Device for full-thickness resectioning of an organ

• US 6,544,271 B1
• Filed: 07/18/2000
• Issued: 04/08/2003
• Est. Priority Date: 07/18/2000
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Buess, Gerhard F., Schurr, Marc O., Adams, Ronald D., Sullivan, Roy H.
• Primary Examiner(s): Milano; Michael J.
• Assistant Examiner(s): ROBERTS, PAUL A
• Application Number:
  US09/620,391
• Time in Patent Office: 994 Days
• Field of Search: 606/219,220,72,75,215,167,170
• US Class Current: 606/139
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/2905 flexible

Abstract

A full-thickness resection system is disclosed. In an embodiment for the resection system, the system may include a flexible shaft, a flexible guide member disposed within the flexible shaft, a stapling mechanism disposed around the flexible guide member, and a grasper. The stapling mechanism has an elongated portion that is at least partially disposed within the flexible shaft. The stapling mechanism includes a stapling arm and an anvil arm. The stapling arm has a longitudinal axis and includes a stapling head having a longitudinal axis. The anvil includes an anvil head. The stapling arm and anvil arm extend from the elongated portion of the stapling mechanism and are moveable with respect to each other between a tissue receiving position and a stapling position. The grasper extends through the flexible shaft and is adapted to grasp a portion of a tissue that is to be excised from an organ in the patient'"'"'s body. The grasper is movable on an axis that is perpendicular to the longitudinal axis of the stapling head.

Claims

1. A full-thickness resection system for removing a full-thickness portion of a body organ, the system comprising:

a flexible shaft having a longitudinal axis;

a flexible guide member having a longitudinal axis disposed within said flexible shaft and having a distal end extendable beyond a distal end of said flexible shaft;

a stapling mechanism having an elongated portion at least partially disposed within said flexible shaft and disposed around said flexible guide member and including;

a stapling arm having a longitudinal axis, said stapling arm including a stapling head having a longitudinal axis; and

an anvil arm having an anvil head;

wherein said stapling arm and said anvil arm extend from said elongated portion and are moveable with respect to each other between a tissue receiving position and a stapling position; and

a grasper, said grasper extending through said flexible shaft and adapted to grasp a portion of a tissue to be excised from the body organ, said grasper movable on an axis perpendicular to said longitudinal axis of said stapling head.

2. The full-thickness resection system of claim 1 wherein said flexible guide member is a flexible endoscope and wherein said grasper extends through a lumen included within said flexible endoscope.

3. The full-thickness resection system of claim 2 wherein said endoscope includes a guide member disposed on an outer periphery of said endoscope and extending externally from said outer periphery of said endoscope and wherein said elongated portion of said stapling mechanism defines a recess therein, said guide member received within said recess.

4. The full-thickness resection system of claim 2 further comprising a closing cam, said closing cam movably disposed around said flexible endoscope and engageable with said stapling mechanism.

5. The full-thickness resection system of claim 4 further comprising a closing cam actuating device, said closing cam movably coupled to said closing cam actuating device, said closing cam actuating device including:

a worm gear;

a rack disposed on said closing cam and threadedly engageable with said worm gear;

a worm gear shaft attached at a first end to a first end of said worm gear and attached at a second end to said stapling mechanism; and

a drive cable attached to said worm gear at a second end of said worm gear.

6. The full-thickness resection system of claim 4 further comprising a closing cam actuating device, said closing cam movably coupled to said closing cam actuating device, said closing cam actuating device including:

a pulley attached to said stapling mechanism;

a cable, said cable attached to said closing cam at a first end of said cable and disposed around said pulley; and

a pull wire attached to said cable at a second end of said cable.

7. The full-thickness resection system of claim 4 further comprising a closing cam actuating device, said closing cam movably coupled to said closing cam actuating device, said closing cam actuating device including:

a fluid reservoir base sealingly coupled to said closing cam;

a fluid reservoir cavity defined by said fluid reservoir base and said closing cam; and

a fluid supply line in fluid communication with said fluid reservoir cavity.

8. The full-thickness resection system of claim 1 wherein said grasper is a suction catheter.

9. The full-thickness resection system of claim 1 wherein said stapling mechanism includes a plurality of staple drivers each having a wedge-shaped cam surface on a top end thereof and a staple cam movable such that said staple cam contacts each of said plurality of staple drivers to drive a plurality of staples from said stapling head.

