Method and device for full thickness resectioning of an organ
First Claim
1. A full-thickness resection system for removing a full-thickness portion of a body organ, the system comprising:
- a flexible endoscope;
a stapling mechanism which, in an operative position is located within a body of a patient, wherein the endoscope is slidably received through at least a portion of the stapling mechanism, the stapling mechanism comprising;
an anvil;
a stapling head coupled to the anvil so that the anvil and the stapling head are moveable with respect to one another along an axis substantially parallel to a longitudinal axis of the stapling mechanism between a tissue receiving position and a stapling position, wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than in the stapling position;
a position adjusting mechanism for moving at least one of the anvil and the stapling head relative to the other of the anvil and the stapling head between the tissue receiving and stapling positions;
a staple firing mechanism for sequentially firing, when the stapling head and the anvil are in the stapling position, staples received in the stapling head from the stapling head across the gap against the anvil and through any tissue received in the gap; and
a knife operable independently of the staple firing mechanism to cut a portion of tissue received within the gap; and
a control unit which, when the stapling head is in the operative position, remains outside the body, the control unit being coupled to the stapling mechanism for controlling operation of the position adjusting mechanism and the staple firing mechanism.
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Abstract
A full-thickness resection system comprises a flexible endoscope and a stapling mechanism, wherein the endoscope is slidably received through at least a portion of the stapling mechanism. The stapling mechanism comprises an anvil and a stapling head mounted to the anvil so that the anvil and the stapling head are moveable with respect to one another between a tissue receiving position and a stapling position and wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than it is in the stapling position. A position adjusting mechanism is provided for moving the anvil and the stapling head between the tissue receiving and stapling positions and a staple firing mechanism sequentially fires a plurality of staples from the stapling head across the gap against the anvil and through any tissue received in the gap and a knife cuts a portion of tissue received within the gap. A control unit which remains outside the body is coupled to the stapling mechanism for controlling operation of the position adjusting mechanism and the staple firing mechanism.
1827 Citations
31 Claims
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1. A full-thickness resection system for removing a full-thickness portion of a body organ, the system comprising:
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a flexible endoscope;
a stapling mechanism which, in an operative position is located within a body of a patient, wherein the endoscope is slidably received through at least a portion of the stapling mechanism, the stapling mechanism comprising;
an anvil;
a stapling head coupled to the anvil so that the anvil and the stapling head are moveable with respect to one another along an axis substantially parallel to a longitudinal axis of the stapling mechanism between a tissue receiving position and a stapling position, wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than in the stapling position;
a position adjusting mechanism for moving at least one of the anvil and the stapling head relative to the other of the anvil and the stapling head between the tissue receiving and stapling positions;
a staple firing mechanism for sequentially firing, when the stapling head and the anvil are in the stapling position, staples received in the stapling head from the stapling head across the gap against the anvil and through any tissue received in the gap; and
a knife operable independently of the staple firing mechanism to cut a portion of tissue received within the gap; and
a control unit which, when the stapling head is in the operative position, remains outside the body, the control unit being coupled to the stapling mechanism for controlling operation of the position adjusting mechanism and the staple firing mechanism. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A method of performing a full-thickness resection of tissue within a substantially tubular body organ comprising the steps of:
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inserting a stapling mechanism slidably received around a flexible endoscope into a tubular body organ via a body orifice, wherein the stapling mechanism includes a stapling head and an anvil coupled to one another for movement along an axis substantially parallel to a longitudinal axis of the stapling mechanism between a stapling position and a tissue receiving position, wherein a gap formed between the stapling head and the anvil is smaller in the stapling position than in the tissue receiving position, the stapling mechanism further includes a knife movably mounted therein;
advancing the stapling mechanism along the endoscope to a portion of wall tissue of the body organ to be resectioned;
moving the stapling mechanism into the tissue receiving position;
drawing the portion of the wall tissue into the gap;
moving the stapling mechanism into the stapling position;
firing a plurality of staples through the tissue received in the gap, wherein the portion of wall tissue into which the staples are fired extends around a longitudinal axis of the body organ by an angle of less than 360°
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after staple firing has been completed, operating the knife to cut away from the wall of the body organ the portion of tissue to be resectioned. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30)
confirming that the staples have been properly fired into desired locations in the tissue of the body organ;
engaging the knife with the controller; and
operating the controller to draw the knife through the tissue of the body organ to sever the tissue to be resectioned.
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28. The method according to claim 27, the controller and the stapling mechanism being coupled together by a torsionally rigid, longitudinally flexible drive shaft wherein, in a first configuration, the knife is disengaged from the drive shaft so that rotation of the drive shaft does not move the knife from an initial position and wherein in a second configuration, the knife is engaged with the drive shaft so that rotation of the drive shaft moves the knife between the initial position and a final position severing the portion of tissue received within the gap.
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29. The method according to claim 27, wherein the tissue to be resectioned is drawn into the gap by a grasper device inserted into the gap via a first lumen extending through the stapling mechanism.
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30. The method according to claim 29, wherein the grasper device is inserted into the gap via a second lumen extending through a flexible endoscope received within the first lumen.
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31. A full-thickness resection device comprising:
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a stapling mechanism having an endoscope receiving lumen extending therethrough, wherein, in an operative position, the stapling mechanism is entirely received within a body of a patient, the stapling mechanism comprising;
an anvil;
a stapling head coupled to the anvil so that the anvil and the stapling head are moveable with respect to one another along an axis substantially parallel to a longitudinal axis of the stapling mechanism between a tissue receiving position and a stapling position, wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than in the stapling position;
a gear drive for moving at least one of the anvil and the stapling head relative to the other of the anvil and the stapling head between the tissue receiving and stapling positions;
a moveable cam, motion of which past a plurality of firing pins sequentially fires staples, received in the stapling head adjacent to the firing pins, from the stapling head across the gap against the anvil and through any tissue received in the gap; and
a knife for cutting a portion of tissue received within the gap;
a control unit which, when the stapling head is in the operative position, remains outside the body, the control unit being coupled to the stapling mechanism via at least one flexible drive shaft for controlling operation of the position adjusting mechanism, the staple firing mechanism and the knife wherein, in a cutting configuration, the knife is non-rotatably coupled to the drive shaft so that rotation of the drive shaft moves the knife through the gap and in a non-cutting configuration, rotation of the drive shaft does not move the knife through the gap.
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Specification