Methods and apparatus for securing and deploying tissue anchors

• US 9,585,651 B2
• Filed: 05/26/2005
• Issued: 03/07/2017
• Est. Priority Date: 05/26/2005
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Lam, Cang C., Ewers, Richard C., Vaughan, Robert A., Saadat, Vahid
• Primary Examiner(s): ANDERSON, GREGORY A
• Application Number:
  US11/139,920
• Publication Number:
  US 20060271073A1
• Time in Patent Office: 4,303 Days
• Field of Search: 606/139, 606144-150
• 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 17/0487 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 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/003 Steerable
• 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 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• 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 2017/2927 the angular position of the head being adjustable with respect to the shaft

Abstract

Methods and apparatus for securing and deploying tissue anchors are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member. A reconfigurable launch tube is also pivotably coupled to the tissue manipulation assembly, which 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. A deployment assembly is provided for securing engaged tissue via one or more tissue anchors, the deployment assembly also being configured to disengage the anchors endoluminally or laparoscopically.

Claims

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

endoluminally advancing a tissue grasping tool into the hollow body organ;

pivoting the tissue grasping tool about a fixed pivot joint connecting the grasping tool to an elongate member;

reversibly engaging the tissue within the hollow body organ with a tissue engagement member adjacent to the tissue grasping tool;

pulling the engaged tissue with the tissue engagement member;

clamping the engaged tissue with the tissue grasping tool;

after engaging the tissue and pulling the tissue, piercing through the engaged tissue with a needle of an anchor deployment assembly, the needle having a sharpened tip, with the needle separate from the tissue engagement member;

deploying a distal tissue anchor through the needle on a distal side of the engaged tissue;

retracting the needle to a proximal side of the engaged tissue;

deploying a proximal tissue anchor through the needle on the proximal side of the engaged tissue, with a suture connecting the proximal and distal tissue anchors; and

severing the suture adjacent to the proximal anchor using the sharpened tip of the needle, thereby releasing the proximal and distal anchors from the anchor deployment assembly.

2. The method of claim 1 further comprising cinching the proximal and distal anchors to secure the engaged tissue prior to severing the suture element.

3. The method of claim 1 wherein deploying the proximal and distal anchors through the needle further comprises advancing a pusher through the needle.

4. The method of claim 1 wherein endoluminally advancing comprises advancing the tissue grasping tool transesophageally into a stomach.

5. The method of claim 1 further comprising, prior to advancing the needle through the engaged tissue, positioning the anchor deployment assembly at least partially within the tissue grasping tool.

6. A method of deploying an anchor assembly, comprising:

endoluminally advancing a tissue grasping tool of an endoscopic body into a hollow body organ;

pivoting the tissue grasping tool about a pivot joint connecting the grasping tool to a flexible body of the tissue grasping tool;

reversibly engaging a region of tissue within the hollow body organ with a tissue engagement member of the endoscopic body;

pulling the engaged region of tissue with the tissue engagement member towards the endoscopic body to form a tissue fold;

clamping the tissue fold with the tissue grasping tool while pivoting the tissue grasping tool relative to the flexible body;

after clamping the tissue fold, piercing the tissue fold with a needle projecting out of a distal end of the flexible body and having a sharp edge;

deploying an anchor assembly from the flexible body, the anchor assembly including a suture and a cinching member;

advancing the cinching member over the suture; and

severing the suture using the sharp edge of the needle.

7. The method of claim 6, wherein deploying an anchor assembly comprises deploying an anchor assembly through a needle of an anchor deployment assembly, thereby securing the region of tissue.

8. The method of claim 7, wherein severing the suture releases the tissue anchor assembly from the anchor deployment assembly.

9. The method of claim 6 wherein endoluminally advancing comprises advancing the tissue grasping tool transesophageally into a stomach.

10. The method of claim 7, further comprising positioning the anchor deployment assembly at least partially within the tissue grasping tool.