Tissue closure system

• US 7,930,016 B1
• Filed: 11/16/2006
• Issued: 04/19/2011
• Est. Priority Date: 02/02/2005
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Voyage Medical, Inc.
• Inventors: Saadat, Vahid
• Primary Examiner(s): Casler; Brian
• Assistant Examiner(s): KISH, JAMES M
• Application Number:
  US11/560,732
• Time in Patent Office: 1,615 Days
• Field of Search: 600/476, 600/478, 600/479, 600/101, 600/106, 600/109, 600/129
• US Class Current: 600/476
• CPC Class Codes: A61B 1/0008 characterised by distal tip features
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00085 Baskets
• CPC Class Codes: A61B 1/00089 Hoods
• CPC Class Codes: A61B 1/005 Flexible endoscopes
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• 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 17/0401 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 2017/00243 cardiac
• 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 2017/00579 Barbed implements
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00597 Implements comprising a membrane
• CPC Class Codes: A61B 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/00615 Implements with an occluder on one side of the opening and holding means therefor on the other
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• 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 2017/0641 : having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/0645 : being elastically deformed for insertion
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 : Coils or spirals
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00

Abstract

Tissue closure systems are described herein. Such a system may include a deployment catheter and an attached imaging hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. Additionally, the system can be deployed in a number of various ways to effect the closure of wounds or openings in the patient body.

Claims

1. A tissue closure system, comprising:

a deployment catheter defining at least one lumen therethrough;

a hood comprising a non-inflatable membrane forming a fluid barrier projecting distally from the deployment catheter and adapted to self-expand into an expanded deployed configuration defining an open area therein, wherein the open area is in fluid communication with the at least one lumen and with an environment external to the hood through an opening defined by the hood;

a visualization element disposed within or adjacent to the open area of the hood for visualizing tissue adjacent to the open area; and

a tissue approximation assembly deployable from within the hood and configured to secure a tissue opening.

2. The system of claim 1 further comprising a delivery catheter through which the deployment catheter is deliverable.

3. The system of claim 1 wherein the deployment catheter is steerable.

4. The system of claim 3 wherein the deployment catheter is steered via at least one push-pull wire.

5. The system of claim 3 wherein the deployment catheter is steered via computer control.

6. The system of claim 1 wherein the hood is comprised of a compliant material.

7. The system of claim 1 wherein the hood defines a contact edge for placement against a tissue surface.

8. The system of claim 1 wherein the hood is adapted to be reconfigured from a low-profile delivery configuration to an expanded deployed configuration.

9. The system of claim 8 wherein the hood comprises a frame of superelastic or shape memory alloy.

10. The system of claim 1 wherein the visualization element comprises at least one optical fiber, CCD imagers, or CMOS imagers.

11. The system of claim 1 wherein the visualization element is disposed within a distal end of the deployment catheter.

12. The system of claim 1 wherein the visualization element is articulatable off-axis relative to a longitudinal axis of the deployment catheter.

13. The system of claim 1 further comprising a pump for urging fluid into the hood.

14. The system of claim 1 further comprising a cannula or needle defining a lumen through which the tissue approximation assembly is disposable.

15. The system of claim 14 wherein the needle comprises a reconfigurable portion proximal to a piercing tip.

16. The system of claim 1 wherein the tissue approximation assembly comprises a first and a second tissue anchor slidingly coupled to one another via a length of suture.

17. The system of claim 1 wherein the tissue approximation assembly comprises a retaining wire having a reconfigurable distal portion.

18. The system of claim 1 wherein the tissue approximation assembly comprises a patch mechanism having a ring with a patch supported thereby.

19. The system of claim 18 wherein the ring comprises at least one tissue securing projection.

20. The system of claim 18 further comprising a plurality of tissue securement members which are deployable through the patch and into an underlying tissue region.