Single fold device for tissue fixation

• US 9,186,268 B2
• Filed: 03/02/2012
• Issued: 11/17/2015
• Est. Priority Date: 10/14/2003
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Roth, Alex T., Hancock, Andrew H., Weller, Gary, Mata, Gilbert Jr., Gerbi, Craig, Gannoe, James, Julian, Christopher
• Primary Examiner(s): Woo, Julian W
• Application Number:
  US13/410,810
• Publication Number:
  US 20120165844A1
• Time in Patent Office: 1,355 Days
• Field of Search: 606/41, 606/142, 606/153, 606/219, 227/175.1, 227/176.1, 227/179.1
• US Class Current: 1/1
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/0034 adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/00946 malleable
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/1103 Approximator
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61F 5/005 Gastric bands
• CPC Class Codes: A61F 5/0076 preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0083 Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00

Abstract

A system for tissue approximation and fixation is described herein. A device is advanced in a minimally invasive manner within a patient'"'"'s body to create one or several divisions or plications within a hollow body organ. The system comprises a stapler assembly having a tissue acquisition member and a tissue fixation member. The stapler assembly approximates tissue from within the hollow body organ with the acquisition member and then affixes the approximated tissue with the fixation member. In one method, the system can be used as a secondary procedure to reduce the size of a stoma within the hollow body organ.

Claims

1. A surgical method, comprising:

translumenally advancing a flexible elongate shaft having a vacuum chamber at a distal end thereof into a stomach of a patient;

applying a vacuum force through the vacuum chamber to adhere stomach tissue to the vacuum chamber; and

with the tissue adhered to the vacuum chamber, moving the vacuum chamber relative to the shaft in a direction transverse to a longitudinal axis of the shaft to form a fold in the stomach tissue.

2. The method of claim 1, wherein the vacuum chamber is located in a pod at the distal end of the shaft, and moving the vacuum chamber relative to the shaft comprises moving the pod relative to the shaft in the direction transverse to the longitudinal axis of the shaft.

3. The method of claim 2, wherein, when the shaft is advanced, when the vacuum force is applied, and after the pod is moved relative to the shaft in the direction transverse to the longitudinal axis of the shaft, the longitudinal axis of the shaft and a longitudinal axis of the pod are substantially parallel.

4. The method of claim 1, wherein translumenally advancing the shaft comprises advancing the shaft along the longitudinal axis thereof.

5. The method of claim 1, further comprising, with the tissue adhered to the vacuum chamber, applying a fastener to the tissue fold to affix the tissue fold.

6. A surgical method, comprising:

translumenally advancing a flexible elongate shaft having a pod extending from a distal end thereof into a stomach of a patient such that the pod leads the shaft into the stomach;

applying a vacuum force via the pod to adhere stomach tissue to the pod;

with the tissue adhered to the pod, moving the pod radially relative to the shaft to form a fold in the stomach tissue; and

applying a fastener to the tissue fold to affix the tissue fold.

7. The method of claim 6, wherein moving the pod radially relative to the shaft comprises moving the pod perpendicular to a longitudinal axis of the shaft.

8. A surgical device, comprising:

a flexible elongate shaft configured to be translumenally advanced into a body of a patient;

a pod assembly at a distal end of the shaft, the pod assembly being configured to apply a vacuum force to tissue of the patient, and the pod assembly being configured to move relative to the shaft between a first configuration and a second configuration, the pod assembly in the second configuration being moved relative to the shaft in a direction transverse to a longitudinal axis of the shaft such that the pod assembly is a greater radial distance away from the longitudinal axis of the shaft than when the pod assembly is in the first configuration; and

an actuator extending along the shaft and being configured to be actuated to selectively move the pod assembly between the first configuration and the second configuration;

wherein the pod assembly includes opposed first and second pod members;

wherein when the pod assembly is in the first configuration, the first pod member is at a first radial position relative to the longitudinal axis of the shaft and the second pod member is at a second radial position relative to the longitudinal axis of the shaft; and

wherein when the pod assembly is in the second configuration, the first pod member is at a third radial position relative to the longitudinal axis of the shaft and the second pod member remains at the second radial position relative to the longitudinal axis of the shaft, the third radial position being farther away from the longitudinal axis than the first radial position.

9. The device of claim 8, wherein the pod assembly has a vacuum chamber formed therein that is configured to have the tissue adhered thereto.

