Abstract:
A device includes an elongated cannula with an opening positioned at its distal end. A tissue engagement structure is affixed proximate the distal end of the cannula and surrounds the opening. The tissue engagement structure includes a tissue engaging portion to engage and control tissue. An adhesive is dispensed through the cannula opening to repair tissue.

Description:
BACKGROUND 
       [0001]    Following surgery on an internal structure of the body, a surgeon utilizes sutures or other mechanisms to assist in healing the internal structure properly. For example, during septal surgery, a surgeon dissects a portion of the septal lining during the procedure. Once the surgery is complete, the surgeon folds back the septal lining to its original location. In order to heal properly, the surgeon applies a suture to the septal lining and septum in order for the septal lining to heal in place. Attaching a suture within an interior cavity of the patient can be difficult using current approaches, as a surgeon handles both an endoscope and tools to install the suture. 
       SUMMARY 
       [0002]    A method of stabilizing and repairing tissue includes providing a device having a tissue engagement structure surrounding an opening of an elongated cannula. The cannula extends from a proximal end to a distal end and defines a lumen. The device is positioned within a cavity that includes a first tissue structure and a second tissue structure at least partially separated from the first tissue structure. A free end of the second tissue structure is gripped with the tissue engagement structure. The second tissue structure is moved toward the first tissue structure using the tissue engagement structure. An adhesive is dispensed through the opening to the first tissue structure and the second tissue structure. 
         [0003]    A device includes an elongated cannula with an opening positioned at its distal end. A tissue engagement structure is affixed proximate the distal end of the cannula and extends distally beyond the opening. The tissue engagement structure includes a gripping structure to engage and control tissue. An adhesive is dispensed through the opening of the cannula to repair tissue. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0004]      FIGS. 1 and 2  are isometric views of a tissue stabilization and repair device. 
           [0005]      FIG. 3  is a schematic diagram of the device of  FIG. 1  gripping a portion of tissue. 
           [0006]      FIG. 4  is a schematic diagram of the device of  FIG. 1  stabilizing and repairing a portion of tissue. 
       
    
    
     DETAILED DESCRIPTION 
       [0007]      FIGS. 1 and 2  illustrate an isometric view of a tissue stabilization and repair device  10  that includes an elongated cannula  12  and a tissue engagement structure  14 . The cannula  12  extends from a first, proximal end  16  to a second, distal end  18 . The cannula  12  defines an interior lumen  20  extending along the cannula  12  from the proximal end  16  to the distal end  18 . Distal end  18  includes a beveled tip  22  defining an elongated opening  24 . During use, an adhesive (e.g., cyanoacrylate or other fast curing adhesive) is positioned within lumen  20  at the proximal end  16 . The adhesive is then delivered through the lumen  20  to the opening  24 . The proximal end  16  can be configured to receive the adhesive from a suitable adhesive dispenser. For example, the dispenser can be a syringe with a plunger that is connectable to proximal end  16 , wherein the plunger is used to move the adhesive along the lumen  20  to opening  24 . In another example, the dispenser can be a tube filled with adhesive that is connected to proximal end  16  and squeezed to move the adhesive along lumen  20  to opening  24  or the tip end  16  can be integral with the adhesive container. 
         [0008]    Engagement structure  14  assists in stabilizing tissue to be repaired. In particular, the engagement structure  14  extends distally beyond the distal end  18  of the cannula  12  and includes a base portion  30 , a distal tissue engagement portion  32  and opposed legs  34  and  36  extending from the base portion  30  and positioned on one or either side of cannula  12 . Base portion  30  is generally planar and configured to engage and stabilize a portion of tissue while adhesive is applied through opening  24  to a portion of tissue to be repaired. Legs  34  and  36  are coupled to cannula  12  and, in one embodiment, allow for relative movement between the tissue engagement portion  32  and cannula  12 . For example, the legs  34  and  36  can be formed with sufficient flexibility to deflect with respect to the tissue engagement portion  32  such that cannula  12  rotates with respect to the tissue engagement portion  32  when a force is applied to the tissue engagement portion  32 . In another example, cannula  12  can be rotatably coupled to legs  34  and  36  to rotate relative thereto when a force is applied to tissue engagement portion  32 . 
         [0009]    Tissue engaging portion  32  includes one or more teeth extending from the base portion  30  and is positioned spaced apart from the distal end  18  and opening  24  of cannula  12 . In particular, the base portion  30  is positioned between the opening  24  and the distal engagement portion  32 , the distal engagement portion  32  positioned at an end of the base portion  30  opposite the proximal end  16  of the cannula  12 . The distal engagement portion  32  can extend from base portion  30  at various angles, for example, at least 45 degrees, at least 60 degrees, at least 90 degrees, greater than 90 degrees, etc. Illustratively, distal engagement portion  32  includes a first tooth  40 , a second tooth  42  and a third tooth  44 . The second tooth  42  is positioned between the first tooth  40  and third tooth  44  and is illustrated as having a larger surface area than either tooth  40  or tooth  44 . It will be appreciated that any number of teeth (e.g., at least one, three, five) can be provided that extend from the base portion to assist in engaging tissue. Additionally, the teeth can be different sizes as desired. 
         [0010]    As illustrated in  FIGS. 3 and 4 , during a method of tissue stabilization and repair, device  10  is inserted into a cavity  60  (e.g., a sinus cavity) including a first tissue structure  62  (e.g., a septal wall) and a second tissue structure  64  (e.g., a septal lining) at least partially separated from the first tissue structure  62 . In the embodiment illustrated, the second tissue structure  64  is fixed to the first tissue structure  62  at a first end  66  and free from the first tissue structure  62  at a second end  68 . To repair separation of the second tissue structure  64  from the first tissue structure  62 , the distal engagement portion  32  engages the second tissue structure  64  (e.g., at the second end  68 ) and moves the second tissue structure  64  to engage the first tissue structure  62 . In particular, second end  68  is brought into contact or in close proximity to the first tissue structure  62  as illustrated in  FIG. 4 . 
         [0011]    Once device  10  has positioned second tissue structure  64  into place, a force (i.e., pressure, indicated by arrow P) can be applied to device  10  to push second tissue structure  64  against first tissue structure  62 . In one embodiment, the pressure causes cannula  12  to flex with respect to tissue engagement portion  32 . For example, the pressure can cause legs  34  and  36 , along with distal end  18  of cannula  12 , to rotate with respect to the tissue engagement portion  32 . Alternatively, or in addition to, distal end  18  can be rotatably coupled to legs  34  and  36  to facilitate flexing of the cannula  12  with respect to the tissue engagement portion  32 . In one embodiment, flexing of the cannula  12  rotates beveled tip  22  such that the beveled tip  22  is orientated substantially parallel to the first tissue structure  62 . Regardless of the orientation of beveled tip  22  with respect to the first tissue structure  62 , an adhesive  70  can be dispensed through opening  24 . The adhesive  70  is dispensed to adhere the second tissue structure  64  to the first tissue structure  62 . After the adhesive  70  is dispensed, device  10  can be removed from cavity  60 , allowing the adhesive  70  to cure in order to adhere the second tissue structure  64  to the first tissue structure  62 . Alternatively, the pressure to first tissue structure  62  can be applied while adhesive  70  cures sufficiently to hold the first tissue structure  62  and second tissue structure  64  together. 
         [0012]    Although the present disclosure has been described with reference to preferred embodiments, workers skilled in the art will recognize that changes can be made in form and detail without departing from the spirit and scope of the present disclosure.