US20100137885A1 - Method And Apparatus For Endoscopically Performing Gastric Reduction Surgery In A Single Pass - Google Patents

Method And Apparatus For Endoscopically Performing Gastric Reduction Surgery In A Single Pass Download PDF

Info

Publication number
US20100137885A1
US20100137885A1 US12/699,077 US69907710A US2010137885A1 US 20100137885 A1 US20100137885 A1 US 20100137885A1 US 69907710 A US69907710 A US 69907710A US 2010137885 A1 US2010137885 A1 US 2010137885A1
Authority
US
United States
Prior art keywords
fastener
gastric reduction
reduction apparatus
cavity
stomach
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.)
Abandoned
Application number
US12/699,077
Inventor
Mark S. Ortiz
Michael J. Stokes
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.)
Ethicon Endo Surgery Inc
Original Assignee
Ethicon Endo Surgery Inc
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
Priority to US11/206,297 priority Critical patent/US7771440B2/en
Application filed by Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Priority to US12/699,077 priority patent/US20100137885A1/en
Assigned to ETHICON ENDO-SURGERY, INC. reassignment ETHICON ENDO-SURGERY, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: ORTIZ, MARK S., STOKES, MICHAEL J.
Publication of US20100137885A1 publication Critical patent/US20100137885A1/en
Application status is Abandoned legal-status Critical

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/0682Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
    • A61B17/0684Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying above the tissue during stapling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/0003Apparatus for the treatment of obesity; Anti-eating devices
    • A61F5/0013Implantable devices or invasive measures
    • A61F5/0083Reducing the size of the stomach, e.g. gastroplasty
    • A61F5/0086Reducing the size of the stomach, e.g. gastroplasty using clamps, folding means or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064Surgical staples, i.e. penetrating the tissue
    • A61B17/0644Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00296Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B2017/0496Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2901Details of shaft
    • A61B2017/2905Details of shaft flexible
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30Surgical pincettes without pivotal connections
    • A61B2017/306Surgical pincettes without pivotal connections holding by means of suction

Abstract

A gastric reduction apparatus provides for the secure attachment of multiple fasteners into the gastric wall, the fasteners being linked with a flexible member in a manner permitting the reduction of the effective size of an individual's stomach. The apparatus includes an applicator head including a proximal end and a distal end. The applicator head of the gastric reduction apparatus includes a cavity shaped and dimensioned for receiving tissue. A fastener attachment mechanism is positioned within the cavity for access to tissue that is pulled within the cavity and the fastener attachment mechanism includes a plurality of fasteners.

