Stapling and cutting in resectioning for full thickness resection devices

• US 6,716,222 B2
• Filed: 02/26/2002
• Issued: 04/06/2004
• Est. Priority Date: 11/30/2000
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: McAlister, Gary, Sakal, Robert L.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US10/083,097
• Publication Number:
  US 20020082616A1
• Time in Patent Office: 770 Days
• Field of Search: 606/139, 227/179.1, 227/180.1
• US Class Current: 606/139
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07221 curved
• CPC Class Codes: A61B 2017/32004 having a laterally movable cutting member at its most distal end which remains within the contours of said end

Abstract

A stapling unit for use with an endoscopic stapling system adapted to be advanced along an endoscope to a predetermined location within a body lumen to staple the portion of tissue, as part of an occlusal or full thickness resectioning procedure. The stapling unit comprises a first casing having a distal end, a proximal end and a stapling device mounted thereto adjacent to a first window extending through a periphery of the first casing. The invention includes methods for the stapling, severing and removal of tissue by using the device.

Claims

1. A system for endolumenally resecting tissue comprising:

a flexible endoscope;

an operative housing slidably coupleable to the endoscope and including a fixed perimeter window extending through an exterior wall thereof, an anvil formed on a first edge of the window and a stapling apparatus mounted within the housing for movement between a stapling position in which a staple firing surface of the stapling apparatus is adjacent to the anvil and a tissue receiving position in which the staple firing surface is separated from the anvil to open the window and expose a tissue receiving cavity within an interior of the operative housing; and

a tissue grasping mechanism for drawing tissue to be resected through the window into the tissue receiving cavity.

2. The system according to claim 1, further comprising:

a control handle which, when the operative head is in an operative position within a body lumen, remains outside the body; and

a flexible sheath extending from the control handle to a proximal end of the operative housing, wherein, when in an operative configuration, the endoscope is received within the flexible sheath.

3. The system according to claim 2, wherein the flexible sheath has a column strength sufficient to allow an operator to push the operative housing along the endoscope into a body lumen by pushing the flexible sheath into the body lumen.

4. The system according to claim 1, wherein the operative housing is substantially cylindrical and wherein the stapling apparatus is mounted therein to rotate about an axis of the operative housing between the stapling position and the tissue receiving position.

5. The system according to claim 1, the stapling apparatus is mounted within the operative housing for motion substantially parallel to a longitudinal axis of the operative housing.

6. The system according to claim 1, wherein the operative housing is substantially cylindrical and wherein the stapling apparatus is mounted therein to rotate about an axis of the operative housing between the stapling position and the tissue receiving position.

7. The system according to claim 1, wherein the operative housing includes an endoscope receiving lumen extending therethrough from a proximal opening to a distal opening formed in a distal end of the operative housing.

8. The system according to claim 1, further comprising:

a tissue cutting mechanism mounted within the operative housing for cutting tissue located radially within a portion of tissue stapled by the stapling apparatus.

9. The system according to claim 8, wherein the operative housing is substantially cylindrical and wherein the tissue cutting mechanism includes a partially cylindrical member rotatably mounted within the operative housing radially within the stapling apparatus and including an angled tissue cutting surface.

10. The system according to claim 1, wherein the operative housing is substantially cylindrical and wherein the stapling apparatus is mounted therein to rotate about an axis of the operative housing across the window.

11. The system according to claim 1, wherein the operative housing is substantially cylindrical and wherein the stapling apparatus is mounted therein to move along an axis of the operative housing across the window.

12. A method of endolumenally resecting tissue within a body lumen, comprising the steps of:

endoscopically locating a portion of tissue to be resected within a body lumen;

sliding an operative housing along the endoscope to a desired position adjacent to the portion of tissue to be resected, wherein the operative housing includes a fixed perimeter tissue receiving window extending therethrough, an anvil formed on an edge of the window and a stapling apparatus movably mounted within the operative housing;

moving the stapling apparatus to a tissue receiving position in which the stapling apparatus is separated from the anvil;

drawing the portion of tissue to be resected into the housing through the window folded over so that two full thicknesses of tissue of the body lumen are received within the window;

moving the stapling apparatus into a stapling position in which the portion of tissue to be resected is clamped between the stapling apparatus and the anvil;

driving staples from the stapling apparatus through the two thicknesses of tissue to couple the two thicknesses of tissue to one another; and

cutting tissue radially within the stapled tissue from the stapled tissue.

13. The method according to claim 12, wherein the stapling apparatus is rotated within the housing between the tissue receiving and stapling positions.

14. The method according to claim 12, wherein the stapling apparatus is moved longitudinally within the housing between the tissue receiving and stapling positions.

15. The method according to claim 12, wherein the operative housing is coupled to a control handle which remains outside the body by a flexible sheath and wherein the operative housing is slid along the endoscope by pushing the flexible sheath into the body lumen.

16. A device for endolumenally resecting tissue comprising:

an operative housing slidably coupleable to a flexible endoscope and including a fixed perimeter window extending through an exterior wall thereof, an anvil formed on a first edge of the window and a stapling apparatus mounted within the housing for movement between a stapling position in which a staple firing surface of the stapling apparatus is adjacent to the anvil and a tissue receiving position in which the staple firing surface is separated from the anvil to open the window and expose a tissue receiving cavity within an interior of the operative housing; and

a tissue grasping mechanism for drawing tissue to be resected through the window into the tissue receiving cavity.