Tissue reconfiguration

• US 8,277,468 B2
• Filed: 11/24/2010
• Issued: 10/02/2012
• 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: Laufer, Michael D., Cerier, Jeffrey C., Cruz, Amos G., Andrews, Richard, Chuttani, Ram, Piucci, Vincent A. Jr., Barenboym, Michael, Marshall, Neal H., Chinnock, Randal B., O'Keefe, Jonathan
• Primary Examiner(s): WOO, JULIAN W
• Application Number:
  US12/953,625
• Publication Number:
  US 20110068143A1
• Time in Patent Office: 678 Days
• Field of Search: 606/142, 606/144, 606/153, 606/184, 606/185, 607/127, 607/131, 600/104, 600/562
• 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 device for tissue reconfiguration, comprising:

an elongate member having a body disposed on a distal portion thereof, the body having first and second arms extending distally therefrom and defining a space therebetween;

a tissue retrieving mechanism having a helical piercing member configured to move relative to the first and second arms to retrieve a portion of tissue to be reconfigured and position the retrieved portion of tissue in the space between the first and second arms; and

a fastener configured to secure the retrieved portion of tissue positioned in the space between the first and second arms to thereby reconfigure the portion of tissue.

2. The device of claim 1, wherein at least one of the first and second arms is configured to be movable relative to the other to grasp tissue therebetween.

3. The device of claim 1, wherein the first and second arms are in a fixed non-movable position.

4. The device of claim 2, wherein the first and second arms are opposed pivotable jaws that are movable between an open position and a closed position.

5. The device of claim 1, wherein the helical piercing member is configured to retrieve a portion of tissue from inside a stomach.

6. The device of claim 1, wherein the fastener includes at least one of a suture, and a bar having one or more holes.

7. The device of claim 1, wherein a tissue penetrating tip extends from the first arm and is configured to extend into the space and penetrate the retrieved portion of tissue when the retrieved portion of tissue is positioned between the first and second arms.

8. The device of claim 1, wherein the first arm is configured to pivot relative to the body.

9. A device for tissue reconfiguration, comprising:

an elongate member having first and second members positioned at a distal portion thereof and configured to be positioned substantially parallel to each other to receive tissue therebetween;

a tissue retrieving element having a tissue piercing element formed thereon, the tissue retrieving element being configured to be movable relative to the first and second members to pierce tissue and move the pierced tissue proximally relative to the first and second members to position the tissue between the first and second members; and

a fastener coupled to at least one of the first and second members, the fastener being configured to secure the tissue positioned between the first and second members, wherein a tissue penetrating tip extends from the first member and is configured to move toward the second member to penetrate tissue positioned between the first and second members.

10. The device of claim 9, wherein the tissue piercing element comprises a helical piercing element.

11. The device of claim 9, wherein at least one of the first and second members is configured to be positioned at an angle relative to the other to receive tissue therebetween.

12. The device of claim 9, wherein the tissue retrieving element is configured to retrieve tissue from inside a stomach.

13. The device of claim 9, wherein the fastener includes at least one of a suture, and a bar having one or more holes.

14. The device of claim 9, wherein the fastener is coupled to the first member and is configured to move toward the second member with the first member.