Description

    REFERENCE TO RELATED APPLICATIONS
  • This continuation application claims the benefit of U.S. patent application Ser. No. 11/206,297 entitled: “Method and Apparatus For Endoscopically Performing Gastric Reduction Surgery In a Single Pass”, filed on Aug. 18, 2005.
  • BACKGROUND OF THE INVENTION
  • 1. Field of the Invention
  • The present invention relates to gastric reduction surgery. More particularly, the invention relates to a method and apparatus for endoscopically performing gastric reduction surgery in a single pass.
  • 2. Description of the Prior Art
  • Morbid obesity is a serious medical condition. In fact, morbid obesity has become highly pervasive in the United States, as well as other countries, and the trend appears to be heading in a negative direction. Complications associated with morbid obesity include hypertension, diabetes, coronary artery disease, stroke, congestive heart failure, multiple orthopedic problems and pulmonary insufficiency with markedly decreased life expectancy. With this in mind, and as those skilled in the art will certainly appreciate, the monetary and physical costs associated with morbid obesity are substantial. In fact, it is estimated the costs relating to obesity are in excess of 100 billion dollars in the United States alone.
  • A variety of surgical procedures have been developed to treat obesity. Currently, the most commonly performed procedure is Roux-en-Y gastric bypass (RYGB). This operation is highly complex and is commonly utilized to treat people exhibiting morbid obesity. More than 100,000 procedures are performed annually in the United States alone. Other forms of bariatric surgery include Fobi pouch, bilio-pancreatic diversion, and gastroplastic or “stomach stapling”. In addition, implantable devices are known which limit the passage of food through the stomach and affect satiety.
  • RYGB involves movement of the jejunum to a high position using a Roux-en-Y loop. The stomach is completely divided into two unequal portions (a smaller upper portion and a larger lower gastric pouch) using an automatic stapling device. The upper pouch typically measures less than about 1 ounce (or 20 cc), while the larger lower pouch remains generally intact and continues to secrete stomach juices flowing through the intestinal track.
  • A segment of the small intestine is then brought from the lower abdomen and joined with the upper pouch to form an anastomosis created through a half-inch opening, also called the stoma. This segment of the small intestine is called the “Roux loop” and carries the food from the upper pouch to the remainder of the intestines, where the food is digested. The remaining lower pouch, and the attached segment of duodenum, are then reconnected to form another anastomotic connection to the Roux loop at a location approximately 50 to 150 cm from the stoma, typically using a stapling instrument. It is at this connection that the digestive juices from the bypass stomach, pancreas, and liver, enter the jejunum and ileum to aid in the digestion of food. Due to the small size of the upper pouch, patients are forced to eat at a slower rate and are satiated much more quickly. This results in a reduction in caloric intake.
  • The conventional RYGB procedure requires a great deal of operative time. Because of the degree of invasiveness, post-operative recovery time can be quite lengthy and painful.
  • In view of the highly invasive nature of the current RYGB procedure, other less invasive procedures have been developed. One commonly employed gastric reduction procedure is vertical gastroplasty. This procedure is achieved by applying a series of sutures to create an incomplete horizontal line defining a small fundic pouch for restriction of food ingestion. This procedure is commonly performed laparoscopically and as such also requires substantial preoperative, operative, postoperative resources.
  • With the foregoing in mind, procedures that allow for the performance of gastric reduction surgery in a time efficient and patient friendly manner are needed. The present invention provides such a method and an associated apparatus.
  • SUMMARY OF THE INVENTION
  • It is, therefore, an object of the present invention to provide a gastric reduction apparatus which provides for the secure attachment of multiple fasteners into the gastric wall, the fasteners being linked with a flexible member in a manner permitting the reduction of the effective size of an individual's stomach. The apparatus includes an applicator head having a proximal end and a distal end. The applicator head of the gastric reduction apparatus includes a cavity shaped and dimensioned for receiving tissue. A fastener attachment mechanism is positioned within the cavity for access to tissue that is pulled within the cavity, the fastener attachment mechanism includes a plurality of fasteners.
  • It is also an object of the present invention to provide a method for gastric reduction surgery. The method is achieved by first inserting a gastric reduction apparatus as discussed above within the stomach. The gastric reduction apparatus is then positioned such that the opening of the cavity is adjacent a predetermined portion of the stomach wall. A vacuum is then created within the cavity drawing predetermined tissue of the stomach wall within the cavity and the fastener attachment mechanism is actuated to secure the fastener within the tissue of the stomach.
  • Other objects and advantages of the present invention will become apparent from the following detailed description when viewed in conjunction with the accompanying drawings, which set forth certain embodiments of the invention.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a perspective view of the present gastric reduction apparatus.
  • FIG. 2 is a detailed view showing the present gastric reduction apparatus.
  • FIG. 3 is a side cross-sectional view of the present gastric reduction apparatus.
  • FIGS. 4, 5, 6, 7 and 8 show the application of fasteners and the formation of a stomach cavity in accordance with the present invention.
  • FIG. 9 is a perspective view of an alternate embodiment in accordance with the present invention.
  • FIG. 10 is a detailed view of the gastric reduction apparatus in accordance with the embodiment shown with reference to FIG. 9.
  • FIGS. 11, 12 and 13 show the steps involved in the application of fasteners in accordance with the present invention.
  • FIG. 14 is a perspective view showing the details of the links making up the embodiment disclosed with reference to FIG. 9.
  • FIGS. 15, 16, 17, 18 and 19 disclose an alternate fastener attachment mechanism in accordance with the present invention.
  • DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • The detailed embodiment of the present invention is disclosed herein. It should be understood, however, that the disclosed embodiment is merely exemplary of the invention, which may be embodied in various forms. Therefore, the details disclosed herein are not to be interpreted as limiting, but merely as the basis for the claims and as a basis for teaching one skilled in the art how to make and/or use the invention.
  • With reference to FIGS. 1 to 8, a first embodiment of an apparatus 10 and method for gastric reduction surgery is disclosed. In accordance with the invention, a gastric reduction apparatus 10 is provided which facilitates the secure attachment of multiple fasteners 12, for example, surgical staplers, into the gastric wall 14. The fasteners 12 are linked with a flexible member 16, for example, a suture, in a manner permitting the reduction of the effective size of an individual's stomach. The apparatus 10 is particularly designed for providing an improved mechanism for performing vertical gastroplasty type procedures. While the present apparatus and method have been developed with certain gastroplasty procedures in mind, the underlying concepts may be applied to a variety of temporary or permanent gastroplasty procedures.
  • The gastric reduction apparatus 10 is shaped and dimensioned for selective attachment to the distal end 18 of a traditional endoscopic flexible gastroscope 20. The gastric reduction apparatus 10 is manipulated utilizing cabling and suction available via the gastroscope 20 so as to position the gastric reduction apparatus 10 at a desired orientation within the stomach 22. Although the present invention is adapted for attachment to the distal end of a gastroscope, the present invention could be constructed with its own shaft without departing from the spirit of the present invention.
  • In particular, the gastric reduction apparatus 10 includes a proximal end 24 and a distal end 26. The proximal end 24 is shaped and dimensioned for secure attachment to the distal end 18 of the gastroscope 20. In accordance with a preferred embodiment, the proximal end 24 is secured to the gastroscope 20 using conventional coupling elements, for example, a spring clamp or elastic sleeve, which those skilled in the art will fully appreciate.
  • The distal end 26 of the gastric reduction apparatus 10 includes an applicator head having a cavity 28 shaped and dimensioned for receiving tissue 54 in a manner discussed below in greater detail. The cavity 28 is substantially bell-shaped providing a wide opening 30 for receiving tissue 54 for the purpose of securing fasteners 12 thereto while the tissue 54 is pulled within the cavity 28.
  • A fastener attachment mechanism 32 is positioned within the cavity 28 for access to tissue 54 that is pulled within the cavity 28. The fastener attachment mechanism 32 includes a plurality of fasteners 12, a hook 34 and an anvil 36. The hook 34 includes a first end 38 and a second end 40. The first end 38 of the hook 34 is shaped and dimensioned for grabbing the uppermost fastener 12 supported by the fastener attachment mechanism 32 and drawing it against the anvil 36 to close the fastener 12 in a configuration coupling the fastener 12 to the tissue 54 drawn within the cavity 28.
  • A leaf spring 55 serves to advance additional fasteners 12 into the ready to fire position. As the fastener attachment mechanism 32 is actuated in the manner described below, fasteners 12 are successively secured to tissue 54 drawn within the cavity 28 and each of the fasteners 12 positioned in a stack are biased toward the firing area by the leaf spring 55. When the firing area is empty, the bias of the leaf spring 55 loads the uppermost fastener 12 in the stack into the ready to fire zone, which is then ready for attachment to tissue in accordance with the principles of the present invention.
  • The second end 40 of the hook 34 is coupled to a firing mechanism 42 extending through the gastroscope 20. The firing mechanism 42 generally includes a cable, rod or bar 44, which extends through the gastroscope 20 to the hook 34. As such, the hook 34 is manipulated from the proximal end 46 of the gastroscope 20 via the cable 44. Manipulation of the hook 34 via the cable 44 allows the hook 34 to draw the fasteners 12 into contact with the anvil 36 in a manner discussed below in greater detail.
  • The firing mechanism 42 includes a lever 50 that actuates the cable 44 for drawing the hook 34 proximally in a controlled manner. More particular, the cable 44 extending through the gastroscope 20 links the hook 34 to the lever 50 which includes a handle 52 that may be actuated by a user of the present apparatus 10. By actuating the lever 50 via the handle 52, the cable 44 is moved axially drawing the hook 34 rearwardly toward the anvil 36. The rearward movement of the hook 34 draws a fastener 12 into contact with the anvil 36 in a manner that closes the fastener 12 upon the stomach tissue 54. After the lever 50 and cable 44 are moved axially, forcing the hook 34 proximally and causing the fastener 12 to form about the anvil 36, the handle 52, lever 50, cable 44 and hook 34 are returned to their initial positions via a spring bias or reverse movement of the handle 52. The fastener stack is then advanced as described previously to load the next fastener in firing apparatus.
  • An alternate fastener attachment mechanism 232 is disclosed with reference to FIGS. 15, 16, 17, 18 and 19. These figures specifically focus upon the fastener attachment mechanism 232 and do not show the cavity discussed above with reference to the previously disclosed embodiment, although those skilled in the art will appreciate the cavity is substantially identical to that disclosed with reference to FIGS. 1 to 8. The fastener attachment mechanism 232 includes a plurality of fasteners 212, a fastener press 234 and an anvil 236. The fastener press 234 includes a first end 238 and a second end 240. The first end 238 of the fastener press 234 includes a substantially U-shaped recess 239 which is slightly smaller than the fasteners 212 in a manner which functions to close the fasteners 212 as the first end 238 of the fastener press 234 is pushed toward the anvil 236 during actuation of the fastener attachment mechanism 232.
  • The forward tip 241 of the U-shaped recess 239 is shaped and dimensioned to receive the lowermost fastener 212 supported by the fastener attachment mechanism 232 and pushing it against the anvil 236 to close the fastener 212 in a configuration coupling the fastener 212 to the tissue drawn within the cavity.
  • As the fasteners 212 are sequentially fired and used, a leaf spring 255 serves to contain and advance additional fasteners 212 into the ready to fire position. The leaf spring 255 includes a lower surface 256 with a guide protrusion 257 forcing the fasteners 212 downwardly and forwardly for sequential engagement with the forward tip 241 of the U-shaped recess 239. As the fasteners 212 are used and the fastener press 234 is retracted to its ready position, the downward bias of the spring 255 loads the lowest fastener 212 in the stack into the ready to fire zone at the forward tip 241 of the U-shaped recess 239.
  • More particularly, the fastener press 234 is moved between a retracted position adapted for receiving the lowermost fastener 212 from the fastener stack and a fired position in engagement with the anvil 236. When in the retracted position, the lowermost fastener 212 is forced downward to a position adjacent the forward tip 241 of the U-shaped recess 239. Once the fastener 212 is positioned, the fastener press 234 is moved forward toward the anvil 236. This causes the fastener 212 to bend in a desired configuration. Thereafter, the fastener press 234 is retracted for receiving a new fastener 212 and the process is repeated. Controlled movement of the fastener press 234 relative to the anvil 236 is achieved by the provision of guide arms 243 which extend outwardly from the fastener press and about the support arm 245 of the anvil 236.
  • The second end 240 of the fastener press 234 is coupled to a firing mechanism 242 extending within the gastroscope 220. The firing mechanism 242 generally includes a linkage assembly 244 which controls the movement of the first end 238 of the fastener press 234 between its retracted position and fired position. The linkage assembly 244 generally includes an actuation lever 246 pivotally linked to a control arm 248, which is in turn pivotally linked to the second end 240 of fastener press 234. The movement of the components of the linkage assembly 244 is controlled by guides formed in the body of the handle 250 positioned at the proximal end 252 of the gastrscope 220 in a manner those skilled in the art will certainly appreciate. Control of the firing mechanism 242 is further facilitated by a lock bar 254 which interacts with the fastener press 234 to prevent actuation thereof.
  • Returning to the disclosure of the cavity 28 and the retention of tissue 54 therein, tissue 54 is drawn within the cavity 28 via a vacuum. More specifically, the internal space defined by the cavity 28 is in fluid communication with a vacuum line 56 extending through the gastroscope 20. In this way, one may selectively create a vacuum of sufficient strength within the cavity 28 to draw the gastric tissue 54 within the cavity 28.
