Apparatus and methods for positioning and securing anchors

• US 8,057,511 B2
• Filed: 05/07/2004
• Issued: 11/15/2011
• Est. Priority Date: 05/07/2004
• Status: Active Grant

• Current Assignee: USGI Medical, Inc., USGI Medical Incorporated
• Original Assignee: USGI Medical, Inc.
• Inventors: Maahs, Tracy D., Flores, Jesus, Khairkhahan, Alex, Saadat, Vahid, Ewers, Richard C., Peh, Ruey-Feng
• Primary Examiner(s): Jackson; Gary
• Assistant Examiner(s): YABUT, DIANE D
• Application Number:
  US10/841,411
• Publication Number:
  US 20050251207A1
• Time in Patent Office: 2,748 Days
• Field of Search: 606/213, 606/151, 606/72, 606/232, 241/15.R, 241/36.R
• US Class Current: 606/232
• 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 17/0401 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• 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 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• 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 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0451 Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 : Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0459 : Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• CPC Class Codes: A61B 2017/0461 : with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0475 : using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 : with pre-tied sutures
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06028 : by means of a cylindrical longitudinal blind bore machined at the suture-receiving end of the needle, e.g. opposite to needle tip
• 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 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/081 : Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue
• CPC Class Codes: Y10T 24/39 : Cord and rope holders
• CPC Class Codes: Y10T 24/3936 : Pivoted part
• CPC Class Codes: Y10T 24/3969 : Sliding part or wedge

Abstract

Apparatus and methods for positioning and securing anchors are disclosed herein. The anchors are adapted to be delivered and implanted into or upon tissue, particularly tissue within the gastrointestinal system of a patient. The anchor is adapted to slide uni-directionally over suture such that a tissue plication may be cinched between anchors. A locking mechanism either within the anchor itself of positioned proximally of the anchor may allow for the uni-directional translation while enabling the anchor to be locked onto the suture if the anchor is pulled, pushed, or otherwise urged in the opposite direction along the suture. This uni-directional anchor locking mechanism facilitates the cinching of the tissue plication between the anchors and it may be utilized in one or several anchors in cinching a tissue fold.

Claims

1. An anchor for implantation in a body, comprising:

an anchor body adapted for placement against a tissue surface, the anchor body having a proximal collar;

a cinching sleeve positionable within the collar, said cinching sleeve comprising a generally cylindrical body having a first end and a second end, and said cylindrical body defining a lumen extending therethrough substantially from said first end to said second end, and having at least one side opening on the cylindrical body at a location between the first end and the second end that provides a passage from the exterior of said sleeve to the lumen; and

a flexible member extending through the at least side opening of the sleeve and being interposed between the collar and the sleeve and extending along the longitudinal direction of the sleeve to simultaneously prevent relative motion between the collar and the flexible member in a first direction and allow relative motion between the collar and the flexible member in a second direction.

2. The anchor of claim 1 wherein the anchor body comprises a basket anchor.

3. The anchor of claim 2 wherein the basket anchor is reconfigurable from a delivery configuration within a hollow tubular delivery member to an expanded configuration outside the hollow tubular delivery member.

4. The anchor of claim 3 wherein the hollow tubular delivery member is selected from the group consisting of tubular members, catheters, needles, and trocars.

5. The anchor of claim 1 wherein the flexible member comprises a length of suture.

6. The anchor of claim 1 wherein the sleeve comprises a tubular structure having an outer diameter less than an inner diameter of the collar.

7. The anchor of claim 1 wherein the sleeve is adapted to engage the flexible member between the collar and the sleeve when the collar is proximally translated relative to the flexible member.

8. The anchor of claim 1 wherein the sleeve further comprises at least one retaining arm at a distal end of the sleeve, the retaining arm being adapted to extend radially within the anchor body.

9. A method for cinching an anchor relative to tissue, comprising:

ejecting an anchor body from a hollow tubular delivery member in proximity to the tissue;

moving the anchor body distally along a flexible member into contact against a surface of the tissue; and

inhibiting the anchor body from moving proximally along the flexible member while simultaneously allowing the anchor body to move distally along the flexible member by engaging the flexible member between the anchor body and a cinching sleeve positioned within the anchor body, wherein the cinching sleeve comprises a generally cylindrical body having a first end and a second end, and said cylindrical body defines a lumen extending thcrethrough substantially from said first end to said second end, and having at least one side opening on the cylindrical body at alocation between the first end and the second end that provides a passage from the exterior of said sleeve to the lumen, wherein the flexible member is passed through the side opening of the sleeve to within the lumen defined through the sleeve and extending along the longitudinal direction of the sleeve.

10. The method of claim 9 wherein ejecting an anchor body comprises urging the anchor body from an opening defined at a distal end of the hollow tubular delivery member.

11. The method of claim 9 wherein moving the anchor body distally comprises pushing the anchor body via the hollow tubular delivery member.

12. The method of claim 9 wherein moving the anchor body distally comprises pushing the anchor body via an elongate push rod.

13. The method of claim 9 wherein moving the anchor body distally comprises urging the anchor body along a length of suture.

14. The method of claim 9 wherein inhibiting the anchor body from moving proximally comprises automatically engaging the flexible member.

15. The method of claim 9 further comprising adjusting a tension upon the tissue by further moving the anchor body distally along the flexible member.