Single fold device for tissue fixation

• US 20050256533A1
• Filed: 04/15/2005
• Published: 11/17/2005
• Est. Priority Date: 10/14/2003
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Roth, Alex T., Julian, Christopher, Gerbi, Craig, Hancock, Andrew H., Mata, Gilbert Jr., Gannoe, James, Weller, Gary
• Granted Patent: US 7,914,543 B2
• Time in Patent Office: Days
• US Class Current: 606/167
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/0034 adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/00946 malleable
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/1103 Approximator
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61F 5/005 Gastric bands
• CPC Class Codes: A61F 5/0076 preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0083 Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00

Abstract

A system for tissue approximation and fixation is described herein. A device is advanced in a minimally invasive manner within a patient'"'"'s body to create one or several divisions or plications within a hollow body organ. The system comprises a stapler assembly having a tissue acquisition member and a tissue fixation member. The stapler assembly approximates tissue from within the hollow body organ with the acquisition member and then affixes the approximated tissue with the fixation member. In one method, the system can be used as a secondary procedure to reduce the size of a stoma within the hollow body organ.

Claims

1. A tissue fixation device, comprising:

an elongated body having a proximal end and a distal end; and

a fixation assembly connected to the distal end of the elongated body having an acquisition member and a fixation member;

wherein the acquisition member is integrated into a portion of the fixation member.

2. The device of claim 1, wherein the acquisition member defines at least one opening adapted to adhere tissue thereto via a vacuum.

3. The device of claim 2, further comprising at least one vacuum tubing positioned along at least a portion of the elongated body.

4. The device of claim 1, wherein the acquisition member is a vacuum pod permanently attached to at least a portion of the fixation assembly.

5. The device of claim 1, wherein the fixation assembly includes an atraumatic distal tip.

6. The device of claim 5, wherein the distal tip defines a guide wire lumen therethrough.

7. The device of claim 1, wherein the elongated body is configured to be curved.

8. The device of claim 1, further comprising a handle connected to the proximal end of the elongated body.

9. The device of claim 8, wherein the handle includes at least one actuation mechanism adapted to articulate the fixation assembly from a first configuration to a second configuration.

10. The device of claim 8, wherein the handle is adapted to deploy a plurality of staples from the fixation assembly.

11. The device of claim 1, wherein the fixation assembly comprises a staple cartridge and an anvil in apposition to the staple cartridge.

12. The device of claim 11, wherein the staple cartridge is adapted to rotate about a pivot relative to the anvil from a closed configuration to an open configuration.

13. The device of claim 11, wherein the anvil is adapted to rotate about a pivot relative to the staple cartridge from a closed configuration to an open configuration.

14. The device of claim 1, wherein the acquisition member is a mechanical device.

15. The device of claim 14, wherein the mechanical device is a grasper having a cable and a claw disposed at the distal end of the cable.

16. The device of claim 1, wherein a hinged member pivotally connects the fixation assembly to the distal end of the elongated body.

17. A tissue fixation device, comprising:

a flexible shaft having a proximal end and a distal end; and

a cartridge assembly connected to the distal end of the elongated body having an acquisition member and a fixation member, wherein the fixation member includes a first jaw and a second jaw capable of pivoting relative to one another from a closed position to an open position, and the acquisition member includes a vacuum pod fixed to at least one of the first and second jaws;

wherein when the first and second jaws are in the open position, the vacuum pod acquires and holds at least one fold of tissue between the first and second jaws, and the first and second jaws pivot into the closed position to plicate the tissue.

18. A method of acquiring and affixing tissue from within a hollow body organ, comprising:

positioning a cartridge assembly attached to a distal end of an elongated body within the hollow body organ adjacent to a region of tissue to be acquired;

articulating at least one jaw of the cartridge assembly from a closed configuration to an open configuration;

acquiring the region of tissue with an acquisition member attached to at least a portion of the cartridge assembly, the region of tissue is acquired and held between the at least one jaw of the cartridge assembly; and

affixing the acquired tissue by articulating the at least one jaw of the cartridge assembly from the open configuration to the closed configuration.

19. The method of claim 18, further comprising inserting a guide wire into the hollow body organ and advancing the cartridge assembly over the guide wire.

20. The method of claim 18, further comprising employing an imaging device alongside or integral to the elongated body and into the hollow body organ to view the cartridge assembly and the region of tissue to be acquired.

21. The method of claim 18, wherein acquiring the region of tissue with the acquisition member, the acquisition member is a vacuum pod.

22. The method of claim 18, wherein acquiring the region of tissue with the acquisition member, the acquisition member is a mechanical device.

23. The method of claim 18, wherein affixing the acquired tissue, the cartridge assembly fires staples to affix the tissue.

24. The method of claim 18, further comprising releasing the region of tissue from the acquisition member.

25. A method of treating tissue within a hollow body organ, comprising:

performing a primary procedure to reduce the volume of the hollow body organ; and

placing at least one plication to increase the success of the primary procedure.

26. The method of claim 25, wherein placing the at least one plication reinforces the primary procedure.

27. The method of claim 25, wherein placing the at least one plication further reduces the volume of the hollow body organ.

28. A method of treating tissue within a hollow body organ, comprising:

placing at least one initial plication within the hollow body organ forming at least one reduced orifice having an inlet and an outlet; and

placing at least one secondary plication to reduce the outlet formed by the at least one initial plication.

29. The method of claim 28, wherein placing the at least one secondary plication perpendicular to the at least one initial plication to block the outlet.

30. A method of treating tissue within a hollow body organ, comprising:

placing at least one initial plication within the hollow body organ forming at least one reduced orifice having an inlet and an outlet; and

performing at least one secondary procedure to reduce the outlet formed by the at least one initial placation, the secondary procedure being chosen from the group consisting of;

placing an additional plication at or near the outlet, injecting a bulking agent at or near the outlet, placing a valve at or near the outlet, placing a stent at or near the outlet, laparoscopically placing an external band at or near the outlet, placing an internal band at or near the outlet, applying energy to the tissue at or near the outlet, and applying a caustic agent or schlerosing agent at or near the outlet.