  • In practice, the gastric reduction apparatus 10 is moved within the stomach 22 and positioned such that the opening 30 of the cavity 28 is adjacent a predetermined portion of the stomach wall 14. A vacuum is then created within the cavity 28, drawing the predetermined tissue 54 of the stomach 22 within the cavity 28.
  • Once the tissue 54 is fully drawn within the cavity 28, the hook 34 is actuated via the firing mechanism 42 to draw the uppermost fastener 12 off the fastener platen delivery mechanism 58. The firing mechanism 42 is then actuated to draw the cable 44 toward the proximal end 46 of the gastroscope 20, pulling the hook 34 away from the tissue 54 and into contact with the anvil 36 of the fastener attachment mechanism 32. This closes the opposite sides of the fastener 12 into the stomach tissue, securing the fastener 12 within the tissue 54 of the stomach 22.
  • In accordance with a preferred embodiment of the present invention, the fasteners are metal, plastic or other biocompatible materials determined to be appropriate for use in the practice of the present invention. In order to induce tissue overgrowth and thus reinforcement of the resultant line, a mesh or buttress material may be fastened between the stomach wall and the staple. This would have the net effect of distributing some of the loading over the mesh and ensuring that if one fastener were to come loose, the integrity of the entire line would not be compromised.
  • The process is repeated at a variety of predetermined stomach wall 14 locations. In accordance with a preferred embodiment of the present invention, the fasteners 12 are applied vertically along the stomach 22 creating a fastener arrangement necessary to ultimately form a mattress stitch pattern. The exact direction in which the fasteners are applied is not critical, and medical practitioners may apply the fasteners in a direction and order which best suits the specific patient. That is, the fasteners 12 are applied to the stomach wall 14 alternating between the anterior wall and posterior wall of the stomach 22 as the gastric reduction apparatus 10 is moved distally to proximally.
  • The flexible member 16 (for example, suture, ribbon) is prestrung through a connection aperture 60 within the fastener 12 and connected to the fasteners 12. The flexible member 16 is strung to create a mattress stitch pattern within the stomach 22 in a substantially vertical direction extending distally and proximally within the stomach 22. Once all of the fasteners 12 are placed along the stomach wall 14 and the flexible member 16 is strung through the connection apertures 60 of the fasteners 12 in a mattress stitch pattern, the flexible member 16 may be pulled taut to bring the gastric walls 14 into approximation with each other. Although a mattress stitch pattern is disclosed in accordance with a preferred embodiment of the present invention, other stitch patterns may be employed without departing from the spirit of the present invention.
  • The resulting structure of the stomach 22 is that of a tubular member connecting the esophagus to the pylorus with the gastric remnant allowed to pass gastric acid into the food stream. This produces a smaller stomach volume as well as a restrictive means for the bolus. In an alternative embodiment, the resulting structure may be that of a tubular member starting substantially at the esophagus and extending some distance toward the pylorus.
  • Although use of the present apparatus is disclosed with reference to the embodiment of FIGS. 1 to 8, those skilled in the art will appreciate the procedure described herein applies equally to the embodiment described with reference to FIGS. 15 to 19.
  • In accordance with an alternate embodiment, and with reference to FIGS. 9 to 14, the gastric reduction apparatus 110 includes its own integral shaft 162. With this in mind, the gastric reduction apparatus 110 in accordance with an alternate embodiment of the present invention includes an elongated shaft 162 having a distal end 164 and a proximal end 166. The proximal end 166 includes access to the various control mechanisms described below while the applicator head 168 is secured to the distal end 164 of the elongated shaft 162.
  • As with the embodiment described above with reference to FIGS. 1 to 8, the applicator head 168 includes a proximal end 124 and a distal end 126. The proximal end 124 is shaped and dimensioned for secure attachment to the elongated shaft 162 of the gastric reduction apparatus 110. The distal end 126 of the applicator head 168 includes a cavity 128 shaped and dimensioned for receiving tissue 154 in a manner discussed below in greater detail. The cavity 128 is substantially bell-shaped providing a wide opening 130 for receiving tissue 154 for the purpose of securing fasteners 112 thereto while the tissue 154 is pulled within the cavity 128.
  • A fastener attachment mechanism 132 is positioned within the cavity 128 for access to tissue 154, which is pulled within the cavity 128. The fastener attachment mechanism 132 includes a plurality of fasteners 112, a hook 134 and an anvil 136. The hook 134 includes a first end 138 and a second end 140. The first end 138 of the hook 134 is shaped and dimensioned for grabbing the uppermost fastener 112 supported by the fastener attachment mechanism 132 and drawing it against the anvil 136 to close the fastener 112 in a configuration coupling the fastener 112 to the tissue 154 drawn within the cavity 128.
  • The second end 140 of the hook 134 is coupled to a firing mechanism 142 extending through the elongated shaft 162. The firing mechanism 142 generally includes a cable 144, which extends through the elongated shaft 162 to the hook 134. As such, the hook 134 may be manipulated from the proximal end 166 of the elongated shaft 162 via the cable 144. The cable 144 links the hook 134 to an actuating switch 150 at the handle 152 of the apparatus 110 such that it may be selectively actuated by a user of the present apparatus 110. As the actuating switch 150 is drawn rearwardly, the cable 144 and the hook 134 are simultaneously drawn rearwardly. The rearward movement of the hook 134 draws the fastener 112 mounted upon the hook 134 into contact with the anvil 136 in a manner that closes the fastener 112 upon the stomach tissue 154.
  • As with the prior embodiment, tissue 154 is drawn within the cavity 128 via a vacuum. The internal space defined by the cavity 128 is in fluid communication with a vacuum line 156 extending through the elongated shaft 162. In this way, one may create a vacuum within the cavity 128 of sufficient strength to draw gastric tissue 154 within the cavity 128.
  • As briefly mentioned above, and in accordance with a preferred embodiment of the present invention, the applicator head 168 of the gastric reduction apparatus 110 is mounted at the distal end of the elongated shaft 162 which is composed of a selectively rigidized track 170. However, and as those skilled in the art will certainly appreciate, the applicator head may be mounted in other ways without departing from the spirit of the present invention.
  • As will be discussed below in greater detail with reference to FIG. 14, the track 170 is comprised of a series of links 176 which are all disposed on a common cable 172. In the relaxed condition, the links 176 are loosely associated with each other and the assembly can easily flex for movement around corners. When the cable 172 extending through the track 170 is tensioned, the links 176 lock together the mating features on the links causing the assembly to assume a straight configuration. The rigidized track 170 serves as a guide for the applicator head 168. By controlling the rigidity of the track 170 via a tensioning cable 172 extending between the distal and proximal ends 164, 166 of the track 170, the cable tension is selectively increased and decreased under the control of an actuating switch 174 located on the handle 152 of the present apparatus 110. The track 170 may also be selectively rotated via a pivotal connection between the track 170 and the handle 152.
  • With the foregoing in mind, the applicator head 168 may be rotated at a set angle to each side of the boundary between the anterior and posterior walls 114 a, 114 b of the stomach 122. As the applicator head 168 is moved down the rigidized track, a very repeatable zigzag pattern is established. The applicator head 168 moves down the track 170, swiveling from side to side, attaching a suture to the posterior, then anterior sides in succession. The track 170 serves to linearize the line of suturing. The rigidized track 170 helps the applicator head 168 to fire at a fixed distance from the axis of the track 170, which is the axis around which the applicator head 168 swivels.
  • In accordance with a preferred embodiment, the rigidized track 170 is composed of a plurality of linked track elements 176 having locking faces 178 along respective mating ends. The relative position of the track elements 176 is controlled by a tensioning cable 172 extending between the proximal and distal ends 166, 164 of the rigidized track 170. Relative flexing of the track elements 176 is achieved by providing the track elements 176 with locking faces 178 that permit flexing when the cable 172 tension is released and a rigid configuration when the cable 172 is tensioned.
  • In accordance with an additional feature of this embodiment, the angular displacement of the applicator head 168 to each side may be adjusted and set for each patient so as to provide some adaptability for various patient stomach sizes. Up to a limit of 180°, a wider-angle set point would result in a smaller pouch than a narrower angle set. This is because the flexible member 116 would be applied a further distance apart, allowing for more cinching. A very narrow angle set would result in a larger pouch. The axial translation of the present embodiment may be set by detents in the firing handle or on the rigidized track to standardize the longitudinal spacing of the suture angles. Closer spacing of the suture angles would result in less longitudinal shrinkage of the pouch then would be produced if greater spacing were applied.
  • As with the embodiment described above with reference to FIGS. 9 to 14, the gastric reduction apparatus is employed in the following manner. In practice, the applicator head 168 of the gastric reduction apparatus 110 is moved within the stomach 122 and positioned such that the opening130 of the cavity 128 is adjacent a predetermined portion of the stomach wall 114. A vacuum is then created within the cavity 128, drawing the predetermined tissue 154 of the stomach wall 114 within the cavity.
  • Once the tissue 154 is fully drawn within the cavity 128, the hook 134 is actuated via the firing mechanism 142 to draw the uppermost fastener 112 off the fastener platen delivery mechanism 158. The firing mechanism 142 is then actuated to draw the cable 144 toward the proximal end 166 of the elongated shaft 162 and pull the hook 134 away from the tissue 154 and into contact with the anvil 136 of the fastener attachment mechanism 132. This closes the opposite sides of the fastener 112 into the stomach wall 114, securing the fastener 112 within the tissue 154 of the stomach wall 114.
  • The process is repeated at a variety of predetermined stomach wall locations moving the applicator head 168 anteriorly and posteriorly under the control of the rigidized track 170. In accordance with a preferred embodiment of the present invention, the fasteners 112 are applied vertically along the stomach 122 creating a fastener arrangement necessary to ultimately form a mattress stitch pattern. That is, the fasteners 112 are applied to the stomach wall 114 alternating between the anterior walls 114 a and posterior walls 114 b of the stomach 122 as the gastric reduction apparatus 110 is moved distally to proximally.
  • As with embodiment disclosed above, the flexible member 116 is prestrung through connection apertures 160 within the respective fastener 112, and connected to, the fasteners 112. As a result, a mattress stitch pattern is created within the stomach 122 in a substantially vertical direction extending distally and proximally within the stomach 122. Once all of the fasteners 112 are placed along the stomach wall 114 and the flexible member 116 is strung within the fasteners 112 in a mattress stitch pattern, the flexible member 116 may be pulled taut to bring the gastric walls 114 into approximation with each other.
  • Although a preferred firing mechanism is disclosed above, it is contemplated that advances in technology may permit the firing mechanism to be positioned adjacent the fastener application mechanism. This will allow for the greater transmission of force to the fastener application mechanism without requiring the force be transmitted along the endoscope. More particularly, electroactive polymer technology may be employed adjacent the distal end of the fastener application mechanism to draw the hook within the anvil for closing the fasteners.
  • Electroactive polymers are essentially capacitors, with thin conductive sheets, most recently, carbon fiber composites laminated onto a polymer core. A very low voltage, in the neighborhood of 1.5 to 3.3 volts is induced across the electrodes. This draws the electrodes together, causing deformation of the polymer between the electrodes. The effect causes a change in the shape of a polymer much in the same way that a human muscle works. The end result is an expansion of the polymer in one direction and a contraction in the perpendicular direction. When one employs many sheets stacked together an additive forced generation is achieved. It is this contraction that results in a tensile load on any structure to which the electroactive polymer bundle is attached.
  • It is contemplated such an embodiment would be implemented by using the electroactive polymers to connect the hook and the anvil. The anvil would serve as a mechanical ground to which the electroactive polymer strip is attached. As a voltage is placed across the electroactive polymer laminate structure, the contraction of the strip in the device longitudinal direction would pull the hook back proximally, causing the staple to close due to the interaction with the anvil.
  • In creating optimum strength it is important that the sheet be very thin (20 microns) to optimize the output force. The result of stacking these sheets results in high force output “motors” with an available power density of 200 kg/cm̂2, approximately 100 times the power density of a human muscle. Given the availability of this power source in accordance with an alternate embodiment, the electroactive polymers may be utilized to deliver a load at the needed position within the fastener attachment mechanism without dissipating fastening energy along components of the gastroscope as the cable transmits force from the handle to the applicator head. Implementation of the electroactive polymers will greatly simplify the design requirements of the present apparatus. In addition, the reduced shaft load will allow for the production of a less costly gastric reduction apparatus.
  • It is further contemplated that glues may be used to enhance the seal created in accordance with the present apparatus The glue would be a fibrin based glue such as is commercially available from companies such as Ethicon Inc. Such a glue would be applied separately from this device along the line just prior to cinching down the line. The presence of the glue would reduce tension on the line during the critical two week healing process and lengthen the effective duration of the line.
  • While the preferred embodiments have been shown and described, it will be understood that there is no intent to limit the invention by such disclosure, but rather, is intended to cover all modifications and alternate constructions falling within the spirit and scope of the invention.

