Methods and apparatus for securing and deploying tissue anchors

• US 8,298,291 B2
• Filed: 04/26/2006
• Issued: 10/30/2012
• Est. Priority Date: 05/26/2005
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Ewers, Richard C., Lam, Cang C.
• Primary Examiner(s): McDermott, Corrine M
• Assistant Examiner(s): ANDERSON, GREGORY A
• Application Number:
  US11/412,261
• Publication Number:
  US 20060271074A1
• Time in Patent Office: 2,379 Days
• Field of Search: 623/23.72, 606/139, 606/151, 606/153, 606/191, 606/232
• US Class Current: 623/23.72
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/003 Steerable
• 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
• 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 2017/06052 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 2017/2927 the angular position of the head being adjustable with respect to the shaft

Abstract

Methods and apparatus for securing and deploying tissue anchors are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member. A reconfigurable launch tube is also pivotably coupled to the tissue manipulation assembly, which may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly. A deployment assembly is provided for securing engaged tissue via one or more tissue anchors, the deployment assembly also being configured to disengage the anchors endoluminally or laparoscopically by applying thermal energy through at least one suture cutting element disposed along the deployment assembly.

Claims

1. A tissue anchor deployment system, comprising:

a housing;

an elongate flexible shaft having a proximal end attached to the housing and a distal end having a tissue piercing tip, and with a lumen extending through the elongate flexible shaft;

an elongate pusher slidable within the elongate shaft;

a release suture within the elongate shaft;

a stop fixed to a portion of the release suture, with the stop having a diameter sized to inhibit movement through at least part of the elongate pusher member;

a plug member slidably located along the release suture proximal to the stop;

a retraction control member attached to a proximal end of the release suture; and

an anchor assembly within the lumen of the elongate shaft at a position distal of the elongate pusher member, the anchor assembly comprising a distal anchor connected to a proximal anchor via a flexible connector;

wherein a distal end of the release suture is releasably engaged to the flexible connector of the anchor assembly.

2. The system of claim 1 further comprising a guide in the housing, with the guide including a channel.

3. The system of claim 2 wherein the guide further defines at least a first locking position along the housing.

4. The system of claim 3 wherein the guide further defines at least a second locking position along the housing.

5. The system of claim 2 further comprising an actuation member translatable along the guide and attached to a proximal end of the elongate pusher member.

6. The system of claim 5 wherein the actuation member comprises a carriage slidably positioned within the housing, the carriage defining a lumen through which the release wire is disposed.

7. The system of claim 1 wherein the elongate flexible shaft comprises a catheter shaft.

8. The system of claim 1 wherein the tissue piercing tip comprises a needle body having a lumen defined therethrough.

9. The system of claim 1 wherein the elongate pusher member further comprises a coiled body which is adapted to provide column support when pushed or pulled through the elongate flexible shaft.

10. The system of claim 1 wherein the plug member comprises one or more expandable arms projecting radially from a plug body in an expanded configuration and over or around the stop in a low-profile configuration.

11. The system of claim 10 wherein the one or more expandable arms are positionable around the stop such that distal ends of the one or more expandable arms are constrained within a proximal end of a carriage positioned within the housing.

12. The system of claim 1 wherein the retraction control member comprises a threaded attachment for connection to the housing.

13. The system of claim 1 wherein the release suture is within the pusher lumen extending through the elongate pusher.

14. The system of claim 13 wherein the release suture forms a loop within the pusher lumen.

15. The system of claim 1 wherein, the release suture forms a loop through the elongate shaft.

16. The system of claim 1 wherein a terminal end of the flexible connector is passed at least partially through or around the release suture within the elongate shaft.

17. The system of claim 1 further comprising a locking mechanism slidably positioned along the flexible connector between the tissue anchor assembly and the elongate pusher member.

18. The system of claim 1 further comprising a tissue grasping tool pivotably coupled to a distal end of an outer flexible shaft and adapted to be advanced endoluminally into a body lumen, wherein the elongate flexible shaft with the distal end having a tissue piercing tip is sized for advancement through the outer flexible shaft and through the tissue grasping tool.

19. The system of claim 18 wherein the tissue grasping tool comprises a first jaw member pivotably coupled to a distal end of the outer flexible shaft, a second jaw member pivotably coupled along the first jaw member, and a launch tube member adapted to urge the first and second jaw members between a low-profile delivery configuration and an expanded grasping configuration.

20. The system of claim 18 further comprising a tissue engagement device having a helical tissue engager adapted to reversibly engage tissue and further adapted to be positioned endoluminally within the body lumen adjacent to the tissue grasping tool.

21. The system of claim 18 further comprising an endoluminal elongate body adapted to transition between a flexible state, and a rigid state, wherein the tissue grasping tool and the elongate flexible shaft are removably advanceable therethrough.

22. The system of claim 1 with the release suture comprising a wire.