Doppler directed suture ligation device and method

• US 7,141,057 B2
• Filed: 09/18/2003
• Issued: 11/28/2006
• Est. Priority Date: 11/16/2000
• Status: Expired due to Fees

• Current Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Original Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Inventors: Jones, Michael L., Altieri, Greig E., Burbank, Fred, Uyeno, Jill, Serra, R. J.
• Primary Examiner(s): Woo, Julian W.
• Application Number:
  US10/666,075
• Publication Number:
  US 20040059352A1
• Time in Patent Office: 1,167 Days
• Field of Search: 606/139, 606/144, 606/148, 606/119, 600/453, 600/104, 600/454, 600/459, 600/462, 600/504, 128/898
• US Class Current: 606/148
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/12009 Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/06104 interconnected at their distal ends, e.g. two hollow needles forming a loop for passing a suture
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2090/378 using ultrasound

Abstract

Exemplary embodiments are directed to providing a method of preparing an anatomical vessel contained within a tissue bundle for ligation, including positioning a cannula adjacent to the tissue bundle, wherein the positioning is non-penetrating, the cannula including a first extendable member, a second extendable member, a Doppler wand, and a distal end, transmitting ultrasound signals toward the vessel through the tissue bundle with the Doppler wand, receiving ultrasound signals reflected by the vessel through the tissue bundle with the Doppler wand, invaginating the tissue bundle with the first extendable member on a first side of the tissue bundle, invaginating the tissue bundle with the second extendable member on a second side of the bundle opposite the first side, and interpenetrating a length of ligation material between the first and second extendable members on a side of the vessel opposite the cannula distal end.

Claims

1. A method of occluding a uterine artery of a female patient which includes

a. providing a uterine artery occlusion device which has an elongated cannula with proximal and distal ends, at least first and second lumens extending within the elongated cannula, a first extendable member having a first distal end disposed within the first inner lumen, a second extendable member having a second distal end disposed within the second inner lumen, a blood flow sensor at the distal end of the cannula to facilitate location of the patient'"'"'s uterine artery and the monitoring of blood flow therethrough;

b. introducing the occlusion device with the patient'"'"'s vaginal canal and advancing the device therein until the distal end of the cannula is adjacent to the patient'"'"'s vaginal fornix;

c. locating the patient'"'"'s uterine artery by the blood flow sensor;

d. extending the first extendable member onto a first location of the patient'"'"'s vaginal fornix to invaginate the wall thereof at the first location on a first side of the located uterine artery with the first distal end distal to the located artery; and

e. extending the second extendable member onto a second location of the patient'"'"'s vaginal fornix to invaginate the wall thereof at the second location on a second side of the located uterine artery with the second distal end distal to the located artery;

f. interpenetrating a length of ligation material through the invaginated walls of the patient'"'"'s vaginal fornix at the first and second locations from the first and second distal ends of the first and second extendable members distal to uterine artery to occlude the uterine artery.

2. The method of claim 1 wherein the blood flow sensor used to locate the uterine artery is a Doppler ultrasound based sensor.

3. The method of claim 1, wherein said first extendable member includes a detachable element to which said ligation material is attached, and wherein the detachable element is grabbed by portions of the second extendable member.

4. The method of claim 1, wherein the second extendable member is retracted in a proximal direction;

and wherein the detachable element is released from the first extendable member.

5. The method of claim 1, wherein the first extendable member includes a tissue penetrating element to which said ligation material is attached, and wherein the invaginated walls are is pierced by the tissue penetrating element.

6. The method of claim 5, wherein the tissue penetrating element includes a detachable element to which said ligation material is attached, and wherein the detachable element is grabbed by portions of the second extendable member.

7. The method of claim 5, wherein the second extendable member is retracted in a proximal direction;

and the detachable element is released from the first

extendable member.

