Suturing devices, systems and methods of using the same

1. A system for deploying sutures within a hollow organ, comprising:

a. a central tube having a lumen and an open distal end;

b. an expandable enclosure located to surround the central tube, wherein the expandable enclosure is defined by a distal air-permeable surface and a lateral non air-permeable surface,

wherein the expandable enclosure is movable between a retracted configuration and an expanded configuration; and

c. an expandable suture delivery apparatus having a plurality of suture delivery tubes, each suture delivery tube having an open distal end, the apparatus being configured for movement between a retracted configuration and an expanded configuration,

wherein the suture delivery apparatus is slideably moveable through the central tube lumen while the suture delivery apparatus is in the retracted configuration and wherein the open distal end of one or more of the suture delivery tubes are distally spaced from the expandable enclosure while the suture delivery apparatus is in the expanded configuration.

2. The system of claim 1 , wherein the open distal ends of the suture delivery tubes are spaced from each other and are arranged circumferentially about the suture delivery apparatus when the suture delivery apparatus is in the expanded configuration.

3. The system of claim 2 , wherein the distal spacing between the suture delivery apparatus and the expandable enclosure define a circumferential gap between the suture delivery apparatus and the expandable enclosure that is configured to receive tissue of the organ.

4. The system of claim 3 , wherein the suture delivery apparatus comprises an air-impermeable surface that defines a distal portion of the circumferential gap.

5. The system of claim 3 , wherein the central tube comprises a suction port in communication with the lumen of the central tube, the suction port adapted to be placed in communication with a suction source to evacuate air from the central tube lumen.

6. The system of claim 5 , wherein the evacuation of air from the central tube lumen by the suction source causes organ tissue to enter the circumferential gap.

7. The system of claim 1 , further comprising an actuator mechanism configured for moving the enclosure between its retracted and expanded configuration.

8. The system of claim 7 , further comprising an actuator mechanism configured for moving the suture delivery apparatus between its retracted and expanded configuration.

9. The system of claim 8 , wherein the actuator mechanism is configured for remote operation by an operator located outside of the organ lumen.

10. The system of claim 1 , further comprising a distal ring graft positionable proximal to the open distal ends of the suture delivery tubes.

11. The system of claim 10 , wherein the distal ring graft is moveable through the central tube lumen.

12. The system of claim 10 , further comprising a proximal ring graft positionable proximal to the distal ring graft.

13. The system of claim 1 , wherein the open distal end of the central tube is positionable in the lumen of the hollow organ.

14. The system of claim 13 , wherein the enclosure and suture delivery apparatus are moveable between their expanded and retracted configurations within the organ lumen.

15. The system of claim 13 , wherein the enclosure and suture delivery apparatus are introduced into the organ lumen or removed from the organ lumen in their retracted configurations.

16. The system of claim 1 , further comprising:

a. a plurality of flexible support tubes positioned about the central tube; and

b. a plurality of multi-segmented support rods, wherein the support tubes are configured to accept the multi-segmented support rods.

17. The system of claim 1 , wherein the expandable enclosure includes a plurality of expansion rib tubes positioned to encircle the central tube.

18. The system of claim 17 , further comprising:

a plurality of stiffening wires, wherein the plurality of expansion rib tubes are configured to receive the plurality of stiffening wires,

wherein the plurality of stiffening wires and the plurality of expansion rib tubes are configured to vertically support the expandable enclosure when the enclosure is in the expanded configuration and the plurality of stiffening wires are inserted into the plurality of expansion rib tubes.

19. The system of claim 1 , wherein:

the expandable enclosure includes a plurality of suture receiving tubes, each suture receiving tube having an open distal end.

20. A system for deploying sutures within a hollow organ, comprising:

a. a central tube having an outer surface and a lumen with an open distal end;

b. a proximal enclosure surrounding the central tube,

wherein the enclosure is moveable between a retracted configuration and an expanded configuration; and

c. a distal suture delivery apparatus having a plurality of suture delivery tubes, each suture delivery tube having an open distal end,

wherein the suture delivery apparatus is moveable between a retracted configuration and an expanded configuration,

wherein in the expanded configuration, the expanded enclosure is spaced from the expanded suture delivery apparatus to define a circumferential gap therebetween the enclosure and the suture delivery apparatus,

wherein the circumferential gap is defined by a portion of the outer surface of the central tube,

wherein the proximal enclosure includes a plurality of suture receiving tubes, each suture receiving tube having an open distal end, and

wherein the suture delivery apparatus is slideably moveable through the central tube lumen while the suture delivery apparatus is in the retracted configuration.

21. The system of claim 20 , wherein:

the proximal enclosure includes a distal air-permeable surface; and

the air-permeable surface defines a distal portion of the circumferential gap.

22. The system of claim 20 , wherein the enclosure includes a plurality of expansion rib tubes positioned to encircle the central tube, and the system further comprises:

a plurality of stiffening wires, wherein the plurality of expansion rib tubes are configured to receive the plurality of stiffening wires,

wherein the plurality of stiffening wires and the plurality of expansion rib tubes are configured to vertically support the enclosure when the enclosure is in the expanded configuration and the plurality of stiffening wires are inserted into the plurality of expansion rib tubes.

23. A system for deploying sutures within a hollow organ, comprising:

a. a central tube having an outer surface and a lumen with an open distal end;

b. a proximal enclosure surrounding the central tube,

wherein the enclosure is moveable between a retracted configuration and an expanded configuration; and

c. a distal suture delivery apparatus having a plurality of suture delivery tubes, each suture delivery tube having an open distal end,

wherein the suture delivery apparatus is moveable between a retracted configuration and an expanded configuration, and

wherein the suture delivery apparatus is slideably moveable through the central tube lumen while the suture delivery apparatus is in the retracted configuration.

24. The system of claim 23 , wherein:

in the expanded configuration, the expanded enclosure is spaced from the expanded suture delivery apparatus to define a circumferential gap therebetween the enclosure and the delivery apparatus, and

the circumferential gap is defined by a portion of the outer surface of the central tube.

25. The system of claim 24 , wherein:

the proximal enclosure includes a distal air-permeable surface; and

the air-permeable surface defines a distal portion of the circumferential gap.

26. The system of claim 23 , wherein the enclosure includes a plurality of expansion rib tubes positioned to encircle the central tube, and the system further comprises:

a plurality of stiffening wires, wherein the plurality of expansion rib tubes are configured to receive the plurality of stiffening wires,

wherein the plurality of stiffening wires and the plurality of expansion rib tubes are configured to vertically support the enclosure when the enclosure is in the expanded configuration and the plurality of stiffening wires are inserted into the plurality of expansion rib tubes.