Apparatus and methods for forming gastrointestinal tissue approximations

• US 8,066,719 B2
• Filed: 11/18/2004
• Issued: 11/29/2011
• Est. Priority Date: 12/11/2002
• Status: Active Grant

• Current Assignee: Boris Reydel, Brent D. Seybold, Cang C. Lam, Eugene Y. Chen, Richard C. Ewers, Rodney Brenneman, Vahid Saadat
• Original Assignee: Boris Reydel, Brent D. Seybold, Cang C. Lam, Eugene Y. Chen, Richard C. Ewers, Rodney Brenneman, Vahid Saadat
• Inventors: Seybold, Brent D., Saadat, Vahid, Brenneman, Rodney, Chen, Eugene, Ewers, Richard C., Lam, Cang C., Reydel, Boris
• Primary Examiner(s): LANG, AMY T
• Application Number:
  US10/992,912
• Publication Number:
  US 20050065536A1
• Time in Patent Office: 2,567 Days
• Field of Search: 606/153, 606/139, 606/140, 606142-148, 606167-171, 606174-180
• US Class Current: 606/139
• 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 17/0487 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 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• 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 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/061 hollow or tubular
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue

Abstract

Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point, moving the first tissue contact point from a position initially distal to a second tissue contact point to a position proximal of the second contact point to form a tissue fold, and extending an anchor assembly through the tissue fold near the second tissue contact point.

Claims

1. A tissue securement apparatus, comprising:

a tissue engaging end effector positioned at a distal end of an elongate member, the end effector having a tissue engaging portion comprising a treadmill assembly, having a conveyor, adapted to engage tissue and move relative to the elongate member;

an obturator or hollow needle having a first position in which the obturator or hollow needle is substantially disposed within the elongate member, and a second position in which at least a portion of the obturator or hollow needle extends out of a portion of the elongate member; and

a transmission mechanism having a drive shaft extending through the elongate member. the drive shaft having a manipulatable proximal end and a distal end coupled to the end effector, the transmission mechanism further having a gear coupled to the drive shaft distal end.

2. The apparatus of claim 1 further comprising a control mechanism connected to the manipulatable proximal end.

3. The apparatus of claim 2 wherein the control mechanism comprises a knob or motor.

4. The apparatus of claim 1 wherein the treadmill assembly comprises a conveyor adapted to rotate and engage the tissue thereto.

5. The apparatus of claim 1 wherein the treadmill assembly is reversibly rotatable.

6. The apparatus of claim 1 wherein the needle or obturator is adapted to project through an opening defined in the elongate member.

7. The apparatus of claim 1 wherein the distal end of the drive shaft is coupled to the end effector via a beveled gear.

8. A method for securing tissue, comprising:

positioning a tissue engaging end effector adjacent to tissue to be engaged, the end effector being positioned at a distal end of an elongate member;

engaging the tissue via a treadmill assembly, having a conveyor, of the end effector and moving the treadmill assembly relative to the elongate member, the treadmill assembly being coupled via a gear to a distal end of a drive shaft having a manipulatable proximal end; and

piercing the tissue via a hollow needle of the end effector, said hollow needle having an open distal end.

9. The method of claim 8 wherein positioning a tissue engaging end effector comprises advancing the end effector transorally into a stomach.

10. The method of claim 8 wherein engaging the tissue via a treadmill assembly comprises manipulating a proximal end of the drive shaft to actuate the gear.

11. The method of claim 8 wherein piercing the tissue comprises advancing a needle into the tissue.

12. The method of claim 11 wherein advancing a needle comprises projecting the needle through an opening defined in the elongate member.

13. The method of claim 8 further comprising securing the tissue via a tissue securement apparatus to maintain a tissue configuration thereof.

14. A tissue securement apparatus, comprising:

a tissue engaging end effector positioned at a distal end of an elongate member. the end effector having a tissue engaging portion and a tissue piercing portion. the tissue engaging portion comprising a treadmill assembly, having a conveyor, adapted to rotate and engage the tissue thereto and the tissue piercing portion comprising a hollow needle containing a tissue anchor; and

a transmission mechanism having a drive shaft extending through the elongate member, the drive shaft having a manipulatable proximal end and a distal end coupled to the end effector.

15. The apparatus of claim 14 further comprising a control mechanism connected to the manipulatable proximal end.

16. The apparatus of claim 14 wherein the treadmill assembly is reversibly rotatable.

17. The apparatus of claim 14 wherein the needle is adapted to project through an opening defined in the elongate member.