Method of endoscopic suturing

Patent metadata

Field	Value
Publication number	US-10799232-B2
Application number	US-201213650507-A
Country	US
Kind code	B2
Filing date	Oct 12, 2012
Priority date	Jun 17, 2008
Publication date	Oct 13, 2020
Grant date	Oct 13, 2020

Abstract

An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

First claim

What is claimed is:

1. A method of suturing tissue of a mammal using an endoscopic suturing system, comprising the follow steps:
(a) inserting an endoscope into a body with a suturing device coupled to the endoscope, the endoscope having an instrument channel extending therethrough;
(b) opening a needle arm of the suturing device having a removable needle removably coupled to the needle arm;
(c) drawing tissue at a desired suture site between the needle and a distal end of the endoscope;
(d) closing the needle arm of the suturing device such that the needle axially aligns with the instrument channel of the endoscope;
(e) piercing the tissue with the needle;
(f) recovering the needle within the distal end of the endoscope by using a needle capture device extended through the instrument channel of the endoscope;
(g) opening the needle arm to disengage the needle arm relative to the needle;
(h) closing the needle arm; and
(i) removing the suturing device from the body.

2. A method according to claim 1 , further comprising:
after step (b) and before step (c), engaging a tissue adjacent a desired suture site using a tissue grasper; and
after step (g) and before step (h), releasing the tissue from the tissue grasper.

3. A method according to claim 1 , further comprising:
(j) after step (h) and before step (i), inserting the needle into the needle arm endoscopically using the needle capture device; and
repeating steps (b) through (h) and (j) as needed.

4. A method according to claim 1 , wherein:
the needle arm is rigid.

5. A method according to claim 1 , wherein:
the needle arm is rigid,
the instrument channel opens at a distal end face of the endoscope, and
the needle arm extends through a predefined plane intersecting the distal end face of the endoscope.

6. A method of suturing tissue of a mammal using an endoscopic suturing system, comprising the follow steps:
(a) inserting a guide tube into a body;
(b) inserting a suturing device coupled to an endoscope into the guide tube and inserting the suturing device into the body;
(c) opening a needle holding arm of the suturing device having a removable needle clip;
(d) engaging a tissue adjacent a desired suture site using a tissue grasper;
(e) pushing the needle clip against tissue at a desired suture site;
(f) closing the needle holding arm of the suturing device such that the needle clip pierces the tissue and the needle clip axially aligns with an instrument channel of the endoscope;
(g) grasping the needle clip using a needle capture device extended through the instrument channel of the endoscope;
(h) opening the needle holding arm to remove it from tissue;
(i) releasing the needle clip from the needle capture device;
(j) releasing the tissue from the tissue grasper;
(k) closing the needle holding arm; and
(l) removing the suturing device from the body.

7. A method according to claim 6 , wherein:
the tissue grasper includes a helical coil with a sharp distal tip that is rotated into the tissue to engage the tissue.

8. A method according to claim 7 , wherein:
the suturing device is removed from the body while the needle arm is closed.

9. A method according to claim 6 , wherein:
said engaging tissue includes rotating the tissue grasper relative to the tissue.

10. A method according to claim 6 , further comprising:
after opening the needle arm, releasing the tissue grasper from the tissue.

11. A method according to claim 10 , wherein:
said releasing includes rotating the tissue grasper relative to the tissue.

12. A method according to claim 6 , wherein:
the needle holding arm is rigid.

13. A method of suturing tissue of a mammal using an endoscopic suturing system, comprising the follow steps:
(a) inserting an endoscope into a body with a suturing device coupled to the endoscope, the endoscope having an instrument channel;
(b) rotating open a rigid needle arm of the suturing device having a removable needle with a length of suture fixed thereto;
(c) engaging a tissue adjacent a desired suture site using a tissue grasper;
(d) drawing the engaged tissue into the path of the needle;
(e) rotating the rigid needle arm of the suturing device to cause the needle to pierce the tissue;
(f) engaging the needle with a needle capture device passed through the endoscope;
(g) recovering the needle with the needle capture device within the instrument channel;
(h) rotating open the rigid needle arm;
(i) closing the rigid needle arm; and
(j) removing the suturing device from the body.

14. A method according to claim 13 , wherein:
the tissue grasper includes a helical coil with a sharp distal tip that is rotated into the tissue to engage the tissue.

15. A method according to claim 13 , wherein:
said engaging tissue includes rotating the tissue grasper relative to the tissue.

16. A method according to claim 13 , further comprising:
after opening the needle arm, releasing the tissue grasper from the tissue.

17. A method according to claim 16 , wherein:
said releasing includes rotating the tissue grasper relative to the tissue.

18. A method according to claim 13 , wherein:
the suturing device is removed from the body while the needle arm is closed in a closed position.

19. A method according to claim 13 , wherein:
the instrument channel opens at a distal end face of the endoscope, and
the needle arm rotates in a path extending through a predefined plane intersecting the instrument channel.

20. A method of suturing tissue of a mammal using an endoscopic suturing system, comprising the following steps:
(a) inserting an endoscope into a body with a suturing device coupled at a distal end of the endoscope, the endoscope having an instrument channel that opens at a distal end face of the endoscope, the suturing device having a rigid needle arm and a needle removably coupled thereto, the needle arm rotatable through a predefined plane intersecting the instrument channel of the endoscope;
(b) rotating the needle arm of the suturing device into an open position to define a space between the needle and distal end of the endoscope;
(c) positioning tissue within the space between the needle in the open position and the distal end of the endoscope;
(d) rotating the needle arm into a closed position and toward the distal end of the endoscope in order to pierce the tissue with the needle;
(e) positioning the needle in alignment with the instrument channel of the endoscope;
(f) mechanically engaging the needle with an instrument extending through the instrument channel of the endoscope; and
(g) opening the needle arm to disengage the needle arm relative to the needle.

21. A method according to claim 20 , wherein:
a length of suture is fixed to the needle and extends through an instrument channel of the endoscope.

22. A method according to claim 20 , wherein:
the needle is recovered within the distal end of the endoscope using an instrument that is longitudinally displaceable within and removable from the endoscope.

23. A method according to claim 20 , further comprising:
after step (g), removing the disengaged needle arm from tissue.

24. A method according to claim 20 , further comprising:
after step (g), rotating the needle arm into a closed position, and removing the suturing device from the body with the needle arm in the closed position.

Assignees

• Apollo Endosurgery Inc
• Apollo Endosurgery Us Inc

Inventors

• Gilkey J Landon
• Naglreiter Brett E
• Kratsch Peter K
• Jones Donald K
• Mitelberg Vladimir

Classifications

• A61B1/018

  for receiving instruments · CPC title

• A61B2017/2912

  transmission of forces to actuating rod or piston · CPC title

• A61B2017/0649

  Coils or spirals · CPC title

• A61B2017/06047

  located at the middle of the needle · CPC title

• A61B2017/0608

  J-shaped · CPC title