Suture device

Abstract

The present invention generally relates to devices for endoscopic suturing termination. In some embodiments, the suturing device may include an elongated member having a working channel and a suturing channel, the elongated member having a proximal end and a distal end. The suturing device may also include a suture extending through the suturing channel, and a plurality of anchor assemblies coupled to the suture, wherein the suture and the plurality of anchor assemblies may be deployed from the elongated member to engage with target tissue.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of priority under 35 U.S.C. §119 to U.S. Provisional Patent Application No. 62 / 896,704, filed on September 6, 2019, which is incorporated herein by reference in its entirety for all purposes. Technical Field

[0003] The present invention relates to the treatment of tissue defects and, more particularly, to systems, devices and methods for tissue closure. Background Art

[0004] Surgical procedures performed within body passages, such as the digestive tract, may result in the formation of openings in tissue, for example, due to the dissection of one or more lesions. Effective closure of such openings may be impeded if the surgical procedure is performed using instruments not configured to perform such closures. Therefore, various advantages can be achieved by the medical devices and methods for closing openings in tissue according to the present invention. Summary of the Invention

[0005] The present invention, in its various embodiments, generally relates to systems, suturing devices, and methods for endoscopically deploying stranded anchors. In one or more embodiments, a suturing device may include an elongated member having a working channel and a suturing channel, the elongated member having a proximal end and a distal end; and a suture extending through the suturing channel. The suturing device may also include a plurality of anchor assemblies coupled to the suture, wherein the suture and the plurality of anchor assemblies are deployable from the elongated member to engage target tissue. In some embodiments, the suturing device may also include a delivery device extending within the suturing channel, the delivery device being operable to deploy one of the plurality of anchor assemblies. In some embodiments, the delivery device is retractable toward the proximal end of the elongated member to deploy an anchor assembly from the plurality of anchor assemblies. In some embodiments, an anchor assembly from the plurality of anchor assemblies may include a plurality of legs that are biased from a first collapsed configuration to a second expanded configuration upon deployment; and an attachment device coupled to the plurality of legs, the attachment device being directly connected to the suture. In some embodiments, the attachment device may be a ring surrounding the suture. In some embodiments, the suturing device may also include an instrument within the working channel, the instrument being operable to deform the attachment device to secure the anchor assembly to the suture. In some embodiments, each of the plurality of anchor assemblies can be positioned within a delivery device along the suture axis prior to deployment. In some embodiments, the delivery device can extend beyond the distal end of the elongated member.

[0006] In one or more embodiments, an endoscopic medical device may include an elongated member having a working channel and a suturing channel, the elongated member having a proximal end and a distal end; and a delivery device extending through the suturing channel. The endoscopic medical device may also include a suture extending through the delivery device, and a plurality of anchor assemblies coupled to the suture, wherein the suture and the plurality of anchor assemblies are deployable from the delivery device to engage target tissue. In some embodiments, the delivery device may be extended toward the target tissue to position a distal-most anchor assembly of the plurality of anchor assemblies adjacent to the target tissue prior to deployment. In some embodiments, the delivery device may be retracted toward the proximal end of the elongated member to deploy the distal-most anchor assembly of the plurality of anchor assemblies. In some embodiments, each of the plurality of anchor assemblies may include a plurality of legs that are biased from a first collapsed configuration to a second expanded configuration upon deployment. Each of the anchor assemblies may also include an attachment device coupled to the plurality of legs, the attachment device being directly connected to the suture. In some embodiments, the attachment device includes a loop surrounding the suture. In some embodiments, the endoscopic medical device may also include an instrument within the working channel, the instrument being operable to deform the attachment device to secure the anchor assembly to the suture. In some embodiments, the delivery device can extend beyond the distal end of the elongate member.

[0007] In one or more embodiments, a method may include inserting a suturing device into a patient's body to treat a target tissue, the suturing device comprising an elongated member having a working channel and a suturing channel, the elongated member having a proximal end and a distal end; a delivery device extending through the suturing channel; and a plurality of anchor assemblies coupled to the suture, wherein the plurality of anchor assemblies and the suture are disposed within the delivery device. The method may further include deploying one or more anchor assemblies of the suture and the plurality of anchor assemblies to engage with the target tissue. In some embodiments, the method may further include extending the delivery device toward the target tissue to position the most distal anchor assembly of the plurality of anchor assemblies adjacent to the target tissue; and retracting the delivery device toward the proximal end of the elongated member to deploy the most distal anchor assembly of the plurality of anchor assemblies. In some embodiments, the method may further include biasing the plurality of legs of the most distal anchor assembly from a first collapsed configuration to a second expanded configuration when deployed. In some embodiments, the method may further include securing one or more anchor assemblies of the plurality of anchor assemblies to the suture. In some embodiments, the method may further include extending the suture through an attachment device of each of the plurality of anchor assemblies.

