Closing openings in anatomical tissue

• US 9,918,706 B2
• Filed: 04/23/2015
• Issued: 03/20/2018
• Est. Priority Date: 06/07/2010
• Status: Active Grant

• Current Assignee: Kardium Inc.
• Original Assignee: Kardium Inc.
• Inventors: Lichtenstein, Samuel
• Primary Examiner(s): Woo, Julian W
• Application Number:
  US14/694,521
• Publication Number:
  US 20150223791A1
• Time in Patent Office: 1,062 Days
• 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 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• 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 17/08 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 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00579 Barbed implements
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/0061 Implements located only on one side of the opening
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00668 the implement being a tack or a staple
• CPC Class Codes: A61B 2017/22068 Centering
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2090/08021 of the patient or his organs

Abstract

A device for closing at least one opening leading to an anatomical cavity is delivered via a catheter positioned in a first opening leading to the anatomical cavity. An orientation control unit is positioned within the anatomical cavity. The orientation control unit defines an orientation of a portion of a tissue surface within the anatomical cavity that is skewed with respect to the first opening and orients a closure member of the device with the tissue surface. An occluding member and a constricting unit of the device are positioned within the anatomical cavity with the occluding member blocking a portion of an opening that is constricted by the constricting unit. An intermediate member of the device is positioned within the anatomical cavity and a closure unit employing at least one piercing element pierces through the intermediate member into a tissue wall surrounding the anatomical cavity.

Claims

1. A medical system configured to close one or more openings, each of the one or more openings leading to an anatomical cavity, at least a portion of the medical system sized in at least one configuration to be deliverable through a first opening of the one or more openings into the anatomical cavity, and the at least the portion of the medical system comprising:

an elongated member, a portion of the elongated member sized to be deliverable through the first opening into the anatomical cavity;

a closure unit releasably coupled to the elongated member and arranged to be delivered into the anatomical cavity to a location at least proximate an interior tissue surface within the anatomical cavity, the closure unit further arranged to close an opening of the one or more openings located on the interior tissue surface within the anatomical cavity; and

an intermediate member releasably coupled to the elongated member and arranged to be delivered into the anatomical cavity to a location between at least part of the closure unit and the interior tissue surface within the anatomical cavity,

wherein the closure unit comprises a plurality of piercing elements, each piercing element of the plurality of piercing elements arranged to point back toward the elongated member in a state where the closure unit is coupled to the elongated member, and each piercing element of the plurality of piercing elements arranged to pierce through the intermediate member and pierce through the interior tissue surface into tissue surrounding the anatomical cavity,

wherein the at least the portion of the medical system further comprises a plurality of deployment arms that respectively capture the plurality of piercing elements in at least a first configuration of the medical system,

wherein the intermediate member is coupled to the plurality of deployment arms in at least the first configuration of the medical system, and

wherein the plurality of deployment arms position the intermediate member in a retracted position within a tubular member in at least a second configuration of the medical system, at least a portion of the tubular member sized to be deliverable into the first opening.

2. The medical system of claim 1 wherein the closure unit is arranged to close the opening located on the interior tissue surface within the anatomical cavity by piercing through the interior tissue surface into the tissue surrounding the anatomical cavity to constrict a portion of the opening of the one or more openings located on the interior tissue surface within the anatomical cavity.

3. The medical system of claim 1 wherein the plurality of deployment arms respectively releasably capture respective tissue-piercing tips of the plurality of piercing elements.

4. The medical system of claim 1 wherein respective ends of the plurality of deployment arms respectively capture the plurality of piercing elements in at least the first configuration of the medical system.

5. The medical system of claim 1 wherein the intermediate member extends beyond ends of the plurality of piercing elements in at least the first configuration of the medical system.

6. The medical system of claim 1 wherein the intermediate member is elastic.

7. The medical system of claim 1 wherein the intermediate member is elastic and is stretched from an initial state when coupled to the plurality of deployment arms in at least the first configuration of the medical system.

8. The medical system of claim 1 wherein the intermediate member includes an absorbent material.

9. The medical system of claim 1 wherein the plurality of deployment arms are decoupled from the plurality of piercing elements in at least a third configuration of the medical system.

10. The medical system of claim 9 wherein each of the plurality of piercing elements is arranged to pierce through the intermediate member into the interior tissue surface within the anatomical cavity in at least the second configuration of the medical system.

11. The medical system of claim 1 wherein the plurality of deployment arms outwardly extend the plurality of piercing elements in at least the first configuration of the medical system as compared to the second configuration of the medical system where the plurality of deployment arms retain the plurality of piercing elements in a retracted position sized to be deliverable through the tubular member.

12. The medical system of claim 1 wherein the intermediate member is a pad.

13. The medical system of claim 1 wherein at least a portion of the intermediate member is parallel to at least a portion of at least one of the plurality of deployment arms in at least the first configuration.

14. The medical system of claim 1 wherein the closure unit comprises a clip, and wherein the elongated member is configured to exert a force on the clip to bring the at least one piercing element through the intermediate member into the interior tissue surface.

15. The medical system of claim 1 wherein the closure unit comprises a clip, and wherein the clip is configured to cause the at least one piercing element to constrict the first opening via an elastic restorative force of the clip in at least one configuration of the medical system.

16. A method of operating a medical system for closing one or more openings, each of the one or more openings leading to an anatomical cavity, the medical system sized in at least one configuration to pass through a lumen of a tubular member and a first opening of the one or more openings into the anatomical cavity, the method comprising:

outwardly extending a plurality of piercing elements of a closure unit of the medical system to cause at least tissue-piercing tips of the plurality of piercing elements to outwardly extend beyond a perimeter of the lumen of the tubular member from a retracted position in which at least the plurality of piercing elements is arranged to be deliverable through the lumen of the tubular member, the closure unit arranged to be delivered into the anatomical cavity to a location at least proximate an interior tissue surface within the anatomical cavity, and the closure unit further arranged to close an opening of the one or more openings located on the interior tissue surface within the anatomical cavity; and

causing the tissue-piercing tips of the outwardly-extended plurality of piercing elements to pierce, via a pulling motion of the closure unit toward the tubular member, through an intermediate member of the medical system, the intermediate member arranged at a position between at least a non-piercing portion of the plurality of piercing elements and the tubular member when the plurality of piercing elements are outwardly extended beyond the retracted position, the tissue-piercing tips of the outwardly-extended plurality of piercing elements configured to pierce, via the pulling motion of the closure unit toward the tubular member, through the intermediate member into the interior tissue surface within the anatomical cavity.

17. The method of claim 16 wherein the outwardly extending of the plurality of piercing elements results in placing the intermediate member in an extended position in which the intermediate member extends outwardly from the tubular member.

18. The method of claim 16 wherein the causing is effected by employing an elongated member of the medical system to exert a pulling force on the closure unit to bring the tissue-piercing tips of the plurality of piercing elements through the intermediate member, a portion of the elongated member sized to be deliverable through the lumen of the tubular member, and wherein each of the closure unit and the intermediate member is coupled to the elongated member with the plurality of piercing elements pierced through the intermediate member.

19. The method of claim 18, further comprising, after the causing, de-coupling the elongated member from each of the closure unit and the intermediate member and retracting the elongated member.