Devices and methods for endoluminal plication

• US 9,113,868 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., DiNardo, Brian F.
• Primary Examiner(s): Truong, Thanh
• Assistant Examiner(s): KOTIS, JOSHUA G
• Application Number:
  US13/326,651
• Publication Number:
  US 20130153624A1
• Time in Patent Office: 1,349 Days
• Field of Search: 227/175.1, 227/176.1, 227/175.2, 227/180.1, 227/181.1, 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 channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00862 elastic or resilient for sutures A61B2017/0618
• 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 tissue acquisition and fixation system is disclosed including a stapling member having first and second jaws that are effective to apply at least one staple to tissue engaged between the jaws, a tissue acquisition member coupled to at least one of the first and second jaws, and a secondary tissue acquirer coupled to the tissue acquisition member. The secondary tissue acquirer is configured to engage tissue and maintain the tissue in position relative to the tissue acquisition member.

Claims

1. A tissue acquisition and fixation system, comprising:

a stapling member having first and second jaws and a longitudinal axis extending from a proximal end to a distal end thereof, at least the first jaw being configured to move between an open position for receiving tissue and a closed position for engaging tissue, the first and second jaws being effective to apply at least one staple in a direction transverse to the longitudinal axis of the staple applying assembly to tissue engaged between the first and second jaws;

a tissue acquisition member coupled to at least the first jaw and configured to engage tissue and position the tissue between the first and second jaws; and

a secondary tissue acquirer coupled to the tissue acquisition member and configured to engage tissue and maintain the tissue in position relative to the tissue acquisition member;

wherein movement of the first jaw between the open and closed position is effective to cause corresponding movement of the tissue acquisition member and secondary tissue acquirer.

2. The system of claim 1, wherein the secondary tissue acquirer comprises at least one hook configured to grasp tissue drawn against the tissue acquisition member.

3. The system of claim 2, wherein the at least one hook is coupled to a rotatable shaft extending parallel to a longitudinal axis of the tissue acquisition member such that rotation of the shaft is effective to engage the at least one hook with tissue drawn against the tissue acquisition member.

4. The system of claim 3, further comprising an actuating cable coupled to the rotatable shaft, wherein rotation of the actuating cable is effective to rotate the shaft and thereby engage the at least one hook with the tissue.

5. The system of claim 2, wherein the tissue acquisition member includes a surface configured to engage tissue and wherein the at least one hook is pivotally coupled to the tissue acquisition member such that the at least one hook pivots in a plane parallel to a plane defined by the surface.

6. The system of claim 5, wherein pivoting of the at least one hook is effected by translation of at least one suture attached to an end of each of the at least one hook.

7. The system of claim 6, further comprising a spring attached to each of the at least one hook and configured to bias the at least one hook to a first position.

8. The system of claim 1, wherein the secondary tissue acquirer comprises at least one hinged grasper configured to engage tissue drawn against the tissue acquisition member.

9. The system of claim 8, wherein the secondary tissue acquirer includes a cable coupled to the at least one grasper and configured to move the at least one grasper from an open position for receiving tissue to a closed position for engaging tissue.

10. The system of claim 8, wherein the at least one grasper is disposed on a distal end of the tissue acquisition member.

11. The system of claim 1, wherein the secondary tissue acquirer comprises at least one clamp configured to engage tissue drawn against the tissue acquisition member.

12. The system of claim 11, wherein the secondary tissue acquirer includes at least two clamps that are pivotally coupled to opposing surfaces of the tissue acquisition member.

13. The system of claim 12, further comprising a wedge member slidably mounted to a top surface of the tissue acquisition member and configured to engage the at least two clamps such that the at least two clamps engage tissue drawn against the tissue acquisition member.

14. The system of claim 13, further comprising a cable coupled to the wedge member and configured to slidably move the wedge member.

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

positioning a surgical device having a stapling member with first and second jaws and a tissue acquisition member coupled to at least the first jaw adjacent to a tissue surface such that a longitudinal axis of the stapling member is parallel to the tissue surface and the first and second jaws are between the tissue surface and the tissue acquisition member;

moving at least the first jaw of the stapling member to an open position such that the first and second jaws are separated, wherein movement of the first jaw relative to the second jaw causes corresponding movement of the tissue acquisition member and a secondary acquirer coupled thereto;

moving the tissue acquisition member toward the tissue surface to be between the first and second jaws adjacent to the tissue surface;

drawing tissue against the tissue acquisition member;

engaging the tissue drawn against the tissue acquisition member with the secondary acquirer coupled to the tissue acquisition member;

moving the tissue acquisition member away from the tissue surface to a position offset from the first and second jaws;

moving the stapling member to a closed position such that the first and second jaws are drawn together; and

applying a staple in a direction transverse to the longitudinal axis of the stapling member through the tissue disposed between the first and second jaws.

16. The method of claim 15, wherein engaging the tissue drawn against the tissue acquisition member with the secondary acquirer comprises engaging at least one hook coupled to the tissue acquisition member with the tissue.

17. The method of claim 15, wherein engaging the tissue drawn against the tissue acquisition member with the secondary acquirer comprises engaging at least one grasper coupled to the tissue acquisition member with the tissue.

18. The method of claim 17, wherein engaging the at least one grasper comprises tensioning a cable connected to the at least one grasper via at least one linkage.

19. The method of claim 15, wherein engaging the tissue drawn against the tissue acquisition member with a secondary acquirer comprises engaging at least one clamp pivotally coupled to the tissue acquisition member with the tissue.

20. The method of claim 19, wherein engaging the at least one clamp coupled to the tissue acquisition member comprises slidably moving a wedge member along a track formed in the tissue acquisition member to engage the wedge member with the at least one clamp pivotally coupled to the tissue acquisition member.