Source: http://www.google.fr/patents/US8277468
Timestamp: 2017-10-20 08:37:42
Document Index: 556625256

Matched Legal Cases: ['art 732', 'art 732', 'art 732', 'art 732', 'art 732', 'art 732', 'Application No. 07075291', 'Application No. 2006']

Brevet US8277468 - Tissue reconfiguration - Google Brevets
A medical instrument for engaging tissue includes a flexible shaft, a tissue piercing coil at a distal portion of the shaft, and a tissue stabilizer positioned over the shaft and biased in a distal direction such that as the tissue piercing coil enters tissue, the tissue stabilizer is urged against a...http://www.google.fr/patents/US8277468?utm_source=gb-gplus-shareBrevet US8277468 - Tissue reconfiguration
Numéro de publication US8277468 B2
Numéro de demande US 12/953,625
Autre référence de publication US6821285, US7713277, US7722633, US7857823, US20020040226, US20040193117, US20040193193, US20040193194, US20040194790, US20110068143
Numéro de publication 12953625, 953625, US 8277468 B2, US 8277468B2, US-B2-8277468, US8277468 B2, US8277468B2
Inventeurs Michael D. Laufer, Jeffrey C. Cerier, Amos G. Cruz, Jonathan O'Keefe, Richard Andrews, Ram Chuttani, Vincent A. Piucci, Jr., Michael Barenboym, Neal H. Marshall, Randal B. Chinnock
Citations de brevets (390), Citations hors brevets (97), Référencé par (9), Classifications (57), Événements juridiques (1)
US 8277468 B2
an elongate member having a body disposed on a distal portion thereof, the body having first and second arms extending distally therefrom and defining a space therebetween;
a tissue retrieving mechanism having a helical piercing member configured to move relative to the first and second arms to retrieve a portion of tissue to be reconfigured and position the retrieved portion of tissue in the space between the first and second arms; and
a fastener configured to secure the retrieved portion of tissue positioned in the space between the first and second arms to thereby reconfigure the portion of tissue.
2. The device of claim 1, wherein at least one of the first and second arms is configured to be movable relative to the other to grasp tissue therebetween.
3. The device of claim 1, wherein the first and second arms are in a fixed non-movable position.
4. The device of claim 2, wherein the first and second arms are opposed pivotable jaws that are movable between an open position and a closed position.
5. The device of claim 1, wherein the helical piercing member is configured to retrieve a portion of tissue from inside a stomach.
6. The device of claim 1, wherein the fastener includes at least one of a suture, and a bar having one or more holes.
7. The device of claim 1, wherein a tissue penetrating tip extends from the first arm and is configured to extend into the space and penetrate the retrieved portion of tissue when the retrieved portion of tissue is positioned between the first and second arms.
8. The device of claim 1, wherein the first arm is configured to pivot relative to the body.
9. A device for tissue reconfiguration, comprising:
an elongate member having first and second members positioned at a distal portion thereof and configured to be positioned substantially parallel to each other to receive tissue therebetween;
a tissue retrieving element having a tissue piercing element formed thereon, the tissue retrieving element being configured to be movable relative to the first and second members to pierce tissue and move the pierced tissue proximally relative to the first and second members to position the tissue between the first and second members; and
a fastener coupled to at least one of the first and second members, the fastener being configured to secure the tissue positioned between the first and second members, wherein a tissue penetrating tip extends from the first member and is configured to move toward the second member to penetrate tissue positioned between the first and second members.
10. The device of claim 9, wherein the tissue piercing element comprises a helical piercing element.
11. The device of claim 9, wherein at least one of the first and second members is configured to be positioned at an angle relative to the other to receive tissue therebetween.
12. The device of claim 9, wherein the tissue retrieving element is configured to retrieve tissue from inside a stomach.
13. The device of claim 9, wherein the fastener includes at least one of a suture, and a bar having one or more holes.
14. The device of claim 9, wherein the fastener is coupled to the first member and is configured to move toward the second member with the first member.
This application is a continuation of U.S. application Ser. No. 10/819,996, filed Apr. 8, 2004, which is a continuation of U.S. application Ser. No. 09/859,579, filed May 18, 2001, which is a continuation-in-part of U.S. application Ser. No. 09/574,424, filed May 19, 2000, which is a continuation-in-part of U.S. application Ser. No. 09/520,273, filed Mar. 7, 2000, and U.S. application Ser. No. 09/519,945, filed Mar. 7, 2000, which claim priority from U.S. application Ser. No. 60/140,492, filed Jun. 22, 1999, all hereby incorporated by reference in their entirety.
