TISSUE LIGATION DEVICES AND CONTROLS THEREFOR

• US 20110087247A1
• Filed: 04/01/2010
• Published: 04/14/2011
• Est. Priority Date: 04/01/2009
• Status: Active Grant

• Current Assignee: SentreHeart, LLC (Atricure, Inc.)
• Original Assignee: SentreHEART Incorporated (Atricure, Inc.)
• Inventors: Seiber, Russell A., Garcia, Maria, Sager, Eduardo, Helmuth, Ryan Douglas, Ellison, Douglas Todd, Miller, Gary H., Fung, Gregory W., Cohn, William E., Escano, Arnold M.
• Granted Patent: US 9,198,664 B2
• Time in Patent Office: Days
• US Class Current: 606/148
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/06114 Packages or dispensers for needles or sutures packages for sharps A61B50/3001; for dental floss A61C15/043; packages for needles in general B65D85/24
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/00384 Actuation of one tool by pushing two buttons simultaneously
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• 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 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument

Abstract

Described here are devices for closing one or more tissues, and handles for controlling these devices. Generally, the devices described here comprise a snare loop assembly, wherein the snare loop assembly comprises a snare and a suture loop, and a handle for controlling the snare loop assembly. In some variations the snare loop assembly may comprise a retention member that may releasably connect the suture loop to the snare. In other variations the devices comprise one or more force-reducing suture locks to help prevent the suture loop from inadvertently disengaging from the snare loop assembly. In still other variations, the excess-suture management features. The handles described here may be configured to remove excess suture from a suture loop, and may also be configured to release the suture loop from the snare loop assembly.

Claims

1. A tissue closure device comprising:

an elongate body; and

a snare loop assembly, wherein the snare loop assembly comprises a snare, a suture loop, and a force-reducing suture lock releasably coupling the snare to the suture loop.

2. The device of claim 1 wherein the snare loop assembly further comprises a retention member releasably coupling the snare to the suture loop.

3. The device of claim 1 wherein the elongate body comprises a first lumen and a second lumen.

4. The device of claim 3 wherein the device further comprises separation tubing disposed in the first lumen, and wherein the separation tubing comprises a first sub-lumen and a second sub-lumen.

5. The device of claim 4 wherein at least a portion of suture loop is housed within the first and second sub-lumens of the separation tubing.

6. The device of claim 5 further comprising a suture tube, wherein a first end of the suture tube is attached to the separation tubing and a second end of the suture tube is attached to the snare loop assembly, and wherein the suture tube releasably houses at least a portion of the suture loop.

7. The device of claim 6 wherein the suture tube comprises a plurality of cuts or grooves.

8. The device of claim 6 wherein the suture tube comprises one or more strengthening members.

9. The device of claim 1 wherein the elongate body comprises a tip portion.

10. The device of claim 9 wherein a first end of the snare is releasably held in the tip portion.

11. The device of claim 10 wherein the first end of the snare is connected to a frangible member, and wherein breaking the connection the connection between the snare and the frangible member releases the snare from the tip portion.

12. The device of claim 9 wherein the suture loop comprises a suture knot, and wherein the tip portion comprises a recess for housing the suture knot.

13. The device of claim 12 wherein the tip portion is configured to eject the suture knot from the recess.

14. The device of claim 13 wherein tip is configured to eject the suture knot from the recess using a balloon.

15. The device of claim 14 wherein the tip is configured to eject the suture knot from the recess using a pusher.

16. The device of claim 1 further comprising a handle.

17. The device of claim 16 wherein the handle comprises a device introducer.

18. The device of claim 17 wherein the device introducer is a guidewire introducer.

19. The device of claim 16 wherein the handle comprises a suture tightening element for tightening the suture loop.

20. The device of claim 19 wherein the suture-tightening element may be disengaged from the handle.

21. The device of claim 16 wherein the handle comprises an interconnect for connecting the handle to an elongate body.

22. The device of claim 16 wherein the handle comprises a snare lock.

23. The device of claim 16 wherein the handle comprises a strain relief portion.

24. A tissue closure device comprising:

an elongate body, wherein the elongate body comprises a first lumen and a second lumen;

a snare loop assembly comprising a suture loop, a snare, and a retention member releasably connecting the suture loop and the snare, the snare loop assembly moveable between a closed configuration and an open configuration; and

a pulley suture, wherein the pulley suture is configured to hold a portion of the suture loop inside of the first lumen when the snare loop assembly is in the closed configuration

25. The device of claim 24 wherein a first end of the pulley suture is connected to the snare.

26. The device of claim 25 wherein the first end of the pulley suture is connected to the snare by a suture lock.

27. The device of claim 24 wherein the pulley suture is doubled over a portion of the suture loop.

28. The device of claim 24 wherein the pulley suture is releasably connected to the suture loop by a deformable member.

29. The device of claim 24 further comprising a handle, wherein the handle comprises a suture fob.

30. The device of claim 29 wherein a second end of the pulley suture and an end of the suture loop are attached to the suture fob.

31. The device of claim 24 further comprising a pledget at least partially shielding a suture knot of the suture loop.

32. A method of ligating tissue, comprising:

introducing a closure device into a body, wherein the closure device comprises a snare loop assembly having an opened configuration and a closed configuration and comprising a snare, a suture loop, and a force reducing suture lock releasably coupled to the suture loop, and wherein the suture loop has slack when snare loop assembly is in its closed configuration;

advancing the snare loop assembly in its closed configuration to a target tissue;

opening the snare loop assembly to its open configuration;

advancing snare loop assembly over the target tissue;

closing the snare loop assembly around the target tissue;

removing the slack from the suture loop; and

tightening the suture loop to disengage the suture loop from the snare loop assembly and ligate the target tissue.

33. The method of claim 32 wherein opening the snare loop assembly comprises opening the snare loop assembly using a handle.

34. The method of claim 32 wherein closing the snare loop assembly comprises closing the snare loop assembly using a handle.

35. The method of claim 32 wherein removing the slack from the suture loop comprises removing the slack from the suture loop using a handle.

36. The method of claim 32 further comprising placing an expandable member inside the left atrial appendage.

37. The method of claim 32 further comprising placing an expandable member in an entrance to the left atrial appendage.

38. The method of claim 32 further comprising delivering an embolic or hemostatic material to the left atrial appendage.