Apparatus for manipulating and securing tissue

• US 9,510,817 B2
• Filed: 06/07/2012
• Issued: 12/06/2016
• Est. Priority Date: 12/12/2003
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Saadat, Vahid, Ewers, Richard C., Laduca, Cang C., Vaughan, Robert A., Rothe, Chris, Michlitsch, Kenneth J.
• Primary Examiner(s): YABUT, DIANE D
• Application Number:
  US13/491,273
• Publication Number:
  US 20120296348A1
• Time in Patent Office: 1,643 Days
• Field of Search: 606/142, 606/144, 606/213
• US Class Current: 1/1
• 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 17/0469 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 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• 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 17/06 Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials puncturing needles A61B17/34; hypodermic needles A61M5/32 ; sewing needles D05B85/00
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• 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 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0404 Buttons
• 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 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• CPC Class Codes: A61B 2017/045 : snug fit within the anchor
• CPC Class Codes: A61B 2017/0451 : Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 : the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 : Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0459 : Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• CPC Class Codes: A61B 2017/0461 : with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0475 : using sutures having a slip knot
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks
• 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 2017/081 : Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like

Abstract

Apparatus for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably dispose through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

Claims

1. A needle deployment assembly, comprising:

an elongate flexible catheter;

a control housing at a proximal end of the catheter;

a needle opening at a distal end of the catheter;

two or more anchor assemblies within the catheter, with each anchor assembly including a first anchor attached to a second anchor via a suture, and with the first and second anchors each having a proximal tubular collar attached to a distal tubular collar by one or more flexible elements, with the suture extending through the proximal and distal collars of the first and second anchors;

with the first and second anchors temporarily interlocked via a first pair of curved tabs on the distal tubular collar of the first anchor engaged with a second pair of curved tabs on the proximal tubular collar of the second anchor; and

with the first and second pairs of curved tabs adapted to interlock the first and second anchors when they are within the catheter, and to unlock the first and second anchors from each other when the first anchor is moved out of the catheter.

2. The needle deployment assembly of claim 1 wherein the first and second pairs of curved tabs are mirror images of each other.

3. The needle deployment assembly of claim 1 further including a pusher in the catheter, with a distal end of the pusher interlocking with the proximal tubular collar of the first anchor.

4. The needle deployment assembly of claim 1 with each anchor comprising a basket anchor.

5. The needle deployment assembly of claim 4 with each basket anchor including a plurality of arm members extending between a distal collar and a proximal collar.

6. The needle deployment assembly of claim 1 further comprising a spacer between two or more adjacent anchors.

7. The needle deployment assembly of claim 1 with the first and second anchors temporarily interlocked via a rounded projection fitting on the first anchor projecting into a complementary slot in the second anchor.

8. A needle deployment assembly for use in a surgical plication assembly, comprising:

an elongate flexible catheter;

a control attached to a proximal end of the catheter;

a needle at a distal end of the catheter, with the needle having a needle opening;

an anchor assembly within the catheter and including at least first, second and third basket anchors, with each basket anchor having a proximal collar and a distal collar;

with each collar having a hook-like curved surface interlocking feature contacting and interlocked with a complementary curved surface interlocking feature on a collar of an adjacent anchor to keep the basket anchors aligned with each other while they are in the catheter, and with the basket anchors releasable from each other when deployed out of the catheter and skewed relative to each other;

a suture extending entirely longitudinally through the collars of the basket anchors and through the control; and

a pusher partially within the catheter, with the anchor assembly between the needle opening and a distal end of the pusher, and with a distal end of the pusher having a hook-like circumferential collar fitting for interlocking with a proximal collar fitting on the first basket anchor.

9. The needle deployment assembly of claim 8 further comprising uniformly spaced apart flexible tabs projecting at least partially into the catheter.

10. The needle deployment assembly of claim 8 with each anchor including a plurality of arm members extending between a distal collar and a proximal collar.

11. The needle deployment assembly of claim 8 with a distal end of the suture extending out of a distal end of the catheter through the needle opening.

12. The needle deployment assembly of claim 11 further comprising a loop on the distal end of the suture.