the first plate is coupled to a distalmost one of the spine segments.

173. The medical instrument of claim 164, wherein:

the head is a stapler head having a staple holder; and

the head includes a piston in the chamber, and a staple driver coupled to the piston such that directing fluid from the fluid line into the chamber advances the staple driver at least partially through the staple holder.

174. A method for coupling a shaft having a distal end to a fastener-applying head having a proximal end, comprising:

providing a first face on a first one of the distal end or the proximal end and a second face on the other one of the distal end or the proximal end;

engaging a latch having a first feature on the first face and a second feature on the second face, engaging the latch including engaging the first and second features to removably couple the fastener-applying head to the shaft.

175. The method of claim 174, wherein engaging the latch further includes:

inserting an alignment pin on the first face into a hole in the second face; and

after inserting the alignment pin, rotating the first and second faces relative to the alignment pin to the first and second features to engage with one another

176. The method of claim 175, wherein the method provides the first feature to be a boss having an undercut, and further provides the second feature to be a member, and wherein rotating the first and second faces rotates the member into an engaged positioned beneath the undercut.

177. The medical instrument of claim 174, wherein the method provides the first feature to be a second pin and further provides the second feature to be an opening, and wherein rotating the first and second faces causes the pin to engage with the opening.

178. The medical instrument of claim 174, wherein rotation of the first and second plates to the latched position moves a first drive fluid throughhole in the first plate into alignment with a second drive fluid throughhole in the second plate.

179. The medical instrument of claim 178, wherein the first plate is on the distal end of the elongate shaft, and wherein the medical instrument further includes a drive fluid line extending through the shaft, the drive fluid line positioned on the first plate to direct drive fluid into the first drive fluid throughhole.

180-242. -242. (canceled)