Claims (26)

1. A gastric reduction apparatus which provides for the secure attachment of multiple fasteners into the gastric wall, the fasteners being linked with a flexible member in a manner permitting the reduction of the effective size of an individual's stomach, comprising:
an applicator head including a proximal end and a distal end;
the applicator head of the gastric reduction apparatus includes a cavity shaped and dimensioned for receiving tissue;
a fastener attachment mechanism is positioned within the cavity for access to tissue that is pulled within the cavity, the fastener attachment mechanism includes at least one fastener.
2. The gastric reduction apparatus according to claim 1, wherein the proximal end is shaped and dimensioned for secure attachment to a distal end of a gastroscope.
3. The gastric reduction apparatus according to claim 1, wherein the cavity is substantially bell-shaped providing a wide opening for receiving tissue for the purpose of securing fasteners thereto while the tissue is pulled within the cavity.
4. The gastric reduction apparatus according to claim 1, wherein the fastener attachment mechanism includes a firing mechanism composed of electroactive polymers.
5. The gastric reduction apparatus according to claim 1, wherein a fastener attachment mechanism includes a hook and an anvil.
6. The gastric reduction apparatus according to claim 5, wherein the hook includes a first end and a second end, the first end of the hook is shaped and dimensioned for grabbing an uppermost fastener supported by the fastener attachment mechanism and drawing it against the anvil to close the fastener in a configuration coupling the fastener to the tissue drawn within the cavity.
7. The gastric reduction apparatus according to claim 6, wherein the second end of the hook is coupled to a firing mechanism.
8. The gastric reduction apparatus according to claim 7, wherein the firing mechanism includes a cable, bar, or rod that extends to the hook allowing the hook to be manipulated.
9. The gastric reduction apparatus according to claim 7, wherein the firing mechanism further includes a mechanism, which draws the hook proximally in a controlled manner.
10. The gastric reduction apparatus according to claim 1, wherein internal space defined by the cavity is in fluid communication with a vacuum line.
11. The gastric reduction apparatus according to claim 1, wherein the apparatus includes an elongated shaft which runs down along the side of a gastroscope, the shaft includes a proximal end and a distal end, the proximal end including access to control mechanisms of the fastener attachment mechanism and the applicator head is secured to the distal end of the elongated shaft.
12. The gastric reduction apparatus according to claim 11, wherein the elongated shaft is composed of a selectively rigidized track.
13. The gastric reduction apparatus according to claim 12, wherein the track is composed of a plurality of links disposed on a common cable.
14. The gastric reduction apparatus according to claim 13, wherein the links are loosely associated with each other and controlled via a tensioning cable extending between the distal end and proximal end of the track.
15. The gastric reduction apparatus according to claim 13, wherein the track is rotatable via a pivotal connection between the track and a handle.
16. The gastric reduction apparatus according to claim 13, wherein the plurality of links have locking faces along respective mating ends.
17. The gastric reduction apparatus according to claim 1, wherein the fastener attachment mechanism includes a fastener press and anvil wherein the fastener press receives a fastener and then moves the fastener into contact with the anvil.
18. The gastric reduction apparatus according to claim 17, wherein the fastener attachment mechanism further includes a linkage assembly for moving the fastener press between a retracted position and fired position.
19. A method for gastric reduction surgery, comprising the following steps:
inserting a gastric reduction apparatus within the stomach, the gastric reduction apparatus including an applicator head having a proximal end and a distal end, the applicator head of the gastric reduction apparatus includes a cavity shaped and dimensioned for receiving tissue, a fastener attachment mechanism is positioned within the cavity for access to tissue that is pulled within the cavity, the fastener attachment mechanism includes a plurality of fasteners;
positioning the gastric reduction apparatus such that the opening of the cavity is adjacent a predetermined portion of the stomach wall;
creating a vacuum within the cavity, drawing predetermined tissue of the stomach wall within the cavity;
actuating the fastener attachment mechanism to secure the fastener within the tissue of the stomach.
20. The method according to claim 19, wherein the process is repeated at a variety of predetermined stomach wall locations.
21. The method according to claim 19, wherein the fasteners are applied vertically along the stomach.
22. The method according to claim 21, wherein the fasteners are applied vertically along the stomach creating a fastener arrangement necessary to ultimately form a suturing pattern.
23. The method according to claim 19, wherein the fasteners are applied to the stomach wall alternating between the anterior wall and posterior wall of the stomach.
24. The method according to claim 19, wherein a flexible member is prestrung to the fasteners.
25. The method according to claim 24, wherein the flexible member is strung to create a stitch pattern within the stomach.
26. The method according to claim 24, wherein the flexible member is strung to create a stitch pattern within the stomach in a substantially vertical direction extending distally and proximally within the stomach.
US12/699,077 2005-08-18 2010-02-03 Method And Apparatus For Endoscopically Performing Gastric Reduction Surgery In A Single Pass Abandoned US20100137885A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US11/206,297 US7771440B2 (en) 2005-08-18 2005-08-18 Method and apparatus for endoscopically performing gastric reduction surgery in a single pass
US12/699,077 US20100137885A1 (en) 2005-08-18 2010-02-03 Method And Apparatus For Endoscopically Performing Gastric Reduction Surgery In A Single Pass

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US12/699,077 US20100137885A1 (en) 2005-08-18 2010-02-03 Method And Apparatus For Endoscopically Performing Gastric Reduction Surgery In A Single Pass
US13/343,035 US20120118935A1 (en) 2005-08-18 2012-01-04 Method and apparatus for endoscopically performing gastric reduction surgery in a single pass

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US11/206,297 Continuation US7771440B2 (en) 2005-08-18 2005-08-18 Method and apparatus for endoscopically performing gastric reduction surgery in a single pass

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US13/343,035 Continuation US20120118935A1 (en) 2005-08-18 2012-01-04 Method and apparatus for endoscopically performing gastric reduction surgery in a single pass

Publications (1)

Publication Number Publication Date
US20100137885A1 true US20100137885A1 (en) 2010-06-03

Family

ID=37488046

Family Applications (3)

Application Number Title Priority Date Filing Date
US11/206,297 Active 2028-12-11 US7771440B2 (en) 2005-08-18 2005-08-18 Method and apparatus for endoscopically performing gastric reduction surgery in a single pass
US12/699,077 Abandoned US20100137885A1 (en) 2005-08-18 2010-02-03 Method And Apparatus For Endoscopically Performing Gastric Reduction Surgery In A Single Pass
US13/343,035 Abandoned US20120118935A1 (en) 2005-08-18 2012-01-04 Method and apparatus for endoscopically performing gastric reduction surgery in a single pass

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US11/206,297 Active 2028-12-11 US7771440B2 (en) 2005-08-18 2005-08-18 Method and apparatus for endoscopically performing gastric reduction surgery in a single pass

Family Applications After (1)

Application Number Title Priority Date Filing Date
US13/343,035 Abandoned US20120118935A1 (en) 2005-08-18 2012-01-04 Method and apparatus for endoscopically performing gastric reduction surgery in a single pass

Country Status (7)

Country Link
US (3) US7771440B2 (en)
EP (1) EP1754444A3 (en)
JP (1) JP5000233B2 (en)
CN (1) CN1931102B (en)
AU (1) AU2006203408A1 (en)
BR (1) BRPI0603381A (en)
CA (1) CA2556304A1 (en)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8172857B2 (en) 2004-08-27 2012-05-08 Davol, Inc. Endoscopic tissue apposition device and method of use
US8388632B2 (en) 2000-05-19 2013-03-05 C.R. Bard, Inc. Tissue capturing and suturing device and method
US9375218B2 (en) 2006-05-03 2016-06-28 Datascope Corp. Systems and methods of tissue closure

