Multi-position tissue manipulation assembly

• US 20050251189A1
• Filed: 09/29/2004
• Published: 11/10/2005
• Est. Priority Date: 05/07/2004
• Status: Abandoned Application

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Saadat, Vahid, Ewers, Richard C., Lam, Cang C., Rothe, Chris, Vaughan, Robert A.
• Application Number:
  US10/956,009
• Publication Number:
  US 20050251189A1
• Time in Patent Office: Days
• US Class Current: 606/185
• 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 17/0487 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 17/064 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 17/29 Forceps for use in minimally invasive surgery
• 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 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 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 for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• 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 2017/081 : Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue

Abstract

Multi-position tissue manipulation assemblies 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 disposed 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. One or all the articulation controls and functions can be integrated into a singular handle enclosure connectable to the tissue manipulation assembly via a rigid or flexible tubular body. A needle deployment mechanism may be positioned within the enclosure. Such a mechanism can have multiple positions adapted to lock and/or advance a needle assembly within the enclosure in a controlled manner as well as for deploying the anchor assembly.

Claims

1. A handle for use in forming a tissue fold, comprising:

an enclosure having a proximal end and a distal end; and

a needle deployment mechanism having a first position adapted to lock a needle assembly within the enclosure and allow longitudinal translation of the needle deployment mechanism to pivot a distal portion of a needle tubular member, and a second position adapted to allow longitudinal translation of the needle assembly through the needle tubular member.

2. The handle of claim 1 further comprising a pivotable member mounted on the enclosure and adapted to articulate a tissue engagement assembly relative to the enclosure.

3. The handle of claim 2 wherein the pivotable member is connected via one or more wires to the tissue engagement assembly.

4. The handle of claim 1 further comprising a rotatable tissue engagement control adapted to be translated longitudinally through the enclosure.

5. The handle of claim 4 wherein the enclosure defines an engagement control lumen extending through the enclosure through which the rotatable tissue engagement control is translatable.

6. The handle of claim 1 wherein the enclosure further defines at least one opening therethrough.

7. The handle of claim 1 wherein the enclosure is adapted to be reusable.

8. The handle of claim 1 wherein the enclosure is symmetrically-shaped about a longitudinal axis extending from the proximal end to the distal end.

9. The handle of claim 1 wherein the needle deployment mechanism comprises an outer sleeve rotatably disposed about an inner sleeve such that the outer sleeve and the inner sleeve are configured to interlock in a corresponding manner.

10. The handle of claim 9 wherein the outer sleeve is adapted to interlock with the inner sleeve when rotated about its longitudinal axis relative to the inner sleeve.

11. The handle of claim 1 wherein the needle deployment mechanism when in the first position is adapted to retain the needle assembly when the needle deployment mechanism is partially rotated relative to the enclosure.

12. The handle of claim 11 wherein the needle deployment mechanism is further adapted to longitudinally advance the needle tubular member relative to the enclosure.

13. The handle of claim 1 wherein the needle deployment mechanism when in the second position is adapted to allow for the longitudinal translation of the needle assembly via a slot defined in the needle deployment mechanism.

14. The handle of claim 1 further comprising an elongate tubular member extending from the distal end of the enclosure through which the needle assembly is translatable.

15. The handle of claim 14 wherein the elongate tubular member is detachable from the enclosure.

16. The handle of claim 14 wherein the elongate tubular member comprises a rigid shaft.

17. The handle of claim 14 wherein the elongate tubular member comprises a flexible endoscopic device.

18. The handle of claim 17 wherein the flexible endoscopic device is shape-lockable.

19. A needle deployment system adapted to be retained in an enclosure, comprising:

an outer sleeve disposed about an inner sleeve such that the outer sleeve and the inner sleeve are configured to interlock in a corresponding manner;

wherein the outer sleeve is adapted to partially rotate relative to the inner sleeve such that the deployment mechanism defines;

a first position adapted to lock a needle assembly within the needle deployment mechanism and allow longitudinal translation of the needle deployment mechanism to pivot a distal portion of a needle tubular member, and

a second position adapted to allow longitudinal translation of the needle assembly through the needle tubular member.

20. The system of claim 19 further comprising an enclosure which is adapted to retain the needle deployment mechanism therewithin.

21. The system of claim 20 wherein the enclosure defines an engagement control lumen therethrough.

22. The system of claim 20 wherein the enclosure is symmetrically-shaped about a longitudinal axis extending therealong.

23. The system of claim 20 further comprising an elongate tubular member extending from a distal end of the enclosure.

24. The system of claim 23 wherein the elongate tubular member is detachable from the enclosure.

25. The system of claim 23 wherein the elongate tubular member comprises a rigid shaft.

26. The system of claim 23 wherein the elongate tubular member comprises a flexible endoscopic device.

27. The system of claim 19 wherein the outer sleeve defines a slot thereon.

28. The system of claim 19 further comprising a pivotable member adapted to articulate a tissue engagement assembly relative to the needle deployment system.

29. The system of claim 19 further comprising a rotatable tissue engagement control adapted to be translated longitudinally relative to the needle deployment system.

30. The system of claim 19 further comprising a needle assembly having a hollow needle body disposed at a distal end of an elongate flexible shaft.

31. A method of deploying a needle assembly, comprising:

loading a needle assembly within an enclosure;

articulating a needle deployment mechanism within the enclosure to a first position such that the needle assembly is locked within the needle deployment mechanism;

translationally advancing the needle deployment mechanism relative to the enclosure such that a distal portion of a needle tubular member is pivoted;

articulating the needle deployment mechanism to a second position such that the needle assembly is longitudinally translatable through the needle tubular member.

32. The method of claim 31 wherein loading a needle assembly comprises advancing the needle tubular member through the enclosure.

33. The method of claim 31 wherein articulating a needle deployment mechanism within the enclosure comprises partially rotating the needle deployment mechanism relative to the enclosure such that the needle assembly is locked.

34. The method of claim 31 wherein translationally advancing the needle deployment mechanism comprises urging the deployment mechanism distally relative to the enclosure.

35. The method of claim 31 wherein articulating the needle deployment mechanism to a second position comprises partially rotating the needle deployment mechanism relative to the enclosure such that the needle assembly is translatable distally relative to the enclosure.

36. The method of claim 31 further comprising deploying at least one anchor from the needle assembly.

37. The method of claim 36 further comprising withdrawing the needle assembly from the needle deployment mechanism.

38. The method of claim 37 further comprising re-loading a second needle assembly within the enclosure.