Tissue cutting and stitching device and method

• US 5,947,983 A
• Filed: 03/16/1998
• Issued: 09/07/1999
• Est. Priority Date: 03/16/1998
• Status: Expired due to Term

• Current Assignee: Boston Scientific Corporation
• Original Assignee: Boston Scientific Corporation
• Inventors: Solar, Matthew S., Kratsch, Peter K.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US09/039,249
• Time in Patent Office: 540 Days
• Field of Search: 606/170, 606/171, 606/144, 606/148, 606/180, 604/22, 600/564, 600/565, 600/566, 600/567
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled for sutures A61B2017/06171

Abstract

A device for cutting tissue, the device comprising a first tube having a side window; a second tube positioned within the first tube, the second tube having a side window and being movable within the first tube; a third tube positioned within the second tube, the third tube having a side window and being movable within the second tube; and a needle insertable within the second tube, the needle housing a suture. The windows in the first, second, and third tubes are alignable with each other. The invention includes methods for the cutting and suturing of tissue by using the device.

Claims

1. A device for cutting tissue within a body lumen, said device comprising:

a first tube extending from a proximal portion to a distal portion, wherein, in an operative position, the distal portion is located within the body lumen adjacent to the tissue to be cut;

the first tube having a side window in the distal portion thereof;

a second tube extending from a proximal portion to a distal portion, wherein the distal portion is moveably mounted within the distal portion of the first tube, said second tube having a second side window which, when the first and second tubes are in an alignment with respect to one another, faces the first side window so that an interior of the second tube is open to an exterior of the first tube; and

a third tube extending from a proximal portion to a distal portion, wherein the distal portion is moveably mounted within the distal portion of the second tube, said third tube having a third side window, wherein said third window is alignable with said first and second windows.

2. The device of claim 1, wherein said third window has at least one cutting edge.

3. The device of claim 1, wherein said third tube is a vacuum tube through which negative pressure may be applied to draw tissue into the first, second and third windows.

4. The device of claim 1, further comprising a tissue grasper within said third tube, said tissue grasper for grasping and drawing tissue into the first, second and third windows.

5. The device of claim 1, further comprising a needle insertable within said second tube, said needle housing a suture.

6. The device of claim 5, wherein said needle is substantially helical.

7. The device of claim 6, wherein said second tube has a substantially helical groove in an inner surface thereof, said helical groove being adapted to receive said needle.

8. The device of claim 5, wherein said suture comprises an anchor portion, which when penetrated through a portion of tissue, resists removal therefrom and thus maintains the suture in a desired position.

9. The device of claim 8, wherein said anchor portion comprises an elastic material.

10. The device of claim 9, wherein said elastic material is selected from the group consisting of a polymeric material, stainless steel and nitinol.

11. The device of claim 8, wherein said anchor portion has a pointed tip.

12. The device of claim 8, wherein during insertion of the needle through the tissue, the anchor member is maintained in a storage position within the needle and, when released from the needle, the anchor member expands to an anchor position.

13. The device of claim 1, wherein said first, second and third windows are elongated in a longitudinal direction of said first, second and third tubes, respectively.

14. The device of claim 1, wherein said first, second and third windows are elongated in the circumferential direction of said first, second and third tubes, respectively.

15. A method for cutting tissue from a body lumen, said method comprising the steps of:

providing a device comprising;

a first tube extending from a proximal portion to a distal portion, wherein, in an operative position, the distal portion is located within the body lumen adjacent to the tissue to be cut;

the first tube having a side window in the distal portion thereof;

a second tube extending from a proximal portion to a distal portion, wherein the distal portion is moveably mounted within the distal portion of the first tube, said second tube having a second side window which, when the first and second tubes are in an alignment with respect to one another, faces the first side window so that an interior of the second tube is open to an exterior of the first tube; and

a vacuum tube extending from a proximal portion to a distal portion, wherein the distal portion is moveably mounted within the distal portion of the second tube, said vacuum tube having a third side window, wherein said third window is alignable with said first and second windows;

inserting said device into the body lumen so that the first window is positioned adjacent to a portion of tissue to be cut;

aligning said first, second and third windows to form an opening in said device extending from an exterior of said first tube to an interior of said vacuum tube;

sucking the portion of tissue to be cut into said opening;

moving said second tube with respect to said first tube to reduce the size of said opening and grasp the portion of tissue to be cut; and

moving said vacuum tube with respect to said first and second tubes to cut the grasped tissue.

16. The method of claim 15, wherein said step of inserting said device into the body lumen occurs via a natural body orifice.

17. The method of claim 15, further comprising the steps of:

inserting a needle into said second tube, said needle housing a suture;

pushing said needle through said grasped tissue;

withdrawing said needle from the grasped tissue, said step of withdrawing leaving said suture through the grasped tissue; and

tightening said suture to seal a wound resulting from the cutting of the grasped tissue.

18. The method of claim 17, wherein said vacuum tube is removed from said second tube before said needle is inserted into said second tube.