Families Citing this family (94)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101810521B (en) 2001-08-27 2015-05-13 辛尼科有限责任公司 Satiation devices and methods
US7146984B2 (en) 2002-04-08 2006-12-12 Synecor, Llc Method and apparatus for modifying the exit orifice of a satiation pouch
US6675809B2 (en) 2001-08-27 2004-01-13 Richard S. Stack Satiation devices and methods
US7097665B2 (en) 2003-01-16 2006-08-29 Synecor, Llc Positioning tools and methods for implanting medical devices
US20040143342A1 (en) 2003-01-16 2004-07-22 Stack Richard S. Satiation pouches and methods of use
US8206456B2 (en) 2003-10-10 2012-06-26 Barosense, Inc. Restrictive and/or obstructive implant system for inducing weight loss
US20050247320A1 (en) * 2003-10-10 2005-11-10 Stack Richard S Devices and methods for retaining a gastro-esophageal implant
WO2005105003A1 (en) 2004-04-26 2005-11-10 Synecor, Llc Restrictive and/or obstructive implant for inducing weight loss
US20090125040A1 (en) * 2006-09-13 2009-05-14 Hambly Pablo R Tissue acquisition devices and methods
US9055942B2 (en) 2005-10-03 2015-06-16 Boston Scienctific Scimed, Inc. Endoscopic plication devices and methods
US20070191871A1 (en) * 2006-02-10 2007-08-16 Endogastric Solutions, Inc. Transesophageal gastric reduction method and device for reducing the size of a previously formed gastric reduction pouch
US20170014132A9 (en) * 2006-02-10 2017-01-19 Steve G. Baker Transesophageal gastric reduction method and device for reducing the size of a previously formed gastric reduction pouch
EP2572673B1 (en) 2006-09-02 2015-08-19 Boston Scientific Scimed, Inc. Intestinal sleeves and associated deployment systems and methods
WO2008033474A2 (en) * 2006-09-15 2008-03-20 Synecor, Llc System for anchoring stomach implant
EP2129301A4 (en) 2007-03-13 2015-03-25 Peter S Harris Methods and devices for reducing gastric volume
US8500777B2 (en) * 2007-03-13 2013-08-06 Longevity Surgical, Inc. Methods for approximation and fastening of soft tissue
US8979872B2 (en) * 2007-03-13 2015-03-17 Longevity Surgical, Inc. Devices for engaging, approximating and fastening tissue
US20080294179A1 (en) * 2007-05-12 2008-11-27 Balbierz Daniel J Devices and methods for stomach partitioning
US20090030284A1 (en) * 2007-07-18 2009-01-29 David Cole Overtube introducer for use in endoscopic bariatric surgery
CA2696993C (en) 2007-07-18 2017-01-03 Samuel T. Crews Endoscopic implant system and method
US20090171383A1 (en) 2007-12-31 2009-07-02 David Cole Gastric space occupier systems and methods of use
EP2257227A4 (en) * 2008-03-14 2014-03-26 Safestitch Medical Inc Hernia stapler with integrated mesh manipulator
US8870049B2 (en) 2008-03-14 2014-10-28 Transenterix, Inc. Hernia stapler
US8020741B2 (en) 2008-03-18 2011-09-20 Barosense, Inc. Endoscopic stapling devices and methods
US8523040B2 (en) * 2008-05-01 2013-09-03 Ethicon Endo-Surgery, Inc. Fastener and fastener applier having selective suture attachment
US8231042B2 (en) 2008-11-06 2012-07-31 Tyco Healthcare Group Lp Surgical stapler
US7934631B2 (en) 2008-11-10 2011-05-03 Barosense, Inc. Multi-fire stapling systems and methods for delivering arrays of staples
US20100191332A1 (en) 2009-01-08 2010-07-29 Euteneuer Charles L Implantable Tendon Protection Systems and Related Kits and Methods
US9179910B2 (en) 2009-03-20 2015-11-10 Rotation Medical, Inc. Medical device delivery system and method
US8281974B2 (en) 2009-01-14 2012-10-09 Tyco Healthcare, Group LP Surgical stapler with suture locator
US20100276469A1 (en) * 2009-05-01 2010-11-04 Barosense, Inc. Plication tagging device and method
US8961539B2 (en) 2009-05-04 2015-02-24 Boston Scientific Scimed, Inc. Endoscopic implant system and method
WO2010141906A1 (en) 2009-06-04 2010-12-09 Rotation Medical, Inc. Methods and apparatus for deploying sheet-like materials
US8763878B2 (en) 2009-06-04 2014-07-01 Rotation Medical, Inc. Methods and apparatus having bowstring-like staple delivery to a target tissue
US8146790B2 (en) 2009-07-11 2012-04-03 Tyco Healthcare Group Lp Surgical instrument with safety mechanism
FR2948273B1 (en) * 2009-07-22 2011-07-15 Jean Claude Sgro A device for suturing anatomical tissues including walls of blood vessels and gastrointestinal tract
US8322590B2 (en) 2009-10-28 2012-12-04 Covidien Lp Surgical stapling instrument
US8430292B2 (en) 2009-10-28 2013-04-30 Covidien Lp Surgical fastening apparatus
US9198750B2 (en) 2010-03-11 2015-12-01 Rotation Medical, Inc. Tendon repair implant and method of arthroscopic implantation
WO2011146853A2 (en) * 2010-05-21 2011-11-24 Barosense, Inc. Tissue-acquisition and fastening devices and methods
WO2012112565A2 (en) 2011-02-15 2012-08-23 Rotation Medical, Inc. Methods and apparatus for delivering and positioning sheet-like materials
WO2012145059A1 (en) 2011-02-15 2012-10-26 Rotation Medical, Inc. Methods and apparatus for fixing sheet-like materials to a target tissue
CN102218167B (en) * 2011-06-14 2013-12-18 深圳市安保科技有限公司 Visual gastric lavage machine
US8708212B2 (en) 2011-10-18 2014-04-29 Covidien Lp Tilt top anvil with torsion spring
US9016547B2 (en) 2011-10-26 2015-04-28 Covidien Lp EEA tilt top anvil with ratchet/locking mechanism
AU2012355433B2 (en) 2011-12-19 2016-10-20 Rotation Medical, Inc. Apparatus and method for forming pilot holes in bone and delivering fasteners therein for retaining an implant
US9107661B2 (en) 2011-12-19 2015-08-18 Rotation Medical, Inc. Fasteners and fastener delivery devices for affixing sheet-like materials to bone or tissue
WO2013119321A1 (en) 2011-12-19 2013-08-15 Rotation Medical, Inc. Fasteners for affixing sheet -like materials to bone or tissue
US9271726B2 (en) 2011-12-19 2016-03-01 Rotation Medical, Inc. Fasteners and fastener delivery devices for affixing sheet-like materials to bone or tissue
WO2013101641A2 (en) 2011-12-29 2013-07-04 Rotation Medical, Inc. Anatomical location markers and methods of use in positioning sheet-like materials during surgery
WO2013101640A1 (en) 2011-12-29 2013-07-04 Rotation Medical, Inc. Guidewire having a distal fixation member for delivering and positioning sheet-like materials in surgery
AU2012362671B2 (en) 2011-12-29 2017-07-06 Rotation Medical, Inc. Methods and apparatus for delivering and positioning sheet -like materials in surgery
US9010605B2 (en) 2012-01-12 2015-04-21 Covidien Lp Sliding sleeve for circular stapling instrument reloads
US9022274B2 (en) 2012-02-15 2015-05-05 Covidien Lp Circular stapler with increased lumen diameter
US9364228B2 (en) * 2012-05-11 2016-06-14 Ethicon, Llc Applicator instruments having distal end caps for facilitating the accurate placement of surgical fasteners during open repair procedures
US8518055B1 (en) 2012-05-11 2013-08-27 Ethicon, Inc. Applicator instruments for dispensing surgical fasteners during open repair procedures
US20130303845A1 (en) * 2012-05-11 2013-11-14 Ethicon, Inc. Applicator instruments with imaging systems for dispensing surgical fasteners during open repair procedures
US9351734B2 (en) 2012-06-19 2016-05-31 Covidien Lp Spring loaded anvil retainer
US10213205B2 (en) 2012-07-06 2019-02-26 Covidien Lp T-slot tilt anvil for circular stapling instrument
US9675359B2 (en) 2012-10-10 2017-06-13 Covidien Lp Surgical instrument with preload assembly
US9572572B2 (en) 2012-11-09 2017-02-21 Covidien Lp Circular stapler mechanical lockout
US9351724B2 (en) 2013-01-11 2016-05-31 Covidien Lp Circular stapling instrument
US9592056B2 (en) 2013-03-14 2017-03-14 Covidien Lp Powered stapling apparatus
US9649109B2 (en) 2013-03-14 2017-05-16 C.R. Bard, Inc. Surgical instrument with an actuation lockout
CN104042292A (en) 2013-03-15 2014-09-17 柯惠Lp公司 Surgical anastomosis device comprising assemblies capable of being repeatedly utilized
US9532780B2 (en) 2013-06-12 2017-01-03 Covidien Lp EEA anvil snap ring activator
US9668740B2 (en) 2013-06-14 2017-06-06 Covidien Lp Anvil assembly with sliding sleeve
US9750503B2 (en) 2013-07-11 2017-09-05 Covidien Lp Methods and devices for performing a surgical anastomosis
US9693773B2 (en) 2013-09-11 2017-07-04 Covidien Lp Anvil assembly with sliding sleeve
US9554802B2 (en) 2013-11-13 2017-01-31 Covidien Lp Anvil assembly with frangible retaining member
US9517070B2 (en) 2013-11-13 2016-12-13 Covidien Lp Anvil assembly and delivery system
WO2015172052A1 (en) 2014-05-09 2015-11-12 Rotation Medical, Inc. Medical implant delivery system for sheet-like implant
US9913643B2 (en) 2014-05-09 2018-03-13 Covidien Lp Interlock assemblies for replaceable loading unit
US9861367B2 (en) 2014-06-24 2018-01-09 Covidien Lp Anvil assembly delivery systems
US9867619B2 (en) 2014-06-24 2018-01-16 Covidien Lp System for delivering an anvil assembly to a surgical site
US9757133B2 (en) 2014-07-09 2017-09-12 Covidien Lp Methods and devices for performing a surgical anastomosis
US10123796B2 (en) 2014-11-04 2018-11-13 Rotation Medical, Inc. Medical implant delivery system and related methods
US10085744B2 (en) 2014-12-08 2018-10-02 Covidien Lp Loading unit attachment band for surgical stapling instrument
US9855045B2 (en) 2014-12-09 2018-01-02 Covidien Lp Anvil assembly delivery system
EP3229703A4 (en) * 2014-12-10 2018-09-05 Edwards Lifesciences AG Multiple-firing securing device and methods for using and manufacturing same
CR20170276A (en) 2014-12-24 2017-09-22 Edwards Lifesciences Corp Deployment device suture clips
US10022126B2 (en) 2015-01-07 2018-07-17 Covidien Lp Loading unit locking collar
US10039549B2 (en) 2015-01-07 2018-08-07 Covidien Lp Loading unit retention clip for surgical stapling instrument
US10117656B2 (en) 2015-01-07 2018-11-06 Covidien Lp Loading unit locking collar
US10159471B2 (en) 2015-05-13 2018-12-25 C.R. Bard, Inc. Actuation lockout for a surgical instrument
US9987001B2 (en) 2015-06-12 2018-06-05 Covidien Lp Surgical anastomosis apparatus
US10111668B2 (en) 2015-07-02 2018-10-30 Covidien Lp Anvil assembly with snap backup ring
US9974536B2 (en) 2015-07-02 2018-05-22 Covidien Lp Anvil assemblies and delivery systems
EP3319527A1 (en) * 2015-07-07 2018-05-16 Mor Research Applications Ltd. Device and method for suturing
US10117655B2 (en) 2015-07-22 2018-11-06 Covidien Lp Loading unit locking band for surgical stapling instrument
US10085756B2 (en) 2015-07-24 2018-10-02 Covidien Lp Anvil assembly and anvil assembly delivery system
US10117675B2 (en) 2015-07-28 2018-11-06 Covidien Lp Trocar tip protector
US9980730B2 (en) 2015-09-21 2018-05-29 Covidien Lp Loading unit locking collar with rotational actuated release
US10111684B2 (en) 2015-09-25 2018-10-30 Covidien Lp Adapter assembly including a removable trocar assembly