8. A method of occluding a uterine artery of a female patient which includes

a. providing a uterine artery occlusion device which has an elongated cannula with proximal and distal ends, a first extended member having a first distal end, a second extended member having a second distal end, a blood flow sensor at the distal end of the cannula to facilitate location of the patient'"'"'s uterine artery and the monitoring of blood flow therethrough;

b. introducing the occlusion device with the patient'"'"'s vaginal canal and advancing the device therein until the distal end of the cannula is adjacent to the patient'"'"'s vaginal fornix;

c. locating the patient'"'"'s uterine artery by the blood flow sensor;

d. pressing the first extended member onto a first location of the patient'"'"'s vaginal fornix to invaginate the wall thereof at the first location on a first side of the located uterine artery with the first distal end distal to the located artery; and

e. pressing the second extended member onto a second location of the patient'"'"'s vaginal fornix to invaginate the wall thereof at the second location on a second side of the located uterine artery with the second distal end distal to the located uterine artery;

f. interpenetrating a length of ligation material through the invaginated walls of the patient'"'"'s vaginal fornix at the first and second locations from the first and second distal ends of the first and second extended members distal to uterine artery to occlude the uterine artery.

9. An intravaginal uterine artery occlusion device for a female patient, comprising:

a. a cannula having a distal end that is configured for advancement through a vaginal canal of the female patient and that is configured for positioning the distal end thereof adjacent the patient'"'"'s vaginal fornix;

b. a blood flow sensor on the distal end configured to detect the uterine artery to be occluded;

c. a first elongated member extending distal to the distal end of the cannula which is configured to invaginate tissue on a first side of the uterine artery which has a distal end extending distal to the uterine artery;

d. a second elongated member extending distal to the distal end of the cannula which is configured to invaginate tissue on a second side of the uterine artery and which has a distal end extending distal to the uterine artery; and

e. a penetrating member configured for advancing a length of ligation material between the distal ends of the first and second elongated members opposite the cannula distal end.

10. The occlusion device of claim 9, wherein the first elongated member has a detachable element attached to the ligation material, and wherein the second elongated member has a snare configured to grab the detachable element.

11. The occlusion device of claim 10, wherein the second elongated member is configured to be retracted in a proximal direction, and a release mechanism configured for releasing the detachable element from the first elongated member.

12. The occlusion device of claim 11, wherein the first elongated member includes a tissue penetrating element attached to the ligation material.

13. The occlusion device of claim 12, wherein the tissue penetrating element is part of the detachable element secured to the ligation material, and is configured to be captured by the snare of the second elongated member.

14. An intravaginal uterine artery occlusion device for a female patient, comprising:

a. a cannula having a distal end that is configured for advancement through a vaginal canal of the female patient and that is configured for positioning the distal end thereof adjacent the patient'"'"'s vaginal fornix;

b. a blood flow sensing means on the distal end configured to detect the uterine artery to be occluded;

c. a first elongated means extending distal to the distal end of the cannula which is configured to invaginate tissue on a first side of the uterine artery which has a distal end extending distal to the uterine artery;

d. a second elongated means extending distal to the distal end of the cannula which is configured to invaginate tissue on a second side of the uterine artery and which has a distal end extending distal to the uterine artery; and

e. a penetrating means configured for advancing a length of ligation material between the distal ends of the first and second elongated means opposite the cannula distal end.

15. A method of occluding a uterine artery of a female patient which includes the steps of:

a. providing a uterine artery occlusion device which has an elongated cannula with proximal and distal ends, a first extended member having a first distal end, a second extended member having a second distal end, a blood flow sensor at the distal end of the cannula to facilitate location of the patient'"'"'s uterine artery and the monitoring of blood flow therethrough;

b. introducing the occlusion device with the patient'"'"'s vaginal canal and advancing the device therein until the distal end of the cannula is adjacent to the patient'"'"'s vaginal fornix;

c. locating the patient'"'"'s uterine artery by the blood flow sensor;

d. pressing the first extended member onto a first location of the patient'"'"'s vaginal fornix to invaginate the wall thereof at the first location on a first side of the located uterine artery with the first distal end distal to the located artery; and

e. pressing the second extended member onto a second location of the patient'"'"'s vaginal fornix to invaginate the wall thereof at the second location on a second side of the located uterine artery with the second distal end distal to the located uterine artery;

f. interpenetrating a length of ligation material through the invaginated walls of the patient'"'"'s vaginal fornix at the first and second locations from the first and second distal ends of the first and second extended members distal to uterine artery to occlude the uterine artery.