Devices and methods for endoluminal plication

• US 9,113,866 B2
• Filed: 12/15/2011
• Issued: 08/25/2015
• Est. Priority Date: 12/15/2011
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Felder, Kevin D., Crainich, Lawrence, Harris, Jason L., Zeiner, Mark S., Sherrill, Justin W.
• Primary Examiner(s): Lopez, Michelle
• Application Number:
  US13/326,634
• Publication Number:
  US 20130153622A1
• Time in Patent Office: 1,349 Days
• Field of Search: 227/175.1, 227/176.1, 227/19, 606/151
• US Class Current: 1/1
• 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 17/068 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 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00327 with actuating members moving in opposite directions
• 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 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00862 elastic or resilient
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/07271 characterised by its cartridge
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/2926 Details of heads or jaws
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2017/2941 Toggle linkages
• CPC Class Codes: A61B 2017/2943 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2944 Translation of jaw members
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61B 2017/308 : with suction cups
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 5/0083 : Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00

Abstract

Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a method of acquiring and fixating tissue is disclosed that includes inserting a surgical device having first and second jaws and a tissue acquisition member into a body lumen, positioning the device in a first position in which the jaws extend substantially parallel to a tissue surface, drawing tissue through the jaws by moving the tissue acquisition member away from the jaws, and driving at least one fastener through the tissue disposed between the jaws.

Claims

1. A method of acquiring and fixating tissue, comprising:

inserting a surgical device having first and second jaws and a tissue acquisition member into a hollow body lumen;

positioning the surgical device in a first position wherein the first and second jaws extend substantially parallel to a tissue surface and the tissue acquisition member extends parallel to the tissue surface and is positioned on an opposite side of the jaws from the tissue surface;

drawing tissue through the jaws and against the tissue acquisition member;

actuating the surgical device to move the tissue acquisition member away from the first and second jaws while maintaining the parallel orientation of the tissue acquisition member and the tissue surface, thereby drawing the tissue through the first and second jaws; and

closing the first and second jaws and driving at least one fastener through the tissue disposed between the first and second jaws.

2. The method of claim 1, wherein the tissue acquisition member is connected to any of the first and second jaws by a hinge assembly and positioning the surgical device in the second position further comprises actuating a positioning cable connected to the hinge assembly to cause the tissue acquisition member to move relative to the first and second jaws.

3. The method of claim 1, wherein driving at least one fastener through the tissue comprises actuating a firing linkage to drive a fastener out of the second jaw, through the tissue disposed between the first and second jaws, and against the first jaw.

4. The method of claim 1, wherein drawing tissue against the tissue acquisition member comprises actuating a vacuum source to suction the tissue against the tissue acquisition member.

5. A method of acquiring and fixating tissue, comprising:

positioning a stapling member having first and second jaws adjacent to a tissue surface such that a longitudinal axis of at least one of the first and second jaws is parallel to the tissue surface;

engaging the tissue surface with a tissue acquirer that extends parallel to the longitudinal axis of at least one of the first and second jaws;

moving the tissue acquirer while maintaining the parallel orientation of the tissue acquirer and the longitudinal axis of at least one of the first and second jaws to draw tissue up through the first and second jaws;

moving the first and second jaws to a closed position to engage the tissue therebetween; and

applying at least a first staple from at least one of the first and second jaws through the tissue disposed between the first and second jaws.

6. The method of claim 5, further comprising moving the first and second jaws to an open position, moving the tissue acquirer to reposition the tissue disposed between the first and second jaws, moving the first and second jaws to the closed position, and applying at least a second staple from at least one of the first and second jaws.

7. The method of claim 5, further comprising, prior to moving the tissue acquirer, actuating a secondary tissue acquirer effective to engage tissue to retain the position of the tissue surface relative to the tissue acquirer.

8. The method of claim 5, wherein moving the tissue acquirer to draw tissue up through the first and second jaws comprises translating a positioning cable coupled to the tissue acquirer.

9. The method of claim 5, wherein engaging the tissue surface comprises activating a vacuum source to draw the tissue surface against the tissue acquirer.

10. A method of acquiring and fixating tissue, comprising:

positioning an end effector having first and second jaws and a tissue acquisition member such that a longitudinal axis of the end effector is parallel to a tissue surface and the tissue acquisition member is extending parallel to the longitudinal axis of the end effector on an opposite side of the first and second jaws from the tissue surface;

applying a vacuum force to draw the tissue surface through the jaws and against the tissue acquisition member; and

moving the tissue acquisition member in a direction away from the tissue surface while maintaining the parallel orientation of the tissue acquisition member and the longitudinal axis of the end effector, to further draw tissue through the first and second jaws to create a tissue fold.

11. The method of claim 10, wherein the tissue acquisition member is connected to any of the first and second jaws by a hinge assembly and positioning the surgical device comprises actuating a positioning cable connected to the hinge assembly to cause the tissue acquisition member to move relative to the first and second jaws.

12. The method of claim 10, further comprising driving at least one fastener through the tissue fold disposed between the first and second jaws.

13. The method of claim 12, wherein driving at least one fastener through the tissue comprises actuating a firing linkage to drive a fastener out of the second jaw, through the tissue fold disposed between the first and second jaws, and against the first jaw.

14. The method of claim 10, further comprising, prior to moving the tissue acquisition member, actuating a secondary tissue acquirer effective to engage tissue to retain the position of the tissue surface relative to the tissue acquisition member.