Citations (68)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4927428A (en) * 1988-10-07 1990-05-22 Ophthalmic Ventures Limited Partnership Surgical suturing system and probe assembly
US4990153A (en) * 1988-10-07 1991-02-05 Ophthalmic Ventures Limited Partnership Surgical suturing system and probe assembly
US5080663A (en) * 1990-09-26 1992-01-14 Univerity College London Sewing device
US5100419A (en) * 1990-04-17 1992-03-31 Ehlers Robert L Device for removing diverticula in the colon
US5355897A (en) * 1992-04-16 1994-10-18 Ethicon, Inc. Method of performing a pyloroplasty/pylorectomy using a stapler having a shield
US5376101A (en) * 1992-10-09 1994-12-27 The United States Surgical Corporation Suture retaining clip
US5383880A (en) * 1992-01-17 1995-01-24 Ethicon, Inc. Endoscopic surgical system with sensing means
US5389102A (en) * 1990-09-13 1995-02-14 United States Surgical Corporation Apparatus and method for subcuticular stapling of body tissue
US5437681A (en) * 1994-01-13 1995-08-01 Suturtek Inc. Suturing instrument with thread management
US5462558A (en) * 1994-08-29 1995-10-31 United States Surgical Corporation Suture clip applier
US5514159A (en) * 1994-09-13 1996-05-07 United States Surgical Corporation Guillotine suture clip
US5540705A (en) * 1995-05-19 1996-07-30 Suturtek, Inc. Suturing instrument with thread management
US5571119A (en) * 1993-10-25 1996-11-05 Children's Medical Center Corporation Retractable suture needle with self-contained driver
US5624453A (en) * 1993-02-23 1997-04-29 Wilson-Cook Medical, Inc. Endoscopic ligating instrument
US5709693A (en) * 1996-02-20 1998-01-20 Cardiothoracic System, Inc. Stitcher
US5713910A (en) * 1992-09-04 1998-02-03 Laurus Medical Corporation Needle guidance system for endoscopic suture device
US5814071A (en) * 1994-11-10 1998-09-29 Innovasive Devices, Inc. Suture anchor assembly and methods
US5853416A (en) * 1997-06-04 1998-12-29 Boston Scientific Corporation Distal end for ligating band dispenser
US6010450A (en) * 1998-06-29 2000-01-04 Welch Allyn, Inc. Measuring adapter for viewing instrument
US6036694A (en) * 1998-08-03 2000-03-14 Innovasive Devices, Inc. Self-tensioning soft tissue fixation device and method
US6059719A (en) * 1997-08-06 2000-05-09 Olympus Optical Co., Ltd. Endoscope system
US6126058A (en) * 1998-06-19 2000-10-03 Scimed Life Systems, Inc. Method and device for full thickness resectioning of an organ
US6264086B1 (en) * 1994-12-07 2001-07-24 Mcguckin, Jr. James F. Surgical apparatus and method
US20010023352A1 (en) * 1992-09-04 2001-09-20 Gordon Norman S. Suturing instruments and methods of use
US6346111B1 (en) * 1992-09-04 2002-02-12 Scimed Life Systems, Inc. Suturing instruments and methods of use
US6352503B1 (en) * 1998-07-17 2002-03-05 Olympus Optical Co., Ltd. Endoscopic surgery apparatus
US20020107531A1 (en) * 2001-02-06 2002-08-08 Schreck Stefan G. Method and system for tissue repair using dual catheters
US20020107530A1 (en) * 2001-02-02 2002-08-08 Sauer Jude S. System for endoscopic suturing
US6443962B1 (en) * 1997-09-11 2002-09-03 Benny Gaber Stitching tool
US6454778B2 (en) * 1998-03-20 2002-09-24 Scimed Life Systems, Inc. Endoscopic suture systems
US20020147447A1 (en) * 2001-03-30 2002-10-10 Long Gary L. Endoscopic ablation system with improved electrode geometry
US6494888B1 (en) * 1999-06-22 2002-12-17 Ndo Surgical, Inc. Tissue reconfiguration
US6506196B1 (en) * 1999-06-22 2003-01-14 Ndo Surgical, Inc. Device and method for correction of a painful body defect
US6544271B1 (en) * 2000-07-18 2003-04-08 Scimed Life Systems, Inc. Device for full-thickness resectioning of an organ
US20030083674A1 (en) * 2001-10-04 2003-05-01 Gibbens George H. Cycling suturing and knot-tying device
US6558400B2 (en) * 2001-05-30 2003-05-06 Satiety, Inc. Obesity treatment tools and methods
US6572629B2 (en) * 2000-08-17 2003-06-03 Johns Hopkins University Gastric reduction endoscopy
US20030120289A1 (en) * 2001-12-20 2003-06-26 Mcguckin James F Apparatus and method for treating gastroesophageal reflux disease
US20030171760A1 (en) * 2000-05-19 2003-09-11 Gambale Richard A Tissue capturing and suturing device and method
US20030181924A1 (en) * 2002-01-30 2003-09-25 Olympus Optical Co., Ltd. Endoscopic suturing system
US6656194B1 (en) * 2002-11-05 2003-12-02 Satiety, Inc. Magnetic anchoring devices
US6663639B1 (en) * 1999-06-22 2003-12-16 Ndo Surgical, Inc. Methods and devices for tissue reconfiguration
US20030233104A1 (en) * 2002-06-12 2003-12-18 Scimed Life Systems, Inc. Suturing instrument with deflectable head
US20040006351A1 (en) * 2002-07-02 2004-01-08 Jamy Gannoe Method and device for use in tissue approximation and fixation
US6689130B2 (en) * 2001-06-04 2004-02-10 Olympus Corporation Treatment apparatus for endoscope
US20040034369A1 (en) * 2001-02-02 2004-02-19 Sauer Jude S. System for endoscopic suturing
US20040044354A1 (en) * 2002-08-30 2004-03-04 Satiety, Inc. Methods and devices for maintaining a space occupying device in a relatively fixed location within a stomach
US6719763B2 (en) * 2000-09-29 2004-04-13 Olympus Optical Co., Ltd. Endoscopic suturing device
US6719764B1 (en) * 2001-08-24 2004-04-13 Scimed Life Systems, Inc. Forward deploying suturing device and methods of use
US20040082963A1 (en) * 2002-10-23 2004-04-29 Jamy Gannoe Method and device for use in endoscopic organ procedures
US6746460B2 (en) * 2002-08-07 2004-06-08 Satiety, Inc. Intra-gastric fastening devices
US20040122473A1 (en) * 2002-12-11 2004-06-24 Ewers Richard C. Delivery systems and methods for gastric reduction
US6755843B2 (en) * 2000-09-29 2004-06-29 Olympus Optical Co., Ltd. Endoscopic suturing device
US20040138682A1 (en) * 2002-07-11 2004-07-15 Olympus Optical Co., Ltd. Endoscopic suture apparatus
US20040147958A1 (en) * 2002-12-11 2004-07-29 Usgi Medical Apparatus and methods for forming and securing gastrointestinal tissue folds
US20040147941A1 (en) * 2002-01-30 2004-07-29 Olympus Corporation Endoscopic suturing system
US20040162568A1 (en) * 1999-06-25 2004-08-19 Usgi Medical Apparatus and methods for forming and securing gastrointestinal tissue folds
US20040194790A1 (en) * 1999-06-22 2004-10-07 Ndo Surgical, Inc. Tissue reconfiguration
US20040210243A1 (en) * 2003-04-16 2004-10-21 Jamy Gannoe Method and devices for modifying the function of a body organ
US20040260344A1 (en) * 2003-05-07 2004-12-23 Anpa Medical, Inc. Suture lock
US6835200B2 (en) * 1999-06-22 2004-12-28 Ndo Surgical. Inc. Method and devices for tissue reconfiguration
US20050015101A1 (en) * 2001-10-04 2005-01-20 Gibbens George H. Leverage locking reversible cyclic suturing and knot-tying device
US20050055038A1 (en) * 2002-09-09 2005-03-10 Brian Kelleher Device and method for endoluminal therapy
US20050070931A1 (en) * 2003-08-06 2005-03-31 Rhodemann Li Method and apparatus for creating a restriction in the stomach or other anatomical structure
US6908427B2 (en) * 2002-12-30 2005-06-21 PARÉ Surgical, Inc. Flexible endoscope capsule
US6923819B2 (en) * 2001-06-14 2005-08-02 Suturtek Incorporated Apparatus and method for surgical suturing with thread management
US20050192599A1 (en) * 2004-02-13 2005-09-01 Demarais Denise M. Methods for reducing hollow organ volume
US7438208B2 (en) * 2005-01-25 2008-10-21 Entrigue Surgical, Inc. Septal stapler apparatus

