Tissue reconfiguration

• US 7,722,633 B2
• Filed: 04/08/2004
• Issued: 05/25/2010
• Est. Priority Date: 06/22/1999
• Status: Expired due to Fees

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Puicci, Vincent A. Jr., Andrews, Richard, Chinnock, Randall B., Marshall, Neal H., Cerier, Jeffrey C., Laufer, Michael D., Cruz, Amos, Barenboym, Michael, Chuttani, Ram, O'Keefe, Jonathan
• Primary Examiner(s): Woo; Julian W
• Application Number:
  US10/819,957
• Publication Number:
  US 20040193193A1
• Time in Patent Office: 2,238 Days
• Field of Search: 606153-159, 606/139, 606142-145, 606/148, 606/151, 606/213, 606/216, 606219-221, 606/232, 606/228, 606/222, 227/175.1, 227/67, 227/68
• US Class Current: 606/153
• 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 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• 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 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• 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 17/0686 having a forming anvil staying below the tissue during stapling
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/00314 Separate linked members
• 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 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 : H-fasteners
• CPC Class Codes: A61B 2017/0441 : the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0472 : Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0474 : Knot pushers
• CPC Class Codes: A61B 2017/0475 : using sutures having a slip knot
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/061 : hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185
• CPC Class Codes: A61B 2017/2905 : flexible
• CPC Class Codes: A61B 2017/2915 : arcuate shaped guiding means
• CPC Class Codes: A61B 2017/2916 : pins in guiding slots
• CPC Class Codes: A61B 2017/2917 : with flexible part
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2932 : Transmission of forces to jaw members
• CPC Class Codes: A61B 2017/308 : with suction cups
• CPC Class Codes: A61B 2090/065 : for measuring contact or contact pressure
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires

Abstract

A medical instrument for engaging tissue includes a flexible shaft, a tissue piercing coil at a distal portion of the shaft, and a tissue stabilizer positioned over the shaft and biased in a distal direction such that as the tissue piercing coil enters tissue, the tissue stabilizer is urged against a surface of the tissue. A medical instrument for reconfiguring tissue includes a flexible shaft defining a lumen housing actuating controls, and a distal actuating assembly with a sealing portion configured to substantially seal the shaft lumen from contact with bodily fluids. A cartridge assembly includes first and second members configured for releasable attachment to a medical instrument, and a holder configured to receive the first and second members and to be released from the first and second members upon action of the first and second members attaching to the medical instrument.

Claims

1. An apparatus comprising:

two tissue piercing elements, and an implant including at least one first rigid portion and at least one second rigid portion connected by a flexible portion, the at least one second rigid portion being disposed circumferentially around at least one of the tissue piercing elements and the at least one first rigid portion being disposed inside at least one of the tissue piercing elements, wherein at least one of the tissue piercing elements is configured to deploy the first rigid portion of the implant through body tissue while the second rigid portion remains substantially stationary at a position at which it contacts the body tissue, wherein the flexible portion is coupled between the first and second rigid portions.

2. The apparatus of claim 1 wherein the first rigid portion defines a hole for receiving the flexible portion.

3. The apparatus of claim 1 wherein the tissue piercing element is a needle.

4. The apparatus of claim 1 wherein the first rigid portion includes a bar defining two holes.

5. The apparatus of claim 1 wherein the tissue piercing element is configured to receive the first rigid portion of the implant.

6. The apparatus of claim 1 wherein the tissue piercing element includes a channel for deploying the first rigid portion of the implant.

7. The apparatus of claim 1, wherein each of the two tissue piercing elements, is configured to deploy one of the rigid portions through the body tissue.

8. The apparatus of claim 7 wherein the tissue piercing elements are parallel with each other.

9. The apparatus of claim 1, wherein the rigid portion and the flexible portion comprise different materials.

10. The apparatus of claim 9 wherein the flexible portion comprises suture.

11. An apparatus comprising:

two tissue piercing elements, and an implant including at least one first rigid portion and at least one second rigid portion having suture coupled therebetween, the at least one second rigid portion being disposed circumferentially around at least one of the tissue piercing elements and the at least one first rigid portion being disposed within at least one of the tissue piercing elements, wherein at least one of the tissue piercing elements is configured to deploy the first rigid portion of the implant through body tissue while the second rigid portion remains substantially stationary at a position at which it contacts the body tissue;

wherein the implant is configured such that the body tissue is secured between the first and second rigid portions.

12. The apparatus of claim 11 wherein the first rigid portion defines a hole for receiving the suture.

13. The apparatus of claim 11 wherein the tissue piercing element defines a channel for receiving the first rigid portion.

14. The apparatus of claim 11 wherein the first rigid portion forms a distal portion of the tissue piercing element.

15. The apparatus of claim 11 wherein the tissue piercing element is a needle.

16. The apparatus of claim 11 wherein the first rigid portion includes a bar defining two holes.

17. The apparatus of claim 11, comprising two first rigid portions.

18. The apparatus of claim 17, wherein each of the two tissue piercing elements, is configured to deploy a respective one of the first rigid portions through the body tissue.

19. The apparatus of claim 18 wherein the tissue piercing elements are parallel with each other.

20. A medical instrument, comprising:

a flexible shaft, an implant having three rigid portions connected by a suture, and first and second members being substantially parallel with each other and coupled to a distal end of the shaft and each configured to releasably receive the three rigid portions of the implant, and to remotely deploy at least two of the three rigid portions of the implant through body tissue at a treatment site with the three rigid portions of the implant each configured to maintain a respective single shape throughout delivery from outside a body to the treatment site, deployment, and securement at the treatment site.