Tissue manipulation and securement system

• US 8,828,027 B2
• Filed: 06/14/2010
• Issued: 09/09/2014
• Est. Priority Date: 05/07/2004
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Lam, Cang C., Ewers, Richard C., Saadat, Vahid, Vaughan, Robert A.
• Primary Examiner(s): Dornbusch, Dianne
• Application Number:
  US12/815,335
• Publication Number:
  US 20100249814A1
• Time in Patent Office: 1,548 Days
• Field of Search: 606/139, 606/142, 606/143
• US Class Current: 606/139
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• 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 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/00876 magnetic
• 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 2017/0464 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 2017/06076 helically or spirally coiled
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

Tissue manipulation and securement systems are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member and has a lower jaw member and an upper jaw member pivotably coupled to the lower jaw member. A reconfigurable launch tube is also pivotably coupled to the upper jaw member and is used to urge the jaw members from a low-profile configuration to an open configuration for receiving tissue. The tissue manipulation assembly 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.

Claims

1. A method of securing tissue, comprising:

advancing an elongate flexible member to a surgical site in a patient, with the elongate flexible member having a first jaw pivotally attached to a distal end of the elongate flexible member at a first pivot coupling, and a second jaw pivotally attached to the first jaw at a second pivot coupling, and a launch tube extending through a lumen of the elongate flexible member and connecting only to the second jaw at a launch tube pivot coupling distal of the first and second pivot couplings, with the second pivot coupling between the first pivot coupling and the launch tube pivot coupling, and, the launch tube having a substantially tubular shape defining an internal lumen;

moving the first jaw relative to the elongate member distal end by translating the launch tube relative to the elongate flexible member;

moving the second jaw toward the first jaw by translating the launch tube relative to the elongate flexible member.

2. The method of claim 1 wherein advancing comprises advancing the elongate flexible member transesophageally into a stomach.

3. The method of claim 1 wherein advancing comprises advancing the elongate flexible member through an endoscopic device into a hollow body organ.

4. The method of claim 1 wherein moving the first jaw comprises pivoting the first jaw relative to the distal end of the elongate flexible member such that the first jaw is angled relative to a longitudinal axis of the elongate flexible member.

5. The method of claim 1 wherein moving the second jaw comprises rotating the second jaw relatively toward the first jaw about an axis located on the first jaw and into a clamping configuration.

6. The method of claim 1 further comprising positioning a portion of tissue to be secured between the first and second jaws prior to moving the second jaw relatively toward the first jaw.

7. The method of claim 1 further comprising advancing a needle assembly through the launch tube such that the needle assembly exits the launch tube and passes through the first jaw.

8. The method of claim 7 further comprising deploying a first tissue anchor from the needle assembly.

9. The method of claim 8 further comprising deploying a second tissue anchor from the needle assembly after translating the launch tube proximally to move the second jaw relatively away from the first jaw.

10. The method of claim 1 further comprising translating the launch tube proximally to move the second jaw relatively away from the first jaw.

11. A method of securing tissue within a hollow body organ, comprising:

endoluminally advancing a tubular body into a hollow body organ, with the tubular body including a set of jaws comprising a first jaw and a second jaw, each having a front end and a back end, with the back end of the first jaw pivotally attached to a front end of the tubular body at a first pivot coupling, and with the back end of the second jaw pivotally attached to the first jaw member at a second pivot coupling between the front and back ends of the first jaw;

opening the set of jaws by pulling back a launch tube attached only to the second jaw;

engaging tissue of the hollow body organ between the first jaw and the second jaw; and

closing the set of jaws onto the tissue by pushing forward on the launch tube.

12. The method of claim 11 wherein endoluminally advancing comprises advancing the tubular member transesophageally into a stomach with the jaws closed.

13. The method of claim 11 wherein endoluminally advancing comprises advancing the elongate flexible member through an endoscopic device into the hollow body organ.

14. The method of claim 11 further including changing a front end of the launch tube from a straight configuration into a curved configuration when closing the set of jaws.

15. The method of claim 11 further comprising advancing a needle through the launch tube into a position where a tip of the needle exits the launch tube and passes through an opening in the first jaw.

16. The method of claim 15 further comprising deploying a first tissue anchor from the needle.

17. The method of claim 16 further comprising pulling the launch tube back to open the set of jaws, and then deploying a second tissue anchor from the needle.

18. The method of claim 11 wherein the launch tube is pivotally attached to the second jaw member at a third pivot coupling, and wherein the second pivot coupling is in between the first pivot coupling and the third pivot coupling.

19. The method of claim 11 wherein the first jaw is longer than the second jaw.

20. The method of claim 11 wherein the second jaw is connected only to the first jaw and to the launch tube.