Tissue closure and tissue closing device

• US 20060135991A1
• Filed: 12/16/2005
• Published: 06/22/2006
• Est. Priority Date: 12/17/2004
• Status: Active Grant

• Current Assignee: Terumo Kabushiki Kaisha
• Original Assignee: Terumo Kabushiki Kaisha
• Inventors: Maruyama, Tomoji, Kawaura, Masakatsu
• Granted Patent: US 7,875,052 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 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/00619 Locking means for locking the implement in expanded state
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00659 located only on one side of the opening

Abstract

A tissue closure includes a body, and a thread includes a knot which is slidable on the thread. The body is composed of a plate-like anchor portion, and a deformation portion having a frame-like shape which can be deformed between a first form in which the deformation portion is elongated in a direction substantially perpendicular to the anchor portion and contracted in a direction substantially parallel to the anchor portion and a second form in which the deformation portion is contracted in a direction substantially perpendicular to the anchor portion and elongated in a direction substantially parallel to the anchor portion. The tissue closure can also include a connecting portion connecting the anchor portion and the deformation portion to each other. In the condition where the deformation portion is in a desired form between the first form and the second form, the condition is maintained by the thread.

Claims

1. A tissue closure for closing an opening on a wall of living body cavity, comprising:

a plate-shaped anchor portion adapted to be held at and around the opening from one side of the wall of the living body cavity;

a deformation portion comprising a frame-shaped body, the deformation portion being deformable between a first form in which the body is elongated in a direction substantially perpendicular to the anchor portion and contracted in a direction substantially parallel to the anchor portion and a second form in which the body is contracted in a direction substantially perpendicular to the anchor portion and elongated in a direction substantially parallel to the anchor portion; and

a thread member adapted to maintain the deformation portion in a desired form between the first form and the second form.

2. The tissue closure according to claim 1, wherein the frame-shaped body of the deformation portion possesses a pantograph-like shape.

3. The tissue closure according to claim 1, wherein the frame-shaped body of the deformation portion possesses a polygonal annular shape formed by a rigid ribbon member having a plurality of bendable portions.

4. The tissue closure according to claim 1, wherein the frame-shaped body of the deformation portion possesses a quadrangular shape formed by four integrated links and is deformable so that two corner portions at diagonally opposite positions move towards and away from one another as the deformation portion deforms between said first and second forms.

5. The tissue closure according to claim 1, wherein said thread member comprises a knot slidable on the thread member, the knot maintaining the deformation portion in the desired form.

6. The tissue closure according to claim 5, wherein when the thread member is maintaining the deformation portion in the desired form, the knot is located at a first end portion on a side of the deformation portion opposite the anchor portion.

7. The tissue closure according to claim 1, wherein the thread member is hooked on one end portion of the deformation portion at a side opposite the anchor portion and is hooked on a another end portion of the deformation portion at a side closer to the anchor portion.

8. The tissue closure according to claim 1, wherein the anchor portion and the deformation portion are integrally formed in one piece of the same material.

9. The tissue closure according to claim 1, further comprising a connecting portion connecting the anchor portion and the deformation portion to each other.

10. The tissue closure according to claim 9, wherein the anchor portion, the connecting portion and the deformation portion are integrally formed in one piece of the same material.

11. The tissue closure according to claim 9, wherein the thread member is hooked on one end portion of the deformation portion on a side opposite the anchor portion and the connecting portion, the thread member penetrating the deformation portion and the connecting portion.

12. The tissue closure according to claim 1, wherein the thread member is hooked on one end portion of the deformation portion on a side opposite the anchor portion, the thread member penetrating the deformation portion and the anchor portion.

13. The tissue closure according to claim 1, further comprising a thread hook portion possessing a hole, the thread hook portion being provided at an inside surface of the deformation portion, and the thread member being hooked on a first end portion of the deformation portion on a side opposite the anchor portion by penetrating a hole in the deformation portion, the thread member being hooked on the thread hook portion by penetrating the hole of the thread hook portion.

14. The tissue closure according to claim 13, wherein the deformation portion and the thread hook portion are integrally formed in one piece of the same material.

15. The tissue closure according to claim 1, comprising a fixing portion different from the thread member, the fixing portion being provided inside the deformation portion, the fixing portion engaging the deformation portion when the deformation portion is in the desired form between said first form and said second form to maintain the deformation portion in the desired form.

16. The tissue closure according to claim 15, wherein the fixing portion is secured to the inside of the deformation portion on a side of the anchor portion.

17. The tissue closure according to claim 15, wherein the deformation portion and the fixing portion are integrally formed in one piece of the same material.

18. The tissue closure according to claim 15, wherein the thread member and the fixing portion maintain the deformation portion in the desired form in a selective manner according to a degree of deformation of the deformation portion between the first form and the second form.

19. The tissue closure according to claim 15, wherein the deformation portion comprises an opening portion in which at least a part of the fixing portion can be inserted, and the fixing portion comprises at least one pawl adapted to engage the deformation portion when the fixing portion is inserted in the opening portion.

20. The tissue closure according to claim 15, wherein the fixing portion possesses a hole, and the thread member is hooked on a first end portion of the deformation portion on a side opposite the anchor portion and the fixing portion, the thread member penetrating the first end portion and the hole of the fixing portion.

21. The tissue closure according to claim 15, wherein:

a first end portion of the deformation portion on a side opposite the anchor portion is provided with an opening portion configured to receive at least a part of the fixing portion;

the fixing portion is provided with a hole and at least one pawl adapted to engage the deformation portion when the fixing portion is inserted in the opening portion; and

when the fixing portions is not inserted in the opening portion, the thread member penetrates the opening portion of the deformation portion and is hooked on the fixing portion by penetrating the hole of the fixing portion.

22. The tissue closure according to claim 21, wherein when the fixing portion is inserted in the opening portion and the pawl is engaged with the deformation portion, the thread member is located outside the deformation portion together with the hole of the fixing portion.

23. The tissue closure as set forth in claim 1, wherein at least one of said anchor portion, said deformation portion and said thread member is comprised of a bioabsorbable material.

24. A tissue closure for closing an opening on a wall of living body cavity, comprising:

an anchor portion positionable at and around the opening on one side of the wall of the living body cavity;

a deformation portion deformable between a first form in which the deformation portion is elongated in a direction substantially perpendicular to the anchor portion and a second form in which the deformation portion is compressed from the first form toward the anchor portion;

a thread member adapted to maintain the deformation portion in a desired form between the first form and the second form;

the thread member being comprised of a double thread having one end portion thereof as a bent-back portion, and being disposed so that the deformation portion is located between the bent-back portion and the anchor portion; and

the bent-back portion forming a loop.

25. The tissue closure as set forth in claim 24, wherein at least one of said anchor portion, said deformation portion and said thread member is comprised of a bioabsorbable material.

26. The tissue closure as set forth in claim 24, wherein the wall of the living body cavity is a blood vessel wall, and the one side of the wall of the living body cavity is an inside surface of the blood vessel wall.

27. A tissue closing device, comprising:

a tissue closure comprising an anchor portion, a deformation portion and a thread member;

the anchor portion being positionable at and around the opening on one side of the wall of the living body cavity;

the deformation portion being deformable between a first form in which the deformation portion is elongated in a direction substantially perpendicular to the anchor portion and a second form in which the deformation portion is compressed from the first form toward the anchor portion;

the thread member maintaining the deformation portion in a desired form between the first form and the second form;

an arrangement device possessing an elongate shape, the arrangement device detachably retaining the tissue closure at a distal end portion thereof; and

the tissue closure being arranged in a living organism so as to close the opening by penetrating a tissue membrane of the wall with the tissue closure.

28. The tissue closing device according to claim 27, wherein the thread member is comprised of a double thread having one end portion thereof as a bent-back portion, the deformation portion being located between the bent-back portion and the anchor portion;

and the bent-back portion forming a loop.

29. The tissue closing device according to claim 27, wherein the thread member is a first thread member, and further comprising a second thread member passing through the loop formed by the bent-back portion of the first thread member, the tissue closure being detachably retained by the second thread member.

30. The tissue closing device according to claim 29, wherein the second thread member is comprised of a double thread possessing one end portion that is a bent-back portion.

31. The tissue closing device according to claim 30, wherein the arrangement device possesses a lumen extending along a longitudinal extent of the arrangement device for passing the second thread member therethrough, and the bent-back portion of the second thread member is located at a proximal end portion of the arrangement device, and further comprising fixing means for inhibiting the bent-back portion of the second thread member from moving in a distal direction in the lumen of the arrangement device.

32. A method of closing an opening on a wall of living body cavity, comprising:

inserting a tissue closure through the opening on the wall of the living body cavity so that an anchor portion of the tissue closure is positioned on one side of the opening;

deforming a deformation portion of the tissue closure to compress the deformation portion in a direction toward the anchor portion while the deformation portion is on an opposite side of the opening from the anchor portion, with the anchor portion being positioned to cover and close off the opening.

33. The method according to claim 32, further comprising retaining the deformation portion in a compressed state by way of a knot of a thread member that extends through holes in the deformation portion.

34. The method according to claim 33, wherein the deformation portion is compressed by applying a force to the deformation portion, and including moving the knot towards the deformation portion.