Tissue reconfiguration

• US 7,857,823 B2
• Filed: 04/08/2004
• Issued: 12/28/2010
• 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: Cerier, Jeffrey C, Andrews, Richard, Chinnock, Randall B., Marshall, Neal H., Laufer, Michael D., Cruz, Amos, Barenboym, Michael, Chuttani, Ram, O'Keefe, Jonathan, Puicci, Vincent A. Jr.
• Primary Examiner(s): Woo; Julian W
• Application Number:
  US10/819,996
• Publication Number:
  US 20040193194A1
• Time in Patent Office: 2,455 Days
• Field of Search: 606/142, 606/151, 606/153, 606/184, 606/185, 606/205, 606/207, 606/210, 607/127, 607/131, 607/130, 607/129, 600/104, 600/562, 604/22
• 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
• 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
• CPC Class Codes: A61B 2017/061 : hollow or tubular
• 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. A medical instrument, comprising:

a flexible shaft, at least a portion of which is formed of a length of shaft coil;

a tissue piercing coil extending from a distal portion of the shaft; and

a tubular member selectively positioned over the tissue piercing coil, the tubular member and the tissue piercing coil coupled for relative movement,

wherein the shaft coil and the tissue piercing coil are wound in opposite directions, and

wherein the tissue piercing coil extends from between opposed jaws of an end effector and is configured to rotate relative to the opposed jaws to pull tissue into the opposed jaws, at least one of the opposed jaws having a fastener disposed in contact therewith and being configured for delivering the fastener into tissue.

2. The medical instrument of claim 1 wherein the tubular member is biased in a distal direction.

3. The medical instrument of claim 2 further comprising a spring biasing the tubular member in the distal direction.

4. A medical instrument, comprising:

a flexible shaft,

a coiled tissue piercing member wound around a distal portion of the shaft, and

a tissue stabilizer coupled to the shaft for movement relative to the tissue piercing member, the tissue stabilizer being biased in a distal direction such that as the tissue piercing member enters tissue, the tissue stabilizer is urged against a surface of the tissue,

wherein the coiled tissue piercing member extends from between opposed jaws of an end effector and is movable relative to the end effector to pull tissue into the opposed jaws, at least one of the opposed jaws having a tissue piercing member extending therefrom.

5. The medical instrument of claim 4 further comprising a spring biasing the tissue stabilizer in the distal direction.

6. The medical instrument of claim 4 wherein the shaft includes a length of coil.

7. A medical instrument, comprising:

an elongate member having a tissue piercing coil formed around a distal end thereof, the tissue piercing coil extending from between opposed jaws of an end effector and being configured to rotate relative to the end opposed jaws to pull tissue into the opposed jaws, the tissue piercing coil having a distal tip configured to form a hole in tissue;

a tissue stabilizer coupled to the coil for movement relative to the coil, the tissue stabilizer being biased by a spring in a distal direction such that as the coil enters tissue, the tissue stabilizer is urged against a surface of the tissue.

8. A medical instrument comprising:

an elongate member having a tissue piercing coil formed around a distal end thereof, the tissue piercing coil extending from between opposed jaws of an end effector and being movable relative to the end effector to pull tissue into the opposed jaws, at least one of the opposed jaws having a tissue piercing member extending therefrom;

a member selectively positioned over the coil and at least a portion of the elongate member, the member and the coil coupled for relative movement; and

a stop configured to limit the relative movement between the member and the coil.

9. The medical instrument of claim 8 wherein the member comprises a tube surrounding the coil.

10. A medical instrument, comprising:

a flexible coil shaft,

a tissue piercing coil coupled to a distal end of the shaft, the tissue piercing coil being wound in a direction opposite to at least a portion of the flexible coil shaft,

wherein the tissue piercing coil extends from between opposed jaws of an end effector and is configured to move relative to the opposed jaws to pull tissue into contact with the opposed jaws, at least one of the opposed jaws having a fastener disposed in contact therewith and being configured to deliver the fastener into tissue.

11. A medical instrument, comprising:

an elongate, flexible coil shaft having a tissue piercing coil formed at a distal end thereof, the tissue piercing coil movably coupled to an end effector and extending from between opposed jaws pivotally coupled to the end effector and being configured to rotate relative to the opposed jaws to pull tissue into the opposed jaws, and

a member positioned to selectively circumferentially enclose the shaft, wherein the member and the shaft are configured for relative movement.

12. The medical instrument of claim 11 wherein the tissue piercing coil is formed from the shaft.

13. The medical instrument of claim 11 wherein the member is configured to stabilize tissue.