Endoscopic tissue approximation system and methods
Inventors
Mitelberg, Vladimir • Jones, Donald K. • Szymczak, Brian
Assignees
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Publication Number
US-12167844-B2
Publication Date
2024-12-17
Expiration Date
Abstract
A cinch deployment system includes a delivery system and a releasable cinch including an inner tubular, a compressible gripper having a suture passage, the gripper positioned within the inner tubular housing, and a resilient structure biased to compress the gripper to reduce the size of the suture passage. The resilient structure has a first configuration in which the resilient structure is constrained from applying sufficient compression to the gripper to prevent movement of the gripper on the suture, and a second configuration in which sufficient compression is applied to secure the gripper on the suture. The resilient structure is moved from the first to the second configuration by movement of the retainer moved by the deployment system.
Core Innovation
The invention describes an endoscopic tissue approximation system for securing tissue in a mammal using a delivery system that deploys helical suture anchors into GI tissue. The deployed anchors include a rotatable, tethered suture eyelet coupled to a helical coil with a sharpened tip, and the system further includes a suture that joins multiple anchors and a cinch for approximating tissue by tensioning the suture.
The helical suture anchors include a removable engagement receptacle/post connection for selective rotation, retraction, repositioning, and release. The system provides deployment pattern options for forming an array of anchors, including zig-zag, purse-string, and defect-spanning patterns. Tissue approximation is achieved by tensioning the suture that is connected to the deployed anchors.
The cinch includes coaxially mated inner and outer housings that provide relative motion to transition between securing and release functions. A compressible gripper is biased by a leaf-spring-based resilient structure to lock the suture frictionally when the resilient structure applies compression to reduce a suture passage, and after locking, the system cuts the suture using a suture cutting edge through relative rotation of the outer housing.
Claims Coverage
The document provides two independent claims describing an endoscopic cinch with a compressible gripper and a configuration-switched resilient structure, and an endoscopic cinch deployment system that uses a delivery mechanism to move a retainer relative to the resilient structure to control cinching and prevent relative movement of the suture and cinch. Across these independent claims, the core inventive subject matter includes configuration-selective compression to secure a suture via an inner tubular housing and a compressible gripper, with controlled switching by a retainer and, in the deployment system, delivery system actuation using flexible components.
Configuration-switched compression cinch gripper in inner tubular housing
An inner tubular housing having proximal and distal ends, a compressible gripper positioned within the inner tubular housing and having a suture passage extending therethrough for receipt and passage of the suture, and a resilient structure biased towards the compressible gripper to compress the compressible gripper to reduce the size of the suture passage, where the resilient structure has a first configuration constrained from applying sufficient compression to prevent movement of the compressible gripper on the suture, and a second configuration applying compression sufficient to secure the compressible gripper on the suture.
Retainer-controlled switching of resilient compression via flexible control member
A cinch deployment system including a delivery system sized and adapted for passage through an endoscope instrument channel, having a flexible tubular member and a flexible control member longitudinally displaceable relative to the flexible tubular member and having a retainer at a distal end, wherein the retainer is positioned relative to the resilient structure to retain the resilient structure in a position preventing compressing the compressible gripper by an amount that would prevent relative movement of the suture and the cinch, and where the delivery system is operable to move the flexible control member relative to the flexible tubular member to displace the retainer relative to the resilient structure so the resilient structure compresses the compressible gripper by an amount that results in preventing relative movement of the suture and the cinch.
Overall, claim coverage centers on an endoscopic cinch that secures a suture by switching the resilient structure between a constrained first configuration and an active second configuration to control compression of a compressible gripper within an inner tubular housing, and on a cinch deployment system that uses a flexible delivery mechanism with a retainer to switch the resilient structure position to achieve secure cinching and prevent relative movement of the suture and cinch.
Stated Advantages
Deployment through a standard endoscope working channel without endoscope modification or increased distal diameter.
Documented Applications
Endoscopic procedure for approximating and securing tissue within a mammalian body, including securing a suture at a site within a mammal and cinching a suture during an endoscopic procedure.
Endoscopic deployment of helical suture anchors into GI tissue using the described endoscopic tissue approximation system.
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