10. The device of claim 8, wherein when the pod assembly is in the first configuration and in the second configuration, a longitudinal axis of the pod assembly is substantially parallel to the longitudinal axis of the shaft.

11. The device of claim 8, wherein the pod is configured to move relative to the shaft between the second configuration and a third configuration;

and

when the pod assembly is in the third configuration, the first pod member remains at a third radial position and the second pod member is at a fourth radial position relative to the longitudinal axis of the shaft, the fourth radial position being farther away from the longitudinal axis than the second radial position.

12. The device of claim 8, wherein the pod assembly includes a chamber formed therein, the vacuum force being configured to draw the tissue into the chamber.

13. The device of claim 8, wherein the actuator includes a rod extending along the shaft.

14. A surgical method using a device comprising a flexible elongate shaft configured to be translumenally advanced into a body of a patient, and a pot assembly at a distal end of the shaft, the pod assembly being configured to apply a vacuum force to tissue of the patient, and the pod assembly being configured to move relative to the shaft between a first configuration and a second configuration, the pod assembly in the second configuration being moved relative to the shaft in a direction transverse to a longitudinal axis of the shaft such that the pod assembly is a greater radial distance away from the longitudinal axis of the shaft than when the pod assembly is in the first configuration, the method comprising:

advancing the distal end of the shaft into the body of the patient, wherein advancing the distal end of the shaft includes advancing the distal end of the shaft into a stomach of the patient;

positioning the pod assembly adjacent to the tissue of the patient;

applying the vacuum force; and

moving the pod assembly from the first configuration to the second configuration, thereby forming a fold in the tissue;

wherein the pod assembly includes opposed first and second pod members;

wherein when the pod assembly is in the first configuration, the first pod member is at a first radical position relative to the longitudinal axis of the shaft and the second pod member is at a second radical position relative to the longitudinal axis of the shaft; and

wherein when the pod assembly is in the second configuration the first pod member is at a third radial position relative to the longitudinal axis of the shaft and the second pod member remains at the second radical position relative to the longitudinal axis of the shaft, the third radial position being farther away from the longitudinal axis than the first radial position.

15. The method of claim 14, further comprising moving the pod assembly from the second configuration to a third configuration;

wherein when the pod assembly is in the third configuration, the first pod member remains at a third radial position and the second pod member is at a fourth radial position relative to the longitudinal axis of the shaft, the fourth radial position being farther away from the longitudinal axis than the second radial position.

16. A surgical method using a device comprising a flexible elongate shaft configured to be translumenally advanced into a body of a patient, and a pod assembly at a distal end of the shaft, the pod assembly being configured to apply a vacuum force to a tissue of the patient, and the pod assembly being configured to move relative to the shaft between a first configuration and a second configuration, the pod assembly in the second configuration being moved relative to the shaft in a direction transverse to a longitudinal axis of the shaft such that the pod assembly is a greater radial distance away from the longitudinal axis of the shaft than when the pod assembly is a greater radical distance away from the longitudinal axis of the shaft than when the pod assembly is in the first configuration, the method comprising:

advancing the distal end of the shaft into the body of the patient, wherein advancing the distal end of the shaft includes translumenally advancing the distal end of the shaft into the body of the patient;

positioning the pod assembly adjacent to the tissue of the patient;

applying the vacuum force; and

moving the pod assembly from the first configuration to the second configuration, thereby forming a fold in the tissue;

wherein the pod assembly includes opposed first and second pod members;

wherein when the pod assembly is in the first configuration, the first pod member is at a first radical position relative to the longitudinal axis of the shaft and the second pod member is at a second radial position relative to the longitudinal axis of the shaft; and

wherein when the pod assembly is in the second configuration, the first pod member is at a third radial position relative to the longitudinal axis of the shaft and the second pod member remains at the second radial position relative to the longitudinal axis of the shaft, the third radial position being farther away from the longitudinal axis than the first radial position.

17. The method of claim 16, wherein advancing the distal end of the shaft includes advancing the distal end of the shaft into a stomach of the patient.

18. The method of claim 16, further comprising moving the pod assembly from the second configuration to a third configuration;

wherein when the pod assembly is in the third configuration, the first pod member remains at a third radial position and the second pod member is at a fourth radial position relative to the longitudinal axis of the shaft, the fourth radial position being farther away from the longitudinal axis than the second radial position.