Tissue manipulation and securement system

• US 20050251166A1
• Filed: 03/01/2005
• Published: 11/10/2005
• Est. Priority Date: 05/07/2004
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Saadat, Vahid, Ewers, Richard C., Lam, Cang C., Vaughan, Robert A.
• Granted Patent: US 8,216,252 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• 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 17/0487 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• 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 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0419 H-fasteners
• 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 hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled for sutures A61B2017/06171
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue

Abstract

Tissue manipulation and securement systems are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member and has a lower jaw member and an upper jaw member pivotably coupled to the lower jaw member. A reconfigurable launch tube is also pivotably coupled to the upper jaw member and is used to urge the jaw members from a low-profile configuration to an open configuration for receiving tissue. The tissue manipulation assembly 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.

Claims

1. A tissue manipulation system, comprising:

a tissue grasping tool pivotably coupled to a distal end of an elongate member and adapted to be advanced endoluminally into a body lumen; and

a tissue engagement device having a distal end effector adapted to reversibly engage tissue and further adapted to be positioned endoluminally within the body lumen adjacent to the tissue grasping tool.

2. The system of claim 1 wherein the tissue grasping tool comprises a first jaw member pivotably coupled to the distal end of the elongate member, a second jaw member pivotably coupled along the first jaw member, and a launch tube member adapted to urge the first and second jaw members between a low-profile delivery configuration and an expanded grasping configuration.

3. The system of claim 2 wherein at least one of the first and second jaw members comprise protrusions for facilitating engagement onto the tissue.

4. The system of claim 2 further comprising a stop for limiting a pivoting motion of the first jaw member.

5. The system of claim 2 wherein a distal end of the launch tube member is pivotably coupled to the second jaw member.

6. The system of claim 2 wherein the launch tube member comprises a distally located flexible portion.

7. The system of claim 6 wherein the launch tube member further comprises a rigid portion proximally of the flexible portion.

8. The system of claim 2 wherein the first and second jaw members are adapted to reconfigure into the expanded grasping configuration when the launch tube is urged proximally.

9. The system of claim 1 wherein the distal end effector comprises a helical member having a tissue piercing tip.

10. The system of claim 1 wherein the distal end effector comprises a grasper for reversibly engaging the tissue.

11. A tissue manipulation system, comprising:

an endoscopic device having a flexible body with a steerable distal section, wherein the flexible body is adapted to be rigidized to maintain an arbitrary shape;

a tissue grasping tool pivotably coupled to a distal end of an elongate member and adapted to be advanced through the endoscopic device; and

a tissue engagement device having a distal end effector adapted to reversibly engage tissue and further adapted to be advanced through the endoscopic device.

12. The system of claim 11 wherein the endoscopic device further defines a lumen for visualization.

13. The system of claim 11 wherein the endoscopic device defines at least a first and a second lumen therethrough.

14. The system of claim 13 wherein the tissue grasping tool is adapted to be advanced through the first lumen within the endoscopic device.

15. The system of claim 13 wherein the tissue engagement device is adapted to be advanced through the second lumen within the endoscopic device.

16. The system of claim 11 wherein the tissue grasping tool comprises a first jaw member pivotably coupled to the distal end of the elongate member, a second jaw member pivotably coupled along the first jaw member, and a launch tube member adapted to urge the first and second jaw members between a low-profile delivery configuration and an expanded grasping configuration.

17. The system of claim 16 further comprising a needle assembly having a piercing tip which is adapted to be advanced through the launch tube.

18. The system of claim 17 further comprising at least two tissue anchors adapted to be ejected from the needle assembly for securing the engaged tissue therebetween.

19. A tissue manipulation system, comprising:

a tissue grasping tool pivotably coupled to a distal end of an elongate member and having a first jaw member pivotably coupled to the distal end of the elongate member, a second jaw member pivotably coupled along the first jaw member, and a launch tube member adapted to urge the first and second jaw members between a low-profile delivery configuration and an expanded grasping configuration; and

a tissue engagement device having a helical piercing member on a distal end of a flexible shaft.

20. The system of claim 19 wherein at least one of the first and second jaw members comprise protrusions for facilitating engagement onto the tissue.

21. The system of claim 19 wherein a distal end of the launch tube member is pivotably coupled to the second jaw member.

22. The system of claim 19 wherein the launch tube member comprises a distally located flexible portion.

23. The system of claim 19 wherein the first and second jaw members are adapted to reconfigure into the expanded grasping configuration when the launch tube is urged proximally.

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

endoluminally advancing a tissue grasping tool pivotably coupled to a distal end of an elongate member into the hollow body organ;

reversibly engaging tissue within the hollow body organ with a distal end effector positioned adjacently to the tissue grasping tool; and

clamping the engaged tissue with the tissue grasping tool.

25. The method of claim 24 wherein endoluminally advancing comprises advancing the tissue grasping tool transesophageally into a stomach.

26. The method of claim 24 wherein endoluminally advancing comprises advancing an endoscopic device having a flexible body with a steerable distal section transesophageally, wherein the flexible body is adapted to be rigidized to maintain an arbitrary shape.

27. The method of claim 26 further comprising steering the distal section within the hollow body organ to a tissue region of interest and rigidizing the endoscopic device.

28. The method of claim 24 wherein reversibly engaging tissue comprises rotating a helical piercing member into the tissue and proximally urging the engaged tissue with the helical piercing member.

29. The method of claim 24 wherein clamping the engaged tissue comprises urging a launch tube member distally such that an upper and lower jaw member are urged onto the engaged tissue.

30. The method of claim 24 further comprising securing the engaged tissue via the tissue grasping tool.