Tissue opening locator and everter and method

• US 20010053922A1
• Filed: 08/13/2001
• Published: 12/20/2001
• Est. Priority Date: 12/07/1995
• Status: Active Grant

• Current Assignee: Wolff M. Kirsch, Yong Hua Zhu
• Original Assignee: Wolff M. Kirsch, Yong Hua Zhu
• Inventors: Zhu, Yong Hua, Kirsch, Wolff M.
• Granted Patent: US 6,964,675 B2
• Time in Patent Office: Days
• US Class Current: 606/213
• 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 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• 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 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/128 for applying or removing clamps or clips
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: B29K 2067/003 PET, i.e. poylethylene terephthalate

Abstract

An apparatus for facilitating the locating, everting, and closing of an opening in a blood vessel. The apparatus can include a closure instrument having an elongated member defining a longitudinal axis and proximal and distal ends. The elongated member has a vacuum lumen extending at least a portion of the length thereof for conveying a vacuum and terminating in a vacuum port adjacent the distal end of the elongated member. The distal end of the elongated member is dimensioned to be positioned proximal a vessel opening in a blood vessel whereby vessel edge portions defining the vessel opening are at least partially drawn toward the vacuum port in response to a vacuum conveyed through the vacuum lumen. At least one surgical clip is mounted adjacent the distal end of the elongated member and is adapted to be formed to an at least partially formed condition thereof. The one clip is positioned with respect to the vacuum port so as to engage the vessel edge portions drawn toward the vacuum port when the clip is moved to the formed condition, thus at least partially closing the vessel opening. A method for locating, everting, and closing an opening in a blood vessel is also disclosed.

Claims

1. An apparatus for locating an opening in tissue, comprising:

an elongated member having a lumen formed therein and having a vacuum source attached for conveying a vacuum through said lumen, said elongated member having a vacuum port adjacent the distal end of said elongated member, said vacuum port positioned on said opening and withdrawing body liquid therethrough and through said lumen.

2. The apparatus of

claim 1

, further comprising a body fluid visualization port adjacent the proximal end of said elongated member.

3. The apparatus of

claim 2

wherein said visualization port is a blood visualization port.

4. The apparatus of

claim 1

, wherein the elongated member defines a distal axial opening in communication with the vacuum lumen, the distal axial opening comprising the vacuum port.

5. An apparatus for locating an opening in tissue, comprising:

a suction catheter having a distal end and a proximal end;

a suction port positioned near said distal end of said suction catheter; and

a fluid detection port position near the proximal end of said suction catheter.

6. The apparatus of

claim 5

, wherein said fluid detection port comprises means for determining the nature of the fluid from said opening to determine the location of said opening.

7. The apparatus of

claim 5

, further comprising a tissue modifying apparatus adjacent said distal end of said suction catheter.

8. The apparatus of

claim 7

, wherein said modifying apparatus comprises a closure device for closing said opening.

9. The apparatus of

claim 7

, wherein said modifying apparatus comprises a device for enlarging said opening.

10. The apparatus of

claim 7

, wherein said modifying apparatus comprises a tissue therapy device.

11. The apparatus of

claim 5

, wherein said suction port comprises an edge eversion device for said opening.

12. The apparatus of

claim 5

, further comprising a suction catheter holding device for maintaining the position of said catheter on said opening.

13. The apparatus of

claim 5

, wherein said suction port comprises the distal opening of said suction catheter.

14. A method for modifying an opening in tissue, comprising:

applying a vacuum to the tissue adjacent the opening; and

modifying the tissue adjacent the tissue opening.

15. The method according to

claim 14

, wherein modifying the tissue adjacent the tissue opening comprises everting the edges defining the opening.

16. The method according to

claim 14

, wherein modifying the tissue adjacent the tissue opening comprises therapeutically treating the tissue.

17. The method of

claim 14

, further comprising maintaining the vacuum to hold a modifying catheter in place on the opening.

18. A method for locating a vessel opening in a blood vessel, comprising the steps of:

applying a vacuum to the general area surrounding a vessel opening such that a mixture of blood and clear bodily fluid is suctioned; and

applying the vacuum closer to the vessel opening such that less clear bodily fluid and more blood is suctioned; and

applying the vacuum completely over the vessel opening such that only blood is suctioned; and

applying a vacuum to the vessel opening such that vessel edge portions defining the vessel opening assume an everted condition.

19. The method according to

claim 18

, including the step of providing an instrument having a guidewire guide that guides the instrument toward the vessel opening.

20. A device to facilitate the closure of wounds in the vasculature of a patient comprising:

a body portion having a retracting portion having two movable halves extending away from and substantially perpendicular to said body portion, said halves forming a channel extending completely through said retracting portion; and

a handle portion connected to said body portion which controls the movement of the two movable halves.

21. The device of

claim 20

, wherein said handle portion comprises two handles and a locking mechanism.

22. The device of

claim 21

, wherein the device is formed of a first and second member connected by a hinge, and one movable retracting portion half and one handle half is disposed on each member.

23. The device of

claim 22

, wherein the handle portion and hinge are adapted so that movement of the retracting portion halves toward each other is effected by moving the handles away from each other.

24. The device of

claim 21

, wherein the locking mechanism comprises a toothed arcuate stop member extending from the first handle and a release member extending from a second handle, and the release member includes a stop adapted to releasably engage the stop member teeth.

25. The device of

claim 21

, wherein the handles are biased away from each other.

26. The device of

claim 24

, wherein the release member stop is biased into engagement with the stop member teeth.