INCISION CLOSURE DEVICE

• US 20110152923A1
• Filed: 12/18/2009
• Published: 06/23/2011
• Est. Priority Date: 12/18/2009
• Status: Abandoned Application

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Fox, William D.
• Application Number:
  US12/641,853
• Publication Number:
  US 20110152923A1
• Time in Patent Office: Days
• US Class Current: 606/213
• 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 17/12009 Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
• 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 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0496 for tensioning sutures

Abstract

A surgical instrument which can be inserted into an incision in a patient'"'"'s stomach, wherein tissue-engaging members positioned within a lumen can be deployed therefrom and can engage the stomach wall surrounding the incision. Once engaged with the stomach wall, the tissue-engaging members can be retracted back into the instrument in order to pull at least a portion of the stomach wall into the instrument. In various embodiments, a cinching member can be utilized to cinch the stomach wall tissue and, as a result, seal the incision. The cinching member can comprise a loop and a pull member, wherein the loop can be disposed around a distal end of the surgical instrument such that it can be slid off of the distal end and around the tissue. The pull member can then be pulled proximally in order to decrease the size of the loop and cinch the tissue.

Claims

1. A surgical instrument, comprising:

a handle, comprising;

a first actuator; and

a second actuator;

a shaft, comprising;

a proximal end coupled to said handle; and

a distal end configured to be inserted into a patient;

a first hook member configured to engage tissue, wherein said first hook member is movable between an undeployed position and a deployed position, wherein said first actuator is operably coupled with said first hook member to move said first hook member between its undeployed position and its deployed position;

a second hook member configured to engage tissue, wherein said second hook member movable between an undeployed position and a deployed position, wherein said first actuator is operably coupled with said second hook member to move said second hook member between its undeployed position and its deployed position, wherein at least a portion of said first hook member and at least a portion of said second hook member are positionable within said shaft when said first hook member and said second hook member are in their undeployed positions, and wherein at least a portion of said first hook member and at least a portion of said second hook member extend distally from said distal end of said shaft when said first hook member and said second hook member are in their deployed positions; and

a cinching assembly, comprising;

a pull member; and

a loop, wherein said cinching assembly is slidable between a proximal position and a distal position, wherein said loop is positioned around said distal end of said shaft when said cinching assembly is in said proximal position, wherein said loop is positioned distally relative to said distal end of said shaft when said cinching assembly is in its distal position, wherein said pull member is operably coupled with said second actuator, and wherein said second actuator is configured to pull said pull member proximally and at least partially close said loop.

2. The surgical instrument of claim 1, wherein said shaft defines an axis, wherein said first hook member comprises an end which extends away from said axis, and wherein said second hook member comprises an end which extends away from said axis.

3. The surgical instrument of claim 1, wherein said shaft defines an axis, wherein said first actuator comprises a control slidable between a first position and a second position, wherein said control is slidable from said first position into said second position to move said first hook member and said second hook member into their deployed positions, and wherein said control is slidable from said second position into said first position to move said first hook member and said second hook member into their undeployed positions.

4. The surgical instrument of claim 1, further comprising an anvil sheath, wherein said anvil sheath is configured to bias said first hook member toward said second hook member when said first hook member and said second hook member are in their undeployed positions.

5. The surgical instrument of claim 4, wherein said anvil sheath is configured to bias said second hook member toward said first hook member when said first hook member and said second hook member are in their undeployed positions, and wherein said first hook member and said second hook member are configured to splay outwardly with respect to each other when said first hook member and said second hook member are moved into their deployed positions.

6. The surgical instrument of claim 1, further comprising a slider member positioned within said shaft, wherein said first actuator is operably engaged with said slider member, wherein said first hook member comprises a first cantilever having an end engaged with said slider member, and wherein said second hook member comprises a second cantilever having an end engaged with said slider member.

7. The surgical instrument of claim 1, wherein said pull member and said loop are comprised of a suture, wherein said suture includes a knot to form said loop, and wherein said second actuator is configured to pull said pull member relative to said knot to decrease the size of said loop.

