Method and devices for tissue reconfiguration

• US 8,287,554 B2
• Filed: 05/15/2003
• Issued: 10/16/2012
• Est. Priority Date: 06/22/1999
• Status: Expired due to Term

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Cerier, Jeffrey C., Cruz, Amos G., O'Keefe, Jonathan, Ray, Cheryne, Gordon, Joseph M., Robson, David, Nelsen, Daniel, Petrie, Aidan
• Primary Examiner(s): Jackson, Gary
• Assistant Examiner(s): Yabut, Diane
• Application Number:
  US10/438,346
• Publication Number:
  US 20040010245A1
• Time in Patent Office: 3,442 Days
• Field of Search: 606/142, 606/205
• US Class Current: 606/142
• 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 17/0401 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 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/285 combined with cutting implements
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00323 Cables or rods
• 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 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 2017/0441 the shaft being a rigid coil or spiral
• 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 2017/061 : hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185
• CPC Class Codes: A61B 2017/0649 : Coils or spirals
• 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 2017/3488 : Fixation to inner organ or inner body tissue
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires

Abstract

An instrument for reconfiguring stomach tissue includes a sealing member that seals a section of a tissue manipulator from contact with bodily fluids. The tissue manipulator includes a first portion that is configured for releasable coupling to an actuating member and a second portion configured to receive an implant to be deployed within the patient. The tissue manipulator also includes a rectangular member and a cavity for receiving a coupler of the actuating member. The tissue manipulator has a first member with tissue penetrating elements and a second member with engaging elements configured to deflect the tissue penetrating elements upon relative movement of the first and second members. The actuating member includes a tissue penetrating element support positioned to limit bending of the tissue manipulator. The instrument includes an actuating mechanism that is configured to move at least one of the first and second members of the tissue manipulator.

Claims

1. A medical instrument, comprising:

a tissue manipulator configured for introduction into a patient and including first and second jaws,

a sealing member configured to substantially seal a section of the tissue manipulator from contact with bodily fluids, the first and second jaws being movable within the sealing member and having a portion extending out of the sealing member, the first and second jaws being configured to move in a first plane such that the first and second jaws can move toward and away from one another, and the first and second jaws being configured to move in a second plane generally perpendicular to the first plane such that the first and second jaws can move out of axial alignment with the sealing member, and

a tissue engaging member configured to contact and stabilize tissue, the tissue engaging member being axially movable within the sealing member and having a portion extending out of the sealing member, the tissue engaging member being configured to articulate with the first and second jaws when moving out of axial alignment with the sealing member.

2. The medical instrument of claim 1 wherein the tissue manipulator includes pivots about which the first and second jaws rotate in opposite directions.

3. The medical instrument of claim 1 wherein the sealing member defines a hole for receiving a guide wire to permit advancement of the tissue manipulator into the patient over the guide wire.

4. The medical instrument of claim 1 wherein the sealing member comprises a flexible member.

5. The medical instrument of claim 1 further comprising:

a flexible linkage coupled to the tissue manipulator, and

a sealing portion covering the linkage.

6. The medical instrument of claim 5 wherein the sealing portion abuts the sealing member.

7. The medical instrument of claim 1, wherein the tissue engaging member is axially movable within the sealing member between the first and second jaws.

8. The medical instrument of claim 1, wherein the tissue engaging member is configured to be axially aligned with the first and second jaws and to articulate with the first and second jaws when moving out of axial alignment with the sealing member while remaining axially aligned with the first and second jaws.

9. The medical instrument of claim 1, further comprising an actuating member extending through the sealing member and configured to be actuated to simultaneously articulate the tissue engaging member and the first and second jaws.

10. The medical instrument of claim 1, further comprising a central mount, wherein proximal ends of the first and second jaws are mounted to the central mount, and a proximal end of the tissue engaging member is mounted to the central mount.