Apparatus and methods for endoscopic suturing
View Patent ↗Apparatus & methods for endoscopic suturing are described herein. A distal tip of the endoscopic device engages the tissue and then approximates the engaged tissue to form a tissue fold. A needle body positioned within a flexible catheter is deployed into or through the newly created tissue fold where it is then detached or released from the endoscopic device. The needle body has a length of suture which depends therefrom and can be used to secure the tissue fold. The entire endoscopic device or its tissue engaging assembly can then be rotated relative to the tissue fold while maintaining engagement with the tissue to maneuver the flexible catheter to the opposing side of the penetrated tissue fold. This procedure can be repeated any number of times to create an interrupted, continuous, or running suture to secure the tissue fold.
1. A method for endoscopically suturing a region of tissue, comprising:
endoscopically advancing an elongate tubular member to the region of tissue;
engaging the region of tissue with a tissue engagement device comprising a pair of jaws and a flexible tube extending from a distal end of the elongate tubular member;
approximating the tissue relative to the elongate tubular member via the tissue engagement device;
using the approximating motion to simultaneously curve a distal end of a deployment tubular member extending from the elongate tubular member via a linkage pivotably connecting the tissue engagement device and the deployment tubular member such that a distal tip of the deployment tubular member is aligned substantially transversely with the tissue;
deploying a needle body and a length of suture depending therefrom at least partially into or through the tissue from the deployment tubular member;
rotating the deployment tubular member and the flexible tube about a longitudinal axis of the pair of jaws while the tissue engaging device is engaging the region of tissue; and
grasping the deployed needle body with a needle grasper slidably positioned within the deployment tubular member.
2. The method of claim 1 wherein endoscopically advancing an elongate tubular member comprises advancing the tubular member transesophageally into a stomach.
3. The method of claim 1 wherein engaging the region of tissue comprises temporarily engaging the region of tissue.
4. The method of claim 1 wherein approximating the tissue comprises pulling the tissue proximally into a fold via the tissue engagement device.
5. The method of claim 1 wherein deploying a needle body comprises urging the needle body into the tissue via the needle grasper.
6. The method of claim 1 wherein grasping the deployed needle body comprises drawing the needle body into deployment tubular member via the needle grasper.
7. The method of claim 1 further comprising rotating the deployment tubular member about the longitudinal axis while holding the needle body.
8. The method of claim 7 further comprising deploying the needle body and the length of suture through the tissue such that the tissue is secure.
9. The method of claim 1 further comprising deploying an expandable anchor from the needle body for placement against the tissue.