ENDOSCOPIC TISSUE APRROXIMATION SYSTEM AND METHODS
A deployment system includes a sheath, a shaft having a handle positioned at its proximal end, a micro motor having a motor shaft at the shafts distal end, a detachable helical first suture anchor positioned at the motor shafts distal end and an elongate suture fixedly coupled to the suture anchor. The deployment system can be positioned at a first tissue, and the motor shaft rotated to advance the helical first suture anchor into engagement with the first tissue. The motor shaft is detached from the first suture anchor thereby deploying it at the first tissue location. The deployment system can be reloaded with multiple suture anchors to deploy at multiple tissue locations. The suture extending between the anchors can then be drawn together to reconfigure the coupled tissue.
1 . An endoscopic deployment system for placing a suture anchor at a site within a mammal, said endoscopic deployment system comprising:
an elongated flexible delivery member having proximal, intermediate, and distal regions, and proximal and distal ends;
an elongate shaft member having proximal and distal ends;
a micro motor positioned at the distal end of the elongate shaft member and having a rotatable motor shaft;
a coupling assembly fixedly coupled to the distal end of said motor shaft and configured to releasably engage a proximal end of a suture anchor having a coil member positioned at a distal end thereof;
wherein:
when said deployment system is in a first operable configuration said coupling assembly is operably coupled with a suture anchor and rotation of said motor shaft causes rotation of the suture anchor to advance into tissue; and
said deployment system is shiftable into a second operable configuration detached from said suture anchor.
2 . An endoscopic deployment system according to claim 1 , further comprising a handle coupled to said proximal end of said shaft member.
3 . An endoscopic deployement system according to claim 2 , wherein said handle is operable to supply energy to said micro motor to result in rotation of said motor shaft.
4 . An endoscopic deployment system according to claim 2 , wherein said handle includes:
a stationary member defining a power supply receptacle and a switch assembly;
a power supply positioned in said power supply receptacle and having a plurality of electrical connectors that connect said power supply to said switch assembly; and
a plurality of electrical connectors that connect said switch assembly to a plurality of electrical conductors extending to said micro motor such that when said switch assembly is operated, energy is supplied from said power supply though said electrical conductors to said micro motor causing said motor shaft to rotate.
5 . An endoscopic deployment system according to claim 1 , further comprising a handle, and a sheath having a proximal end and a distal end, said sheath extending over said elongate shaft member such that the distal end of said sheath is located proximal to said suture anchor, and said handle is actuatable to move said sheath distally over said elongate shaft member so as to dislodge said suture anchor from said coupling assembly.
6 . An endoscopic deployment system according to claim 1 , wherein said suture anchor has a suture anchor release surface positioned for distal contact thereagainst to cause said suture anchor to disengage from said coupling assembly.
7 . An endoscopic deployment system according to claim 6 , further comprising a sheath actuatable to contact the suture anchor release surface to disengage said suture anchor from said coupling assembly.
8 . An endoscopic deployment system according to claim 1 , wherein said elongate flexible delivery member is sufficiently flexible to be extended through a tortuous path within a mammal.
9 . An endoscopic deployment system according to claim 1 , wherein the distal region of said elongate flexible delivery member includes a first rotation key, and said suture anchor includes a second rotation key, wherein said first and second rotation keys rotationally interfere with each other.
10 . An endoscopic deployment system according to claim 1 , wherein said coupling assembly includes an engagement post with at least one recess, and said suture anchor includes a receiver and at least one tab, and when said engagement post is coupled with said receiver said at least one tab and at least one recess rotationally interfere such that axial rotation of said engagement post results in rotation of said suture anchor.
11 . An endoscopic deployment system according to claim 1 , wherein said coupling assembly includes one of a recess and tab, and said suture anchor includes the other of a recess and a tab, wherein said tab and recess rotationally interfere such that axial rotation of said coupling assembly results in rotation of said suture anchor.
12 . An endoscopic deployment system according to claim 1 , wherein said suture anchor comprises a tubular member defining a coil member and a receiver configured to receive a distal end of said coupling assembly.
13 . An endoscopic deployment system according to claim 1 , further comprising a suture anchor with a tapered coil member.
14 . An endoscopic deployment system according to claim 1 , further comprising a suture anchor having a coil member with a variable pitch.
15 . A method of deploying a suture anchor into tissue, said method comprising:
providing an endoscopic deployment system having a proximal end and a distal end, the endoscopic deployment system including an elongate shaft member having a proximal end and a distal end and defining a longitudinal axis, the distal end of the elongate shaft member including a micro motor having a rotatable motor shaft configured to be engaged with a suture anchor having a coil at a distal end thereof with a tissue piercing distal tip;
positioning the distal end of the deployment system adjacent a first tissue location with the tissue piercing distal tip of the suture anchor engaging tissue;
actuating the micro motor to rotate the suture anchor to advance the coil into engagement with the first tissue location; and
disengaging the rotatable motor shaft from the suture anchor to deposit the suture anchor at the first tissue location.
16 . The method according to claim 15 , further comprising, after rotating the coil distal end about the longitudinal axis to advance the coil distal end into engagement with the first tissue location, and before retracting the elongate shaft member to uncouple the suture anchor from the elongate shaft member and thereby deposit said suture anchor at the first tissue location:
rotating the coil distal end about the longitudinal axis in an opposite direction to withdraw the coil distal end from engagement with the first tissue location;
re-positioning the distal end of the deployment system adjacent a second tissue location; and
rotating the coil distal end about the longitudinal axis to advance the coil distal end into engagement with the second tissue location.
17 . The method according to claim 15 , wherein the endoscopic deployment system includes a plurality of suture anchors, said method further comprising, for each suture anchor to be deployed:
positioning the distal end of the endoscopic deployment system adjacent a respective tissue location;
rotating the coil distal end about the longitudinal axis to advance the coil distal end into engagement with the respective tissue location; and
retracting the elongate shaft member to uncouple the suture anchor from the shaft member and thereby deposit the suture anchor at the respective tissue location.
18 . The method according to claim 17 , wherein the plurality of suture anchors are coupled to a common suture, said method further comprising applying tension on the common suture between the deposited plurality of suture anchors to reconfigure the first and respective tissue locations relative to each other, and then retaining the applied tension to the common suture.
19 . A method of deploying a suture anchor into tissue, said method comprising:
providing an endoscopic deployment system having a proximal end and a distal end, the deployment system including,
an elongate shaft member having a proximal end and a distal end and defining a longitudinal axis, the distal end of the elongate shaft member including a micro motor having a motor shaft configured to be releasably coupled with a suture anchor, and
a sheath having a proximal end and a distal end, the sheath extending over the elongate shaft member;
positioning the distal end of the deployment system adjacent a first tissue location;
actuating the micro motor to advance the suture anchor into engagement with the first tissue location; and
advancing the sheath relative to the elongate shaft member to cause the distal end of the sheath to disengage the suture anchor from the motor shaft and thereby deposit the suture anchor at the first tissue location.
20 . A method according to claim 19 , wherein the sheath is a longitudinally stiff construct.