Family Cites Families (40)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1327022A (en) 1970-09-02 1973-08-15 Nat Res Dev Tool for applying clips to the skin
US4603693A (en) * 1977-05-26 1986-08-05 United States Surgical Corporation Instrument for circular surgical stapling of hollow body organs and disposable cartridge therefor
GB8422863D0 (en) * 1984-09-11 1984-10-17 Univ London Sewing machine
US4789090A (en) * 1986-11-03 1988-12-06 Blake Joseph W Iii Surgical stapler
CH677728A5 (en) * 1989-10-17 1991-06-28 Bieffe Medital Sa
US5282807A (en) * 1990-11-05 1994-02-01 Knoepfler Dennis J Automatic stapler for laparoscopic procedure with selective cutter, nontraumatic jaws and suction irrigator
US5271543A (en) * 1992-02-07 1993-12-21 Ethicon, Inc. Surgical anastomosis stapling instrument with flexible support shaft and anvil adjusting mechanism
US5242457A (en) * 1992-05-08 1993-09-07 Ethicon, Inc. Surgical instrument and staples for applying purse string sutures
US5306281A (en) * 1992-08-31 1994-04-26 Merrimac Industries, Inc. Suturing cassette device
US5601224A (en) * 1992-10-09 1997-02-11 Ethicon, Inc. Surgical instrument
US5628446A (en) * 1994-05-05 1997-05-13 United States Surgical Corporation Self-contained powered surgical apparatus
CA2197614C (en) * 1996-02-20 2002-07-02 Charles S. Taylor Surgical instruments and procedures for stabilizing the beating heart during coronary artery bypass graft surgery
GB9908098D0 (en) 1999-04-09 1999-06-02 Kabukoba Josaphat J Methods and apparatus for suturing
US7160312B2 (en) * 1999-06-25 2007-01-09 Usgi Medical, Inc. Implantable artificial partition and methods of use
US6527794B1 (en) 1999-08-10 2003-03-04 Ethicon, Inc. Self-locking suture anchor
US7399304B2 (en) * 2000-03-03 2008-07-15 C.R. Bard, Inc. Endoscopic tissue apposition device with multiple suction ports
WO2001089393A1 (en) 2000-05-19 2001-11-29 C.R. Bard, Inc. Tissue capturing and suturing device and method
ES2532327T3 (en) 2000-03-03 2015-03-26 C. R. Bard, Inc. Clip suture
US6592596B1 (en) * 2000-05-10 2003-07-15 Scimed Life Systems, Inc. Devices and related methods for securing a tissue fold
US6702826B2 (en) * 2000-06-23 2004-03-09 Viacor, Inc. Automated annular plication for mitral valve repair
US6755338B2 (en) * 2001-08-29 2004-06-29 Cerebral Vascular Applications, Inc. Medical instrument
US7033373B2 (en) 2000-11-03 2006-04-25 Satiety, Inc. Method and device for use in minimally invasive placement of space-occupying intragastric devices
US6398795B1 (en) * 2000-11-30 2002-06-04 Scimed Life Systems, Inc. Stapling and cutting in resectioning for full thickness resection devices
US6436111B1 (en) * 2000-12-19 2002-08-20 Scimed Life Systems, Inc. Expandable atherectomy burr
US7083629B2 (en) * 2001-05-30 2006-08-01 Satiety, Inc. Overtube apparatus for insertion into a body
US7208005B2 (en) * 2001-08-06 2007-04-24 The Penn State Research Foundation Multifunctional tool and method for minimally invasive surgery
US20040217146A1 (en) * 2002-12-20 2004-11-04 Joachim Beck Surgical stapler apparatus and method
US6986775B2 (en) 2002-06-13 2006-01-17 Guided Delivery Systems, Inc. Devices and methods for heart valve repair
US7220237B2 (en) 2002-10-23 2007-05-22 Satiety, Inc. Method and device for use in endoscopic organ procedures
US7380696B2 (en) * 2003-05-20 2008-06-03 Ethicon Endo-Surgery, Inc. Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US7140528B2 (en) * 2003-05-20 2006-11-28 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having an electroactive polymer actuated single lockout mechanism for prevention of firing
US20070276408A1 (en) 2003-09-02 2007-11-29 Filipi Charles J Suturing Devices and Methods
US7351201B2 (en) * 2003-12-19 2008-04-01 Pentax Corporation Treatment instrument for endoscope
JP4643328B2 (en) * 2004-04-07 2011-03-02 オリンパス株式会社 Ligature and suture device for medical application
JP2005296412A (en) * 2004-04-13 2005-10-27 Olympus Corp Endoscopic treatment apparatus
US20060025812A1 (en) * 2004-07-28 2006-02-02 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating an electrically actuated pivoting articulation mechanism
US7143925B2 (en) * 2004-07-28 2006-12-05 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating EAP blocking lockout mechanism
US7147138B2 (en) * 2004-07-28 2006-12-12 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having an electroactive polymer actuated buttress deployment mechanism
US7857183B2 (en) * 2004-07-28 2010-12-28 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating an electrically actuated articulation mechanism
JP4302602B2 (en) * 2004-09-24 2009-07-29 オリンパス株式会社 Endoscopic treatment instrument and an endoscope surgical system and supporting adapter