10. The full-thickness resection system of claim 9 wherein said stapling mechanism further includes:

a pulley rotatable around a first axis;

a first cable attached at a first end to said staple cam and at a second end to said pulley; and

an actuator in operable engagement with said pulley to rotate said pulley around said first axis.

11. The full-thickness resection system of claim 10 wherein said actuator includes:

a second pulley rotatable around a second axis, said second axis perpendicular to said first axis; and

a second cable attached at a first end to said second pulley.

12. The full-thickness resection system of claim 10 wherein said actuator includes a shaft including gear teeth on a distal end thereof, said gear teeth engaging with gear teeth included on said first pulley.

13. The full-thickness resection system of claim 9 wherein said staple cam is formed as a sphere.

14. The full-thickness resection system of claim 9 wherein said staple cam includes a wedge-shaped surface.

15. The full-thickness resection system of claim 9 wherein said stapling head defines a channel and wherein said staple cam is disposed within said channel.

16. The full-thickness resection system of claim 1 wherein said longitudinal axis of said stapling arm is parallel to said longitudinal axis of said flexible shaft and wherein said longitudinal axis of said stapling head is perpendicular to said longitudinal axis of said stapling arm.

17. The full-thickness resection system of claim 1 wherein said longitudinal axis of said stapling arm is parallel to said longitudinal axis of said flexible shaft and wherein said longitudinal axis of said stapling head is parallel to said longitudinal axis of said stapling arm.

18. The full-thickness resection system of claim 17 wherein said flexible guide member is a flexible endoscope and further comprising a separation member disposed between and engaging with said endoscope and said stapling mechanism.

19. The full-thickness resection system of claim 17 wherein said flexible guide member is a flexible endoscope and wherein said grasper extends through a lumen included within said flexible endoscope and further comprising an endoscope deflector pivotally attached to said stapling mechanism and movable between a first position where said endoscope deflector does not deflect said endoscope and a second position where said endoscope deflector deflects said distal portion of said endoscope such that said distal portion is not aligned with said longitudinal axis of said endoscope.

20. The full-thickness resection system of claim 1 further including a stop member wherein said stop member is disposed around said flexible guide member and extends from an outer periphery of said flexible guide member and wherein said stop member is disposed between said staple arm and said anvil arm.

21. The full-thickness resection system of claim 1 wherein said grasper includes a pair of opposed arms movable between a tissue grasping position and an open position.

22. The full-thickness resection system of claim 1 wherein said grasper is a T-shaped member.

23. The full-thickness resection system of claim 1 further comprising a closing cam, said closing cam included on a distal end of said flexible shaft.

24. A full-thickness resection system for removing a full-thickness portion of a body organ, the system comprising:

a flexible shaft including a suction housing disposed on a distal end thereof;

a flexible suction catheter disposed though said flexible shaft and including a distal end in barometric communication with said suction housing; and

a stapling mechanism having a longitudinal axis and disposed though said flexible shaft and including a stapling arm and an anvil arm both of which are extendable beyond a distal end of said flexible shaft;

wherein said stapling arm and said anvil arm are moveable with respect to each other between a tissue receiving position and a stapling position and wherein a vacuum is drawn by said flexible suction catheter on said suction housing, said vacuum capable of drawing a portion of a tissue to be excised from the body organ between said stapling arm and said anvil arm on an axis perpendicular to said longitudinal axis of said stapling mechanism.

25. The full-thickness resection system of claim 24 wherein said flexible suction catheter is disposed within a flexible endoscope.

26. A full-thickness resection system for removing a full-thickness portion of a body organ, the system comprising:

a flexible shaft; and

a stapling mechanism having a longitudinal axis and disposed though said flexible shaft and including;

a stapling arm extendable beyond a distal end of said flexible shaft;

an anvil arm extendable beyond said distal end of said flexible shaft; and

a pair of graspers pivotally attached to an internal surface of said stapling mechanism;

wherein said stapling arm and said anvil arm are moveable with respect to each other between a tissue receiving position and a stapling position and wherein said pair of graspers are adapted to draw a portion of a tissue to be excised from the body organ between said stapling arm and said anvil arm on an axis perpendicular to said longitudinal axis of said stapling mechanism.

27. The full-thickness resection system of claim 26 further comprising a flexible endoscope disposed within said flexible shaft and having a distal end extendable beyond said distal end of said flexible shaft.