Tissue manipulation and securement system

• US 7,736,374 B2
• Filed: 03/01/2005
• Issued: 06/15/2010
• Est. Priority Date: 05/07/2004
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Vaughan, Robert A., Saadat, Vahid, Ewers, Richard C., Lam, Cang C.
• Primary Examiner(s): Manahan; Todd E
• Assistant Examiner(s): YABUT, DIANE D
• Application Number:
  US11/070,846
• Publication Number:
  US 20050251165A1
• Time in Patent Office: 1,932 Days
• Field of Search: 606/153, 606205-208, 606/144
• US Class Current: 606/153
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• 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 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• 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 17/29 Forceps for use in minimally invasive surgery
• 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 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0464 for soft tissue
• 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
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

Tissue manipulation and securement systems are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member and has a lower jaw member and an upper jaw member pivotably coupled to the lower jaw member. A reconfigurable launch tube is also pivotably coupled to the upper jaw member and is used to urge the jaw members from a low-profile configuration to an open configuration for receiving tissue. The tissue manipulation assembly may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly.

Claims

1. A tissue securement apparatus, comprising:

an elongate body having a proximal end, a distal end, and a flexible length therebetween;

a first jaw member pivotably coupled to the distal end of the elongate member such that the first jaw pivots around a first pivot axis;

a second jaw member pivotably coupled to the first jaw member such that the second jaw pivots around a second pivot axis that does not coincide with the first pivot axis;

a launch tube defining a lumen therethrough, the launch tube being slidably positioned along the elongate body and pivotably coupled to the second jaw member; and

an anchor assembly and anchor deployment catheter movably positioned within the launch tube.

2. The apparatus of claim 1 wherein at least one of the first and second jaw members comprise protrusions for facilitating engagement onto the tissue.

3. The apparatus of claim 1, wherein the lumen of said launch tube extends to the distal end of the launch tube, and wherein a distal end of the launch tube is pivotably coupled to the second jaw member.

4. The apparatus of claim 1 wherein the launch tube comprises a distally located flexible portion.

5. The apparatus of claim 4 wherein the launch tube further comprises a rigid portion proximally of the flexible portion.

6. The apparatus of claim 1 wherein the first and second jaw members are adapted to configure into an expanded configuration when the launch tube is urged proximally.

7. The apparatus of claim 1 wherein the first and second jaw members are adapted to configure into a grasping configuration when the launch tube is urged distally.

8. The apparatus of claim 1 wherein the first jaw member defines an opening for passage of a needle assembly therethrough.

9. The apparatus of claim 1 wherein said anchor deployment catheter comprises a needle assembly slidably positioned within the launch tube, the needle assembly having a needle body and a flexible sheath, with said anchor assembly being positioned within a distal portion of the flexible sheath.

10. The apparatus of claim 1, wherein said anchor assembly comprises a distal anchor, a proximal anchor, and a connector that connects the distal anchor to the proximal anchor.

11. A tissue securement apparatus, comprising:

an elongate body having a proximal end, a distal end, and defining a first lumen that extends through at least a portion of the elongate body, the elongate body further defining a longitudinal axis;

a first jaw member pivotably coupled to the elongate member at or near its distal end;

a second jaw member pivotably coupled to the first jaw member;

a launch tube defining a second lumen therethrough, the launch tube having a proximal portion that is substantially coaxial with and movably positioned within the first lumen of the elongate body, the launch tube also having a distal portion that is pivotably coupled to the second jaw member; and

an anchor assembly and anchor deployment catheter movably positioned within the launch tube.

12. The apparatus of claim 11, wherein said launch tube distal portion extends from a distal end of the first lumen, the distal portion of the launch tube having a first position in which it is substantially coaxial with the elongate body, and a second position in which it has a substantially arcuate shape and is not coaxial with the elongate body.

13. The apparatus of claim 12, wherein the distal portion of said launch tube is substantially restricted to a single plane.

14. The apparatus of claim 11, wherein said launch tube distal portion includes circumferential slots to permit bending of the distal portion.

15. The apparatus of claim 11, wherein movement of said launch tube relative to said elongate body causes pivoting motion of said first jaw member and said second jaw member.

16. The apparatus of claim 15, wherein said launch tube has:

a first position relative to said elongate body that corresponds with a low-profile configuration of said first jaw member and said second jaw member,

a second position relative to said elongate body that corresponds with an expanded configuration of said first jaw member and said second jaw member, and

a third position relative to said elongate body that corresponds with a grasping configuration of said first jaw member and said second jaw member.

17. The apparatus of claim 16, wherein said second position of said launch tube is distal of said first position, and wherein said third position of said launch tube is distal of said second position.

18. The apparatus of claim 16, wherein said launch tube distal portion extends from a distal end of the first lumen, the distal portion of the launch tube having a substantially arcuate shape when said launch tube is in the third position relative to the elongate body.

19. The apparatus of claim 11, wherein said anchor deployment catheter comprises a needle assembly slidably positioned within the second lumen, the needle assembly having a needle body and a flexible sheath, with said anchor assembly being positioned within a distal portion of the flexible sheath.

20. The apparatus of claim 19, wherein said anchor assembly comprises a distal anchor, a proximal anchor, and a connector that connects the distal anchor to the proximal anchor.

21. The apparatus of claim 11, wherein the second lumen extends to the distal portion of the launch tube.