19. The method of claim 17, wherein:

said needle is substantially helical;

said second tube has a substantially helical groove formed in an inner surface thereof, said helical groove being adapted to receive said needle;

said step of pushing said needle through the grasped tissue includes the steps of;

placing said needle in said groove, and rotating said needle in a first direction about its longitudinal axis to advance the needle towards the grasped tissue and to push the needle through the grasped tissue; and

said step of withdrawing said needle from the grasped tissue includes the step of rotating said needle in a second direction about a longitudinal axis thereof, said second direction being opposite said first direction.

20. The method of claim 15, wherein said window in said vacuum tube has at least one cutting edge.

21. The method of claim 15, wherein said step of moving of said second tube includes the step of rotating said second tube relative to said first tube.

22. The method of claim 15, wherein said step of moving said second tube includes the step of moving said second tube relative to the first tube along a longitudinal axis of the second tube.

23. The method of claim 15, wherein said step of moving said vacuum tube includes the step of rotating said vacuum tube relative to the second tube.

24. The method of claim 15, wherein said step of moving said vacuum tube includes the step of moving said vacuum tube relative to the second tube along a longitudinal axis of the vacuum tube.

25. A method for cutting a portion of tissue protruding from a body lumen, said method comprising the steps of:

providing a device comprising;

a first tube extending from a proximal portion to a distal portion, wherein, in an operative position, the distal portion is located within the body lumen adjacent to the tissue to be cut;

the first tube having a side window in the distal portion thereof;

a second tube extending from a proximal portion to a distal portion, wherein the distal portion is moveably mounted within the distal portion of the first tube, said second tube having a second side window which, when the first and second tubes are in an alignment with respect to one another, faces the first side window so that an interior of the second tube is open to an exterior of the first tube; and

a third tube extending from a proximal portion to a distal portion, wherein the distal portion is moveably mounted within the distal portion of the second tube, said third tube having a third side window, wherein said third window is alignable with said first and second windows;

inserting said device into the body lumen so that the first window is positioned adjacent to a portion of tissue to be cut;

aligning said first and second windows to form an opening in said device extending from an exterior of said first tube to an interior of said second tube;

positioning said opening over the portion of tissue to be cut so that the portion of tissue extends into the opening;

moving said second tube with respect to said first tube to grasp the tissue received within the opening;

positioning said window in said third tube over the grasped tissue; and

moving said third tube with respect to said first and second tubes to cut the grasped tissue from the body lumen.

26. The method of claim 25, wherein said step of inserting said device into the body lumen occurs via a natural body orifice.

27. The method of claim 25, further comprising the steps of:

inserting a needle into said second tube, said needle housing a suture;

pushing said needle through said grasped tissue;

withdrawing said needle from the grasped tissue, said step of withdrawing leaving said suture through the grasped tissue; and

tightening said suture to seal a wound resulting from the cutting of the grasped tissue.

28. The method of claim 25, wherein said third tube is removed from said second tube before said needle is inserted into said second tube.

29. The method of claim 25, wherein:

said needle substantially helical;

said second tube has a substantially helical groove formed in an inner surface thereof, said helical groove being adapted to receive said needle;

said step of pushing said needle through the grasped tissue includes the steps of;

placing said needle in said groove, and rotating said needle in a first direction about its longitudinal axis to advance the needle towards the grasped tissue and to push the needle through the grasped tissue; and

said step of withdrawing said needle from the grasped tissue includes the step of rotating said needle in a second direction about a longitudinal axis thereof, said second direction being opposite said first direction.

30. The method of claim 25, wherein said window in said third tube has at least one cutting edge.

31. The method of claim 25, wherein said step of moving of said second tube includes the step of rotating said second tube relative to said first tube.

32. The method of claim 25, wherein said step of moving said second tube includes the step of moving said second tube relative to the first tube along a longitudinal axis of the second tube.

33. The method of claim 25, wherein said step of moving said third tube includes the step of rotating said third tube relative to the second tube.

34. The method of claim 25, wherein said step of moving said third tube includes the step of moving said third tube relative to the second tube along a longitudinal axis of the third tube.

35. A method for cutting tissue from a body lumen, said method comprising the steps of:

providing a device comprising;

a first tube extending from a proximal portion to a distal portion, wherein, in an operative position, the distal portion is located within the body lumen adjacent to the tissue to be cut;

the first tube having a side window in the distal portion thereof;

a second tube extending from a proximal portion to a distal portion, wherein the distal portion is moveably mounted within the distal portion of the first tube, said second tube having a second side window which, when the first and second tubes are in an alignment with respect to one another, faces the first side window so that an interior of the second tube is open to an exterior of the first tube; and

a third tube extending from a proximal portion to a distal portion, wherein the distal portion is moveably mounted within the distal portion of the second tube, said third tube having a third side window, wherein said third window is alignable with said first and second windows;

a tissue grasper extending from a proximal portion to a distal portion, wherein the distal portion is moveably mounted within said third tube,

inserting said device into the body lumen so that the first window is positioned adjacent to a portion of tissue to be cut;

aligning said first, second and third windows to form an opening in said device extending from an exterior of said first tube to an interior of said third tube;

extending said tissue grasper through said opening;

grasping the portion of tissue to be cut with said tissue grasper;

pulling the portion of tissue to be cut into said opening;

moving said second tube with respect to said first tube to reduce the size of said opening and grasp the portion of tissue to be cut; and

moving said third tube with respect to said first and second tubes to cut the grasped tissue.