Patent Citations (74)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4990153A (en) * 1988-10-07 1991-02-05 Ophthalmic Ventures Limited Partnership Surgical suturing system and probe assembly
US4927428A (en) * 1988-10-07 1990-05-22 Ophthalmic Ventures Limited Partnership Surgical suturing system and probe assembly
US5100419A (en) * 1990-04-17 1992-03-31 Ehlers Robert L Device for removing diverticula in the colon
US5389102A (en) * 1990-09-13 1995-02-14 United States Surgical Corporation Apparatus and method for subcuticular stapling of body tissue
US5080663A (en) * 1990-09-26 1992-01-14 Univerity College London Sewing device
US5383880A (en) * 1992-01-17 1995-01-24 Ethicon, Inc. Endoscopic surgical system with sensing means
US5355897A (en) * 1992-04-16 1994-10-18 Ethicon, Inc. Method of performing a pyloroplasty/pylorectomy using a stapler having a shield
US6346111B1 (en) * 1992-09-04 2002-02-12 Scimed Life Systems, Inc. Suturing instruments and methods of use
US20010023352A1 (en) * 1992-09-04 2001-09-20 Gordon Norman S. Suturing instruments and methods of use
US20040059350A1 (en) * 1992-09-04 2004-03-25 Scimed Life Systems, Inc. Suturing instruments and methods of use
US5713910A (en) * 1992-09-04 1998-02-03 Laurus Medical Corporation Needle guidance system for endoscopic suture device
US5376101A (en) * 1992-10-09 1994-12-27 The United States Surgical Corporation Suture retaining clip
US5624453A (en) * 1993-02-23 1997-04-29 Wilson-Cook Medical, Inc. Endoscopic ligating instrument
US5571119A (en) * 1993-10-25 1996-11-05 Children's Medical Center Corporation Retractable suture needle with self-contained driver
US5437681A (en) * 1994-01-13 1995-08-01 Suturtek Inc. Suturing instrument with thread management
US5462558A (en) * 1994-08-29 1995-10-31 United States Surgical Corporation Suture clip applier
US5514159A (en) * 1994-09-13 1996-05-07 United States Surgical Corporation Guillotine suture clip
US5814071A (en) * 1994-11-10 1998-09-29 Innovasive Devices, Inc. Suture anchor assembly and methods
US6264086B1 (en) * 1994-12-07 2001-07-24 Mcguckin, Jr. James F. Surgical apparatus and method
US5540705A (en) * 1995-05-19 1996-07-30 Suturtek, Inc. Suturing instrument with thread management
US5709693A (en) * 1996-02-20 1998-01-20 Cardiothoracic System, Inc. Stitcher
US5853416A (en) * 1997-06-04 1998-12-29 Boston Scientific Corporation Distal end for ligating band dispenser
US6059719A (en) * 1997-08-06 2000-05-09 Olympus Optical Co., Ltd. Endoscope system
US6443962B1 (en) * 1997-09-11 2002-09-03 Benny Gaber Stitching tool
US6454778B2 (en) * 1998-03-20 2002-09-24 Scimed Life Systems, Inc. Endoscopic suture systems
US6126058A (en) * 1998-06-19 2000-10-03 Scimed Life Systems, Inc. Method and device for full thickness resectioning of an organ
US6010450A (en) * 1998-06-29 2000-01-04 Welch Allyn, Inc. Measuring adapter for viewing instrument
US6352503B1 (en) * 1998-07-17 2002-03-05 Olympus Optical Co., Ltd. Endoscopic surgery apparatus
US6036694A (en) * 1998-08-03 2000-03-14 Innovasive Devices, Inc. Self-tensioning soft tissue fixation device and method
US20040194790A1 (en) * 1999-06-22 2004-10-07 Ndo Surgical, Inc. Tissue reconfiguration
US6663639B1 (en) * 1999-06-22 2003-12-16 Ndo Surgical, Inc. Methods and devices for tissue reconfiguration
US6835200B2 (en) * 1999-06-22 2004-12-28 Ndo Surgical. Inc. Method and devices for tissue reconfiguration
US6506196B1 (en) * 1999-06-22 2003-01-14 Ndo Surgical, Inc. Device and method for correction of a painful body defect
US6494888B1 (en) * 1999-06-22 2002-12-17 Ndo Surgical, Inc. Tissue reconfiguration
US20040162568A1 (en) * 1999-06-25 2004-08-19 Usgi Medical Apparatus and methods for forming and securing gastrointestinal tissue folds
US20050075653A1 (en) * 1999-06-25 2005-04-07 Usgi Medical Inc. Apparatus and methods for forming and securing gastrointestinal tissue folds
US20030171760A1 (en) * 2000-05-19 2003-09-11 Gambale Richard A Tissue capturing and suturing device and method
US6544271B1 (en) * 2000-07-18 2003-04-08 Scimed Life Systems, Inc. Device for full-thickness resectioning of an organ
US6572629B2 (en) * 2000-08-17 2003-06-03 Johns Hopkins University Gastric reduction endoscopy
US6719763B2 (en) * 2000-09-29 2004-04-13 Olympus Optical Co., Ltd. Endoscopic suturing device
US6755843B2 (en) * 2000-09-29 2004-06-29 Olympus Optical Co., Ltd. Endoscopic suturing device
US20020107530A1 (en) * 2001-02-02 2002-08-08 Sauer Jude S. System for endoscopic suturing
US20040034369A1 (en) * 2001-02-02 2004-02-19 Sauer Jude S. System for endoscopic suturing
US20020107531A1 (en) * 2001-02-06 2002-08-08 Schreck Stefan G. Method and system for tissue repair using dual catheters
US20020147447A1 (en) * 2001-03-30 2002-10-10 Long Gary L. Endoscopic ablation system with improved electrode geometry
US6558400B2 (en) * 2001-05-30 2003-05-06 Satiety, Inc. Obesity treatment tools and methods
US6689130B2 (en) * 2001-06-04 2004-02-10 Olympus Corporation Treatment apparatus for endoscope
US6923819B2 (en) * 2001-06-14 2005-08-02 Suturtek Incorporated Apparatus and method for surgical suturing with thread management
US20040172047A1 (en) * 2001-08-24 2004-09-02 Scimed Life Systems, Inc. Forward deploying suturing device and methods of use
US6719764B1 (en) * 2001-08-24 2004-04-13 Scimed Life Systems, Inc. Forward deploying suturing device and methods of use
US20030083674A1 (en) * 2001-10-04 2003-05-01 Gibbens George H. Cycling suturing and knot-tying device
US20050015101A1 (en) * 2001-10-04 2005-01-20 Gibbens George H. Leverage locking reversible cyclic suturing and knot-tying device
US20030120289A1 (en) * 2001-12-20 2003-06-26 Mcguckin James F Apparatus and method for treating gastroesophageal reflux disease
US20040147941A1 (en) * 2002-01-30 2004-07-29 Olympus Corporation Endoscopic suturing system
US20030181924A1 (en) * 2002-01-30 2003-09-25 Olympus Optical Co., Ltd. Endoscopic suturing system
US20030233104A1 (en) * 2002-06-12 2003-12-18 Scimed Life Systems, Inc. Suturing instrument with deflectable head
US20030233108A1 (en) * 2002-06-12 2003-12-18 Scimed Life Systems, Inc. Endoscopic suture instrument
US6773440B2 (en) * 2002-07-02 2004-08-10 Satiety, Inc. Method and device for use in tissue approximation and fixation
US20040006351A1 (en) * 2002-07-02 2004-01-08 Jamy Gannoe Method and device for use in tissue approximation and fixation
US20040138682A1 (en) * 2002-07-11 2004-07-15 Olympus Optical Co., Ltd. Endoscopic suture apparatus
US6746460B2 (en) * 2002-08-07 2004-06-08 Satiety, Inc. Intra-gastric fastening devices
US20040044354A1 (en) * 2002-08-30 2004-03-04 Satiety, Inc. Methods and devices for maintaining a space occupying device in a relatively fixed location within a stomach
US20050055038A1 (en) * 2002-09-09 2005-03-10 Brian Kelleher Device and method for endoluminal therapy
US20040082963A1 (en) * 2002-10-23 2004-04-29 Jamy Gannoe Method and device for use in endoscopic organ procedures
US20040088008A1 (en) * 2002-11-05 2004-05-06 Satiety, Inc. Magnetic anchoring devices
US6656194B1 (en) * 2002-11-05 2003-12-02 Satiety, Inc. Magnetic anchoring devices
US20040122473A1 (en) * 2002-12-11 2004-06-24 Ewers Richard C. Delivery systems and methods for gastric reduction
US20040147958A1 (en) * 2002-12-11 2004-07-29 Usgi Medical Apparatus and methods for forming and securing gastrointestinal tissue folds
US6908427B2 (en) * 2002-12-30 2005-06-21 PARÉ Surgical, Inc. Flexible endoscope capsule
US20040210243A1 (en) * 2003-04-16 2004-10-21 Jamy Gannoe Method and devices for modifying the function of a body organ
US20040260344A1 (en) * 2003-05-07 2004-12-23 Anpa Medical, Inc. Suture lock
US20050070931A1 (en) * 2003-08-06 2005-03-31 Rhodemann Li Method and apparatus for creating a restriction in the stomach or other anatomical structure
US20050192599A1 (en) * 2004-02-13 2005-09-01 Demarais Denise M. Methods for reducing hollow organ volume
US7438208B2 (en) * 2005-01-25 2008-10-21 Entrigue Surgical, Inc. Septal stapler apparatus

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8388632B2 (en) 2000-05-19 2013-03-05 C.R. Bard, Inc. Tissue capturing and suturing device and method
US8551120B2 (en) 2000-05-19 2013-10-08 C.R. Bard, Inc. Tissue capturing and suturing device and method
US8172857B2 (en) 2004-08-27 2012-05-08 Davol, Inc. Endoscopic tissue apposition device and method of use
US9149270B2 (en) 2004-08-27 2015-10-06 Davol, Inc. (a C.R. Bard Company) Endoscopic tissue apposition device and method of use
US9375218B2 (en) 2006-05-03 2016-06-28 Datascope Corp. Systems and methods of tissue closure

Also Published As

Publication number Publication date
BRPI0603381A (en) 2007-09-04
JP5000233B2 (en) 2012-08-15
US20070043384A1 (en) 2007-02-22
US7771440B2 (en) 2010-08-10
EP1754444A2 (en) 2007-02-21
US20120118935A1 (en) 2012-05-17
JP2007050261A (en) 2007-03-01
AU2006203408A1 (en) 2007-03-08
CN1931102A (en) 2007-03-21
CN1931102B (en) 2012-01-25
EP1754444A3 (en) 2009-04-22
CA2556304A1 (en) 2007-02-18

Similar Documents

Publication Publication Date Title
AU2002312174B2 (en) Obesity treatment tools and methods
US8828027B2 (en) Tissue manipulation and securement system
JP5331104B2 (en) Apparatus and method for stomach split
CN104434253B (en) Endoscopic stapling device and method
JP6153847B2 (en) Stapling system for plication surgery
CN101044997B (en) Surgical suturing apparatus with collapsible vacuum chamber
CN101156796B (en) Improvements relating to an anastomotic ring applier
US8057384B2 (en) Methods and devices for reducing hollow organ volume
US9675345B2 (en) Devices and related methods for securing a tissue fold
EP1839557B1 (en) Attachment apparatus for coupling with an endoscope
US7704264B2 (en) Apparatus and methods for forming and securing gastrointestinal tissue folds
US10245026B2 (en) Methods and devices for folding and securing tissue
EP1555970B1 (en) Apparatus for treatment of morbid obesity
EP1839594B1 (en) Suture with adhesive/sealant delivery mechanism
US7229428B2 (en) Method and device for use in endoscopic organ procedures
US7892245B2 (en) Apparatus and method for manipulating tissue
US20050251166A1 (en) Tissue manipulation and securement system
US8206456B2 (en) Restrictive and/or obstructive implant system for inducing weight loss
EP2120730B1 (en) Devices for placement of partitions within a hollow body organ
ES2317462T3 (en) Apparatus for performing endoscopic gastric reduction surgical one in a single step.
US8262676B2 (en) Apparatus and methods for forming gastrointestinal tissue approximations
EP1389065B1 (en) Apparatus for use in a method of endoluminal fundoplication
US9839546B2 (en) Apparatus and methods for treatment of morbid obesity
EP1682010B1 (en) System for tissue approximation and fixation
US7757924B2 (en) Single fold system for tissue approximation and fixation

Legal Events

Date Code Title Description
AS Assignment

Owner name: ETHICON ENDO-SURGERY, INC.,OHIO

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:ORTIZ, MARK S.;STOKES, MICHAEL J.;REEL/FRAME:024174/0522

Effective date: 20100330