System for tissue cavity closure
Surgical systems for less invasive access to and isolation of an atrial appendage are provided. A suturing grasper compresses soft tissue structures and deploys one or more sutures through complimentary pledget(s) carried by the grasper. The pledgets are reinforced, containing support members that define the profile of the stitch and distribute stresses applied by the stitch, once tightened, over a length of tissue. This hardware may be applicable to other surgical and catheter based applications as well including: compressing soft tissue structures lung resections and volume reductions; gastric procedures associated with reduction in volume, aneurysm repair, vessel ligation, or other procedure involving isolation of, resection of, and reduction of anatomic structures.
1 . A system for compressing tissue surrounding a cavity, the system comprising:
a plurality of jaw members;
at least one implantable member removably placed on one or more jaw members, where the implantable member is sized to match the compressed tissue; and
at least one tissue piercing member attached to or passable through the implantable member.
2 . The system of claim 1 , where the implantable member comprises a first clip having a plurality of the tissue piercing members attached thereto, the first clip further comprising a plurality of pockets.
3 . The system of claim 2 , further comprising a second clip having a plurality of the tissue piercing members attached thereto, the second clip further comprising a plurality of pockets, such that when mated with the first clip, the tissue piercing members of each clip nest in the plurality of pockets of the other clip to align the first and second clips.
4 . The system of claim 3 , where the first and second clips each include mating locking surfaces that prevent decoupling of the device once joined.
5 . The system of claim 3 , where the first and second clips are joined via a hinge.
6 . The system of claim 2 , where the first clip comprises a material selected from PTFE, PEBAX, polyester, polyurethane, urethane, silicone, polyimide, a thermoplastic polymer, a thermoset polymer, an elastomer.
7 . The system of claim 6 , where the first clip comprises a support structure selected from a metal, a metal alloy, and a polymer.
8 . The system of claim 6 , further comprising a pharmacological substance located on or in the clip.
9 . The system of claim 8 , where the pharmacological substance comprises an agent selected from an antiproliferative agent, an agent to prevent adhesions, an anti-thrombosis agent, an agent that inhibits hyperplasia, an agent that affects platelet congregation.
10 . The system of claim 1 , where the implantable member comprises a pledget body and where the tissue piercing member comprises a needle having a suture attached thereto.
11 . The system of claim 10 , where the pledget body comprises a plurality of openings.
12 . The system of claim 11 , where the plurality of openings comprises at least one eyelet for passage of a needle and suture.
13 . The system of claim 1 , where each jaw member has at least one of the implantable members removably placed thereon.
14 . The system of claim 10 , where the pledget body comprises first profile selected from: planar, arc, sinusoid, or other profile matching the compressed geometry of the appendage.
15 . The system of claim 10 , where the pledget body further comprises a material selected from PTFE, PEBAX, polyester, polyurethane, urethane, silicone, polyimide, a thermoplastic polymer, a thermoset polymer, an elastomer.
16 . The system of claim 10 , where the pledget body comprises a support structure selected from a metal, a metal alloy, and a polymer.
17 . The system of claim 10 , where the pledget body comprises a pharmacological substance located on or in the clip.
18 . The system of claim 17 , where the pharmacological substance comprises an agent selected from an antiproliferative agent, an agent to prevent adhesions, an anti-thrombosis agent, an agent that inhibits hyperplasia, an agent that affects platelet congregation.
19 . The system of claim 10 , where the pledget body comprise an “H” shape.
20 . The system of claim 1 , where the tissue piercing members comprise at least one needle.
21 . The system of claim 20 , where the needle comprises a material selected from a shape memory alloy, a metal, and a metal alloy.
22 . A pledget for compressing tissue surrounding a cavity in the tissue, the pledget body comprising:
a body comprising a compressible material;
a reinforcing member at least partially enclosed within the body;
where the body and reinforcing member define a size and a profile such that the size and the profile matches the compressed geometry of the tissue.
23 . The pledget of claim 22 , further comprising a plurality of openings where the spacing between the openings is chose to accommodate the stress distribution and size of the tissue being compressed.
24 . The pledget of claim 23 , where the plurality of openings comprises two openings separated by a central link.
25 . The pledget of claim 23 , where the plurality of openings comprises two openings such that the shape of the body forms an “H”.
26 . The pledget of claim 22 , further comprising a plurality of fastener eyelets.
27 . The pledget of claim 22 , where the body comprises a profile selected from: planar, arc, sinusoid, or other profile matching the compressed geometry of the appendage.
28 . The pledget of claim 22 , where the body comprises a material selected from PTFE, PEBAX, polyester, polyurethane, urethane, silicone, polyimide, a thermoplastic polymer, a thermoset polymer, an elastomer.
29 . The pledget of claim 22 , where the reinforcing member comprises a material selected from a metal, a metal alloy, and a polymer.
30 . The pledget of claim 22 , where the body carries a pharmacological substance.
31 . The pledget of claim 30 , where the pharmacological substance comprises an agent selected from an antiproliferative agent, an agent to prevent adhesions, an anti-thrombosis agent, an agent that inhibits hyperplasia, an agent that affects platelet congregation.