Needle assembly for tissue manipulation

• US 8,236,009 B2
• Filed: 10/14/2009
• Issued: 08/07/2012
• Est. Priority Date: 05/07/2004
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Saadat, Vahid, Rothe, Chris, Ewers, Richard C.
• Primary Examiner(s): SEVERSON, RYAN J
• Application Number:
  US12/579,295
• Publication Number:
  US 20100042115A1
• Time in Patent Office: 1,028 Days
• Field of Search: 606/139, 606142-145, 606/148, 606/213, 606/215, 606/222, 606/223
• US Class Current: 606/139
• 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 2017/00349 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 2017/00867 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 2017/0488 : 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 2017/06052 : 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 2017/081 : Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue

Abstract

Needle assemblies for tissue manipulation are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. A needle deployment assembly is deployable through the tissue manipulation assembly via a handle assembly, through the tubular member, and into or through tissue. An elongate pusher is translationally disposed within a sheath of the needle deployment assembly and can be urged distally for deploying an anchor assembly from the sheath distal end. The anchor assembly is positioned distally of the pusher within the sheath.

Claims

1. A method of deploying one or more anchors in securing a tissue fold, comprising:

advancing a distal end of a tissue plication assembly having a tubular body to a surgical site;

inserting a needle assembly having a housing into the tubular body;

engaging the housing of the needle assembly to a handle on a proximal end of the tubular body;

advancing a needle at the distal end of the needle assembly into or through a fold of tissue;

after engaging the housing of the needle assembly to the handle, moving an actuation member on the housing to drive a shuttle member enclosed within the housing, with the shuttle member advancing an elongate flexible wire pusher; and

deploying at least one anchor from a lumen in the needle assembly via movement of the pusher.

2. The method of claim 1 wherein manipulating an actuation member comprises urging the shuttle member distally through the housing.

3. The method of claim 1 wherein deploying at least one anchor comprises urging the at least one anchor distally via the elongate pusher until the anchor assumes an expanded configuration.

4. The method of claim 1 further comprising monitoring a position of the shuttle member within the housing via an indicator defined along the housing while manipulating an actuation member.

5. The method of claim 1 further comprising deploying a second anchor from the tubular sheath via the elongate pusher, with the second anchor connected to the first anchor only via suture.

6. The method of claim 1 further comprising removing the needle body from the fold of tissue.

7. A surgical method, comprising:

advancing a first end of a tubular body to a surgical site in the stomach of a patient;

engaging a housing of the needle assembly to a handle on a second end of the tubular body;

advancing a needle of the needle assembly out from the first end of the tubular body and into or through a fold of tissue;

after engaging the housing of the needle assembly to the handle, moving an actuation member on the housing of the needle assembly to drive an elongate flexible pusher within a lumen of the needle assembly;

deploying at least one anchor from the lumen in the needle assembly via movement of the pusher.

8. The method of claim 7 further comprising moving a shuttle member enclosed within the housing, with the shuttle member advancing an elongate flexible pusher.