8. A surgical instrument, comprising:

a handle comprising an actuator;

a shaft, comprising;

a shaft aperture;

a proximal end coupled to said handle; and

a distal end configured to be inserted into a patient;

a first hook member configured to engage tissue of the patient, wherein said first hook member is movable between a retracted position and an extended position;

a second hook member configured to engage tissue of the patient, wherein said second hook member is movable between a retracted position and an extended position, wherein at least a portion of said first hook member and at least a portion of said second hook member are positionable within said shaft aperture when said first hook member and said second hook member are in their retracted positions, wherein at least a portion of said first hook member and at least a portion of said second hook member extend distally from said distal end of said shaft when said first hook member and said second hook member are in their extended positions, wherein said first hook member and said second hook member are operably engaged with said actuator, and wherein said actuator is configured to move said first hook member between its retracted position and its extended position and said second hook member between its retracted position and its extended position; and

an anvil sheath configured to resiliently move said first hook member toward said second hook member when said first hook member is moved into its retracted position, and wherein said first hook member is configured to move away from said second hook member when said first hook member is moved into its extended position.

9. The surgical instrument of claim 8, wherein said shaft defines an axis, wherein said first hook member comprises an end which extends away from said axis, and wherein said second hook member comprises an end which extends away from said axis.

10. The surgical instrument of claim 8, wherein said shaft defines an axis, wherein said actuator comprises a control slidable between a first position and a second position, wherein said control is slidable from said first position into said second position to move said first hook member and said second hook member into their extended positions, and wherein said control is slidable from said second position into said first position to move said first hook member and said second hook member into their retracted positions.

11. The surgical instrument of claim 8, wherein said anvil sheath is configured to bias said second hook member toward said first hook member when said first hook member and said second hook member are in their retracted positions, and wherein said first hook member and said second hook member are configured to splay outwardly with respect to each other when said first hook member and said second hook member are moved into their extended positions.

12. The surgical instrument of claim 8, further comprising a slider member positioned within said shaft, wherein said actuator is operably engaged with said slider member, wherein said first hook member comprises a first cantilever having an end engaged with said slider member, and wherein said second hook member comprises a second cantilever having an end engaged with said slider member.

13. The surgical instrument of claim 8, further comprising:

a cinching assembly, comprising;

a pull member; and

a loop, wherein said cinching assembly is slidable between a proximal position and a distal position, wherein said loop is positioned around said distal end of said shaft when said cinching assembly is in said proximal position, wherein said loop is positioned distally relative to said distal end of said shaft when said cinching assembly is in its distal position, and wherein said pull member is configured to be pulled proximally to at least partially close said loop.

14. The surgical instrument of claim 13, wherein said pull member and said loop are comprised of a suture, wherein said suture includes a knot to form said loop, and wherein said pull member is configured to be pulled relative to said knot to decrease the size of said loop.

15. A surgical instrument, comprising:

a handle comprising an actuator;

a shaft, comprising;

a proximal end coupled to said handle; and

a distal end configured to be inserted into a patient;

a hook assembly, wherein said actuator is configured to move said hook assembly between a first position and a second position, said hook assembly comprising

a slider operably coupled with said actuator;

a first hook member, comprising;

a first attached end mounted to said slider; and

a first free end configured to engage tissue of the patient, wherein said first free end is movable relative to said first attached end; and

a second hook member, comprising;

a second attached end mounted to said slider; and

a second free end configured to engage tissue of the patient, wherein said second free end is movable relative to said second attached end;

an anvil, wherein said anvil defines an axis, wherein said anvil is configured to position said first hook member and said second hook member relative to said axis when said hook assembly is in said first position, and wherein said first hook member and said second hook member are configured to resiliently splay outwardly away from said axis when said hook assembly is moved from said first position into said second position.

16. The surgical instrument of claim 15, wherein said first free end of said first hook member and said second free end of said second hook member are positioned distally with respect to said distal end of said shaft when said hook assembly is in said second position.

17. The surgical instrument of claim 15, further comprising:

a cinching assembly, comprising;

a pull member; and

a loop, wherein said cinching assembly is slidable between a proximal position and a distal position, wherein said loop is positioned around said distal end of said shaft when said cinching assembly is in said proximal position, wherein said loop is positioned distally relative to said distal end of said shaft when said cinching assembly is in its distal position, and wherein said pull member is configured to be pulled proximally to at least partially close said loop.

18. The surgical instrument of claim 15, wherein said pull member and said loop are comprised of a suture, wherein said suture includes a knot to form said loop, and wherein said pull member is configured to be pulled relative to said knot to decrease the size of said loop.

19. The surgical instrument of claim 15, wherein said anvil comprises an aperture, and wherein at least a portion of said first hook member and at least a portion of said second hook member are configured to be positioned within said aperture when said hook assembly is in said first position.

20. The surgical instrument of claim 19, wherein said aperture is defined by sidewalls, and wherein said first hook member and said second hook member are held in deflected positions by said sidewalls when said hook assembly is in said first position.