[0008] One or more of the various features outlined above may be interchanged, exchanged, combined, or substituted with other features outlined above for use in conjunction with the medical systems and methods outlined above and with respect to the embodiments described in more detail below and otherwise within the scope of the present invention. BRIEF DESCRIPTION OF THE DRAWINGS

[0009] Non-limiting embodiments of the present invention are described by way of example with reference to the accompanying drawings, which are not intended to be drawn to scale. In the drawings, each identical or nearly identical component shown is generally represented by a single numeral. For clarity, not every component is labeled in every figure, nor is every component of every embodiment shown necessary to allow one skilled in the art to understand the present invention. In addition, some of the figures include cross-sectional views in "slice" format or "close-up" cross-sectional views, omitting certain background lines or features that would otherwise be visible in a "true" cross-sectional view for clarity of illustration. In the drawings:

[0010] Figures 1A to 1C Various examples of stitching patterns according to embodiments of the present invention are shown;

[0011] Figure 2A is a perspective view of a system according to an embodiment of the present invention;

[0012] Figures 2B to 2C is a method for operating according to an embodiment of the present invention Figure 2A A side view of a handle of the system;

[0013] Figure 3 According to an embodiment of the present invention Figure 2A A side cross-sectional view of a system;

[0014] Figure 4A is during use according to an embodiment of the present invention Figure 2A A side view of the system;

[0015] Figure 4B The embodiment of the present invention is shown Figure 4A The stitching pattern produced by the system;

[0016] Figure 5A is during use according to an embodiment of the present invention Figure 2A A side view of the system;

[0017] Figure 5B The embodiment of the present invention is shown Figure 5A The stitching pattern produced by the system;

[0018] Figure 6A is during use according to an embodiment of the present invention Figure 2A A side view of the system;

[0019] Figure 6B The embodiment of the present invention is shown Figure 6A The stitching pattern produced by the system;

[0020] Figure 7Ais during use according to an embodiment of the present invention Figure 2A A side view of the system;

[0021] Figure 7B The embodiment of the present invention is shown Figure 7A The stitching pattern produced by the system;

[0022] Figure 8A is during use according to an embodiment of the present invention Figure 2A A side view of the system;

[0023] Figure 8B The embodiment of the present invention is shown Figure 8A The stitching pattern produced by the system;

[0024] Figure 9A is during use according to an embodiment of the present invention Figure 2A A side view of the system;

[0025] Figure 9B The embodiment of the present invention is shown Figure 9A The stitching pattern produced by the system;

[0026] Figure 10A is during use according to an embodiment of the present invention Figure 2A A side view of the system;

[0027] Figure 10B The embodiment of the present invention is shown Figure 10A The stitching pattern generated by the system; and

[0028] Figure 11 is a flowchart of a method according to an embodiment of the present invention. DETAILED DESCRIPTION

[0029] The present invention is not limited to the specific embodiments described herein. The terminology used herein is intended only to describe specific embodiments and is not intended to limit the scope of the appended claims. Unless otherwise specified, all technical terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs.

[0030] The medical trend is shifting from laparoscopy and open surgery to miniaturized endoscopic surgery. Endoscopists can perform more complex non-invasive or minimally invasive procedures under direct visualization. Current endoscopes provide a working channel so that special instruments can be used to perform such treatments, but they may not include the inherent ability to treat and manipulate the tissue being approached and examined. There is a demand for endoscopes with specific built-in treatment capabilities. Such endoscopes can facilitate a wide range of surgical interventions (which are becoming more and more common in hospitals) and can lead to the development of significantly more capable and more complex scope designs.

[0031] Furthermore, infection prevention in clinical settings has created a need for single-use duodenoscopes that reduce the risk of patient infection and associated serious adverse events. For example, current commercial duodenoscopes often include distal tips with complex mechanical features. This complexity can make it difficult to properly disinfect reusable duodenoscopes between procedures, which in some cases can be a cause of persistent patient infection.

[0032] Embodiments include closure devices made of a superelastic material such as nitinol, however other materials, such as polymers with suitable elastic properties, may also be used. In some embodiments, the closure device can be delivered via an endoscope, while in other embodiments, the closure device can be delivered via a needle. The closure device can be positioned within a lumen of a delivery device and can be delivered to a target tissue site in a straightened / constrained configuration. The delivery device can deploy the closure device out of a distal end of the device