Devices and related methods for securing a tissue fold

• US 6,592,596 B1
• Filed: 05/10/2000
• Issued: 07/15/2003
• Est. Priority Date: 05/10/2000
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Geitz, Kurt E.
• Primary Examiner(s): Hale; Gloria M.
• Application Number:
  US09/568,012
• Time in Patent Office: 1,161 Days
• Field of Search: 606/139,142,151,157,219-221,167,185,153-156 600/201,210 128/898 227/175.1,176.1,19,177.1,178.1,179.1,180.1
• US Class Current: 606/139
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/07214 Stapler heads

Abstract

The present invention relates to devices and methods for creating and securing a tissue fold during an endoluminal medical procedure. The devices and methods may be used for folding and securing, for example, a fundus wall onto an esophagus wall. An aspect of the invention includes a two-piece tissue clip configured to be installed through an endoluminal device to secure a tissue fold. The clip includes a female member and a male member configured to engage one another to secure the tissue fold. Another aspect of the invention includes a clipping device comprising a tissue clip magazine. The magazine is configured to hold a plurality of tissue clips and install the plurality of tissue clips in a single actuation of the magazine. A method for using the clipping device together with the tissue clips of the present invention to create and secure a fold of tissue during an endoluminal procedure also is disclosed.

Claims

1. A clipping device for securing a tissue fold, comprising:

a tube having an actuator;

a magazine disposed on a distal end of the tube and configured to hold a plurality of tissue clips for securing the tissue fold, the magazine including an opening configured to receive the tissue fold; and

means for drawing the tissue fold into the opening,

wherein actuation of the actuator simultaneously installs the plurality of tissue clips.

2. The clipping device of claim 1, wherein the tube and the magazine are configured to be inserted through an esophagus into a stomach to install a plurality of tissue clips to secure a fundus wall to an esophagus wall.

13. The clipping device of claim 1, wherein the tube includes a lumen configured to receive an endoscope.

14. The clipping device of claim 1, wherein the means for drawing the tissue fold includes at least one suction port in the magazine.

15. The clipping device of claim 14, wherein the suction port is in fluid communication with a vacuum lumen disposed in the tube.

3. A clipping device for securing a tissue fold, comprising:

a tube having an actuator; and

a magazine disposed on a distal end of the tube, said magazine configured to hold a plurality of tissue clips for installation to secure the tissue fold,

wherein the magazine includes a stationary clip holder and a sliding clip holder disposed substantially opposite to each other and actuation of the actuator simultaneously installs the plurality of tissue clips.

4. The clipping device of claim 3, wherein the magazine further includes a slider track configured to guide the sliding clip holder toward the stationary clip holder.

5. The clipping device of claim 3, wherein the actuator imparts motion to the sliding clip holder.

6. The clipping device of claim 3, wherein each of the plurality of tissue clips is comprised of a female member and a male member, wherein each female member and male member are configured to engage with one of the sliding clip holder and the stationary clip holder, and wherein motion of the sliding clip holder toward the stationary clip holder causes the male member and the female member to engage each other and form the tissue clip.

7. The clipping device of claim 6, wherein the magazine includes a plurality of stationary clip holders and sliding clip holders disposed at a plurality of angular intervals around a longitudinal axis of the magazine.

8. The clipping device of claim 6, wherein each of the stationary clip holder and the sliding clip holder are configured to hold a plurality of respective female and male members forming the tissue clip.

9. The clipping device of claim 4, wherein the slider track extends along a base of the magazine from the tube to an outer wall of the magazine.

10. The clipping device of claim 3, wherein the actuator includes a cable.

11. The clipping device of claim 10, wherein the cable connects to the sliding clip holder.

12. The clipping device of claim 3, further comprising a biasing member connected to the sliding clip holder.

25. The clipping device of claim 3, wherein the tube and the magazine are configured to be inserted through an esophagus into a stomach to install a plurality of tissue clips to secure a fundus wall to an esophagus wall.

26. The clipping device of claim 3, wherein the tube includes a lumen configured to receive an endoscope.

16. A method for securing a tissue fold during an endoluminal medical procedure, comprising:

providing a tissue clip magazine holding a plurality of tissue clips configured to engage and secure a tissue fold, the tissue clip magazine including a stationary clip holder and a sliding clip holder disposed substantially opposite to each other;

inserting the tissue clip magazine endoluminally into an area of the body where a tissue fold is to be secured;

positioning the tissue clip magazine proximate the tissue fold; and

actuating the tissue clip magazine to simultaneously engage the tissue fold with the plurality of tissue clips.

17. The method of claim 16, wherein the tissue clip magazine is inserted through an esophagus into a stomach and the tissue fold includes a fundus wall and an esophagus wall.

18. The method of claim 16, wherein actuating the magazine includes moving the sliding clip holder toward the stationary clip holder.

19. The method of claim 18, wherein each tissue clip includes a male member and a female member each engaged with one of the stationary clip holder and the sliding clip holder, and moving the sliding clip holder causes the male and female members to engage each other.

20. The method of claim 19, wherein the tissue clip magazine includes a plurality of sliding clip holders and corresponding stationary clip holders disposed about a longitudinal axis of the magazine.

21. The method of claim 20, wherein actuating the magazine includes exerting a force on an actuator to move the sliding clip holder along a track disposed along a base of the magazine.

22. The method of claim 16, wherein providing the tissue clip magazine includes disposing the magazine on a distal end of a tube, the tube including a lumen configured to receive an endoscope.

23. The method of claim 16, further comprising inserting the tissue of the tissue fold into an opening in the tissue clip magazine.

24. The method of claim 23, wherein inserting the tissue fold includes drawing the tissue of the tissue fold into the opening by suction.

27. A method for securing a tissue fold during an endoluminal medical procedure, comprising:

providing a tissue clip magazine having a plurality of tissue clips configured to secure the tissue fold, the tissue clip magazine including an opening configured to receive the tissue fold;

inserting the tissue clip magazine endoluminally;

positioning the tissue clip magazine proximate the tissue fold to be secured;

drawing at least a portion of the tissue fold into the opening; and

actuating the tissue clip magazine to simultaneously engage the tissue fold with the plurality of tissue clips.

28. The method of claim 27, wherein drawing at least a portion of the tissue fold includes drawing the tissue fold by suction.

29. The method of claim 27, wherein inserting the tissue clip magazine endoluminally includes inserting the clip magazine through esophagus into a stomach and the tissue fold includes a fundus wall and an esophagus wall.

30. The method of claim 27, further including disposing the magazine on a distal end of a tube, the tube including a lumen configured to receive an endoscope.

31. A method for securing a tissue fold during an endoluminal medical procedure, comprising:

providing a tissue clip magazine having a plurality of tissue clips configured to secure the tissue fold, each tissue clip including a male member and a female member;

inserting the tissue clip magazine endoluminally;

positioning the tissue clip magazine proximate the tissue fold to be secured; and

actuating the tissue clip magazine to simultaneously engage the tissue fold with the plurality of tissue clips.

32. A method of claim 31, wherein:

the magazine includes a pair of clip holders for holding respective one of the male and female members, the pair of clip holders disposed substantially opposite to each other and at least one of the pair of clip holders being slidably movable relative to the other; and

moving the at least one of the clip holders causes the male members to engage corresponding female members.

33. The method of claim 32, wherein actuating the magazine includes moving the at least one clip holder toward the other clip holder.

34. The method of claim 31, wherein the tissue clip magazine is inserted through an esophagus into a stomach and the tissue fold includes a fundus wall and an esophagus wall.

35. The method of claim 31, wherein the tissue clip magazine includes a plurality of sliding clip holders for holding one of the male and female members and corresponding stationary clip holders for holding the other of the male and female members.

36. The method of claim 31, wherein actuating the magazine includes exerting a force on an actuator to move a sliding clip holder.

37. The method of claim 31, wherein providing the tissue clip magazine includes disposing the magazine on a distal end of a tube, the tube including a lumen configured to receive an endoscope.

38. The method of claim 31, further comprising inserting the tissue of the tissue fold into an opening in the tissue clip magazine.

39. The method of claim 38, wherein inserting the tissue of the tissue fold includes drawing the tissue of the tissue fold into the opening by suction.

40. A clipping device for securing a tissue fold, comprising:

a tube having an actuator; and

a magazine disposed on a distal end of the tube and configured to hold a plurality of tissue clips for securing the tissue fold, each tissue clip having a male member and a female member

wherein actuation of the actuator simultaneously engages the male and female members of the plurality of tissue clips, thereby securing the tissue fold.

41. The clipping device of claim 40, wherein the tube and the magazine are configured to be inserted through an esophagus into a stomach to install the plurality of tissue clips to secure a fundus wall to an esophagus wall.

42. The clipping device of claim 40, wherein the magazine includes a stationary clip holder for holding one of the male and female members and a sliding clip holder for holding the other of the male and female members, the stationary and sliding clip holders disposed substantially opposite to each other.

43. The clipping device of claim 42, wherein the magazine further includes a slider track configured to guide the sliding clip holder toward the stationary clip holder, wherein motion of the sliding clip holder toward the stationary clip holder causes the male and female members to engage each other and form the tissue clip.

44. The clipping device of claim 43, wherein the slider track extends along a base of the magazine from the tube to an outer wall of the magazine.

45. The clipping device of claim 42, wherein the actuator imparts motion to the sliding clip holder.

46. The clipping device of claim 42, wherein the magazine includes a plurality of stationary clip holders and sliding clip holders disposed around a longitudinal axis of the magazine.

47. The clipping device of claim 42, wherein the actuator includes a cable.

48. The clipping device of claim 47, wherein the cable connects to the sliding clip holder.

49. The clipping device of claim 42, further comprising a biasing member connected to the sliding clip holder.

50. The clipping device of claim 40, wherein the tube includes a lumen configured to receive an endoscope.

51. The clipping device of claim 40, wherein the magazine defines an opening configured to receive a tissue fold.

52. The clipping device of claim 51, wherein the magazine defines at least one suction port proximate the opening.

53. The clipping device of claim 52, wherein the suction port is in fluid communication with a vacuum lumen disposed in the tube.