CA2447382A1 - Apparatus adapted to assist in performing endoluminal fundoplication - Google Patents

Apparatus adapted to assist in performing endoluminal fundoplication Download PDF

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Publication number
CA2447382A1
CA2447382A1 CA002447382A CA2447382A CA2447382A1 CA 2447382 A1 CA2447382 A1 CA 2447382A1 CA 002447382 A CA002447382 A CA 002447382A CA 2447382 A CA2447382 A CA 2447382A CA 2447382 A1 CA2447382 A1 CA 2447382A1
Authority
CA
Canada
Prior art keywords
arms
closing mechanism
assembly
distal
arm
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002447382A
Other languages
French (fr)
Other versions
CA2447382C (en
Inventor
Ronald Adams
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Boston Scientific Ltd Barbados
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Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of CA2447382A1 publication Critical patent/CA2447382A1/en
Application granted granted Critical
Publication of CA2447382C publication Critical patent/CA2447382C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00174—Optical arrangements characterised by the viewing angles
    • A61B1/00179—Optical arrangements characterised by the viewing angles for off-axis viewing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0643—Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00353—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00818—Treatment of the gastro-intestinal system
    • A61B2017/00827—Treatment of gastro-esophageal reflux
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2905—Details of shaft flexible
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2933—Transmission of forces to jaw members camming or guiding means
    • A61B2017/2934—Transmission of forces to jaw members camming or guiding means arcuate shaped guiding means

Abstract

A distal assembly of an endoscopic surgical device, and a related method, having a first arm (12) and a second arm (14) pivotal relative to the first arm (12). Each arm (12, 14) is configured to hold a part of a two-part fastener (40, 42) at a distal end of the arm (12, 14). A closing mechanism (17) is positioned proximate a proximal end of each of the first and second arms (12, 14) opposite the distal end of each of the first and second arms (12, 14). The closing mechanism (18) is configured to move in relation to the first and second arms (12, 14) so as to close over at least one of the first and second arms (12, 14) to cause the distal ends of the arms to come together. An actuation member is also attached to the closing mechanism (18) actuable to cause the closing mechanism (18) to move in relation to the first and second arms (12, 14).

Claims (36)

1. A distal assembly of an endoscopic surgical device, comprising:

a first arm and a second arm pivotal relative to the first arm, each arm configured to hold a part of a two-part fastener at a distal end of the arm;

a closing mechanism positioned proximate a proximal end of each of the first and second arms opposite the distal end of each of the first and second arms, the closing mechanism configured to move in relation to the first and second arms so as to close over at least one of the first and second arms to cause the distal ends of the arms to come together; and an actuation member attached to the closing mechanism actuable to cause the closing mechanism to move in relation to the first and second arms.
2. The distal assembly of claim 1,wherein the actuation member is a cable.
3. The distal assembly of claim 1, wherein each of the first and second arms is straight.
4. The distal assembly of claim 1, wherein one of the first and second arms is curved.
5. The distal assembly of claim 4, wherein the closing mechanism is configured to close over the curved arm.
6. The distal assembly of claim 1, further comprising a spring at a pivot between the first and second arms.
7. The distal assembly of claim 6, wherein the spring provides a force to cause the distal ends of the arms to be pushed apart.
8. The distal assembly of claim 1, wherein the actuation member includes an elongate member having a threaded end that mates with a threaded hole in the closing mechanism.
9. The distal assembly of claim 1, wherein the closing mechanism includes a tube.
10. An assembly for endoscopically deploying a two-part fastener, comprising:

a flexible endoscope;

a tissue fastening tool configured to be guided along the endoscope;
and a stop mechanism located on the endoscope and configured to stop the advancement of the tissue fastening tool at a location relative to the endoscope.
11. The assembly of claim 10, wherein the stop mechanism includes a ring.
12. The assembly of claim 10, wherein the tissue fastening tool includes:

a first arm and a second arm pivotal relative to the first arm, each arm configured to hold a part of the two-part fastener at a distal end of the arm;

a closing mechanism positioned proximate a proximal end of each of the first and second arms opposite the distal end of each of the first and second arms, the closing mechanism configured to move in relation to the first and second arms so as to close over at least one of the first and second arms to cause the distal ends of the arms to come together; and an actuation member attached to the closing mechanism actuable to cause the closing mechanism to move in relation to the first and second arms.
13. The assembly of claim 12, wherein the actuation member is a cable.
14. The assembly of claim 12, wherein each of the first and second arms is straight.
15. The assembly of claim 12, wherein one of the first and second arms is curved.
16. The assembly of claim 15, wherein the closing mechanism is configured to close over the curved arm.
17. The assembly of claim 12, further comprising a spring at a pivot between the first and second arms.
18. The assembly of claim 17, wherein the spring provides a force to cause the distal ends of the arms to be pushed apart.
19. The assembly of claim 12, wherein the actuation member includes an elongate member having a threaded end that mates with a threaded hole in the closing mechanism.
20. The assembly of claim 12, wherein the closing mechanism includes a tube.
21. The assembly of claim 10, wherein the endoscope further comprises a distal assembly including a housing having a first light source and imaging system facing a distal direction and a second light source and imaging system facing a proximal direction opposite the distal direction.
22. A distal assembly of an endoscope, comprising:

a housing having a first light source and imaging system facing a distal direction and a second light source and imaging system facing a proximal direction opposite the distal direction.
23. A method for fastening tissue, comprising the steps of:

guiding a tissue fastening tool along an endoscope until the tissue fastening tool contacts a stop mechanism so as to position the tissue fastening tool relative to the endoscope, wherein the tissue fastening tool includes a pair of arms, each arm holding a part of a two-part fastener;

positioning the pair of arms about the tissue to be fastened; and closing the arms to deploy the two-part fastener and fasten the tissue.
24. The method of claim 23, further comprising turning a distal end of the endoscope to face the tissue fastening tool and the tissue to be fastened.
25. The method of claim 23, further comprising the step of switching from a first light source and imaging system of the endoscope that faces a distal direction and a second light source and imaging system of the endoscope that faces a proximal direction opposite the distal direction.
26. The method of claim 23, further comprising the step of actuating a closing mechanism to move in relation to the arms so as to close over at least one of the arms and cause the arms to come together.
27. The method of claim 26, wherein actuating the closing mechanism includes pulling on a cable attached to the closing mechanism.
28. The method of claim 26, wherein actuating the closing mechanism includes rotating a shaft with a threaded end that is coupled to the closing mechanism,
29. The method of claim 23, wherein the pair of arms are in a substantially closed configuration during the guiding step.
30. The method of claim 29, further comprising the step of opening the arms prior to the position step.
31. A method for fastening tissue, comprising the steps of:

guiding a tissue fastening tool through a body lumen to tissue to be fastened, wherein the tissue fasting tool includes a pair of arms, each arm holding a part of a two-part fastener;

positioning the pair of arms about the tissue to be fastened; and actuating a closing mechanism to close over at least one of the arms to cause the arms to come together and the parts of the two-part fastener to mate and fasten the tissue.
32. The method of claim 31, wherein actuating the closing mechanism includes pulling on a cable attached to the closing mechanism.
33. The method of claim 31, wherein actuating the closing mechanism includes rotating a flexible shaft with a threaded end that coupled to the closing mechanism.
34. The method of claim 31, wherein the arms are in a substantially closed configuration during the guiding step.
35. The method of claim 34, further comprising the step of opening the arms prior to the positioning step.
36. The method of claim 31, wherein the guiding step includes guiding the tissue fastening tool along an endoscope.
CA2447382A 2001-05-23 2002-05-22 Apparatus adapted to assist in performing endoluminal fundoplication Expired - Fee Related CA2447382C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/863,666 US6916332B2 (en) 2001-05-23 2001-05-23 Endoluminal fundoplication device and related method for installing tissue fastener
US09/863,666 2001-05-23
PCT/US2002/011904 WO2002094105A2 (en) 2001-05-23 2002-05-22 Method for performing endoluminal fundoplication and apparatus for use in the method

Publications (2)

Publication Number Publication Date
CA2447382A1 true CA2447382A1 (en) 2002-11-28
CA2447382C CA2447382C (en) 2012-07-03

Family

ID=25341535

Family Applications (1)

Application Number Title Priority Date Filing Date
CA2447382A Expired - Fee Related CA2447382C (en) 2001-05-23 2002-05-22 Apparatus adapted to assist in performing endoluminal fundoplication

Country Status (7)

Country Link
US (4) US6916332B2 (en)
EP (1) EP1389065B1 (en)
JP (1) JP4300033B2 (en)
AT (1) ATE293920T1 (en)
CA (1) CA2447382C (en)
DE (1) DE60203899T2 (en)
WO (1) WO2002094105A2 (en)

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