FIG. 6A is an illustration of a first part of the tissue fixation device of FIG. 2; FIG. 6B is an illustration of the first jaw member with the first part of the tissue fixation device mounted to the jaw member;
FIG. 13B is a cross-sectional view of the torque generator of FIG. 13A; FIG. 14A is an illustration of an alternative tissue engaging member;
FIG. 42 is an illustration of a tissue fixation device for use with the end effector of FIGS. 41;
First part 732 of tissue fixation device 730 is shown in more detail in FIGS. 6A and 6B. First part 732 of tissue fixation device 730 defines through holes 820 a, 820 b (FIG. 6A), and part 732 is loaded onto jaw 720 with tips 818 a, 818 b received in through holes 820 a, 820 b, respectively. Connected to part 732 with a suture 822 are two securing elements, e.g., bars 824 a,824 b. Each bar 824 a, 824 b defines two through holes 826 a, 826 b. Suture 822 is threaded through holes 826 a, 826 b of the bars and through holes 820 a, 820 b of part 732, and is tied together forming a knot 823 to secure bars 824 a, 824 b to part 732. Tubes 818 a, 818 b each define a channel 827 for receiving one of bars 824 a, 824 b, and a slot 828 communicating with channel 827 for receiving suture 822 therethrough.
For example, rather than a coil 740, alternative tissue penetrating or grasping elements such as a T -bar suture or two small grasping jaws can be employed. Instrument 700 can be used without the third tissue engaging member.
Referring to FIG. 12A, in an alternative embodiment, a third tissue engagement member 740′ includes a tissue-engaging coil 860 with a tissue piercing end 860 a, a helical drive shaft 862, and a coupling member 864 for translating a torque applied by drive shaft 862 to coil 860. Helical drive shaft 862 is preferably wound in a direction opposite that of tissue engaging coil 860, for reasons described below. Positioned over and axially movable relative to coupling member 864 is a sprung sheath 866. Tissue engagement member 740′ can be used alone or can replace tissue engagement member 740 of FIG. 1. Coil 860 has, e.g., six loops with a pitch of 1 mm from loop-to-loop and a diameter of 2 mm. Other configurations can be used, e.g., one loop and greater with the number of loops times the pitch corresponding to the desired penetration depth into the tissue.
Referring to FIG. 12B, in which tissue engagement member 740′ is shown without spring sheath 866, coupling member 864 includes a first, distal-most section 864 a with a diameter, DI; a second section 864 b with a diameter D2 larger than D1; a third section 864 c with a diameter D3 between DI and D2; a fourth section 864 d with a diameter D4 about equal to D2; a fifth section 864 e with a diameter D5 larger than D4; and a proximal-most section 864 f having a diameter D6 about equal to D1. Diameters D1-D6 are, for example, about 0.04″, 0.09″, 0.06″, 0.09″, 0.12″ and 0.04″, respectively. Defined between sections 864 a and 864 b is a shelf 867 a; defined between sections 864 b and 864 c is a shelf 867 b; defined between sections 864 c and 864 d is a shelf 867 c; defined between sections 864 d and 864 e is a shelf 867 d; and defined between sections 864 e and 864 f is a shelf 867 e. Drive shaft 862 is received over coupling member section 864 f and coil 860 is received over coupling member section 864 a. Drive shaft 862 and coil 869 are attached to coupling member 864 by, for example, soldering. Coil 860 has a coil length, L, of, for example, about 0.25″, extending beyond the distal end 868 of section 864 a. Positioned on coupling member section 864 c between shelves 867 b and 867 c is a spring 870 that biases sprung sheath 866 distally.
Referring to FIG. 32, in an alternative embodiment, tubes 1120′ include a pair of radially opposed slots 1132 that impart flexibility to end 1133 of the tube to aid in release of the bars from the tubes. Bars 824′ can include a pair of guide nubs 1134 received in slots 1132 to radially orients bars 824′ relative to tubes 1120′. Referring to FIG. 33, bars 824″ include a bump or undercut 1136 that determine the force needed to remove the bars from the tubes. The tubes can be formed from plastic and molded as an integral component of the cartridges, and the bars can be insert molded into the tubes. Referring to FIG. 34, bars 824″ are connected to tubes 1120″ by a weak area 1137 of decreased diameter that breaks upon application of lateral force to bars 824′.
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Classification internationale A61B17/115, A61B17/068, A61B17/08, A61B17/064, A61M25/01, A61B17/28, A61B17/06, A61B17/128, A61B17/00, A61B17/04
Classification coopérative A61B2017/00314, A61B2017/0474, A61B2017/00557, A61B2017/06052, A61B2017/00349, A61B2017/0458, A61B2017/2905, A61B17/0467, A61B2017/0417, A61B2017/0441, A61B2017/2927, A61B2090/065, A61B2017/0419, A61M25/0147, A61B2017/0496, A61B2017/308, A61B17/0482, A61B17/1285, A61B17/0485, A61B2017/2932, A61B17/00234, A61B17/0401, A61B2017/0472, A61B17/0643, A61B2017/2916, A61B2017/0404, A61B17/29, A61B17/068, A61B17/0057, A61B2017/2917, A61B2017/0409, A61B2017/00827, A61B2017/00296, A61B17/0686, A61B17/0218, A61B2017/061, A61B2017/0475, A61B2017/0464, A61B2017/2915
Classification européenne A61B17/068, A61B17/04A, A61B17/064C, A61B17/00P, A61B17/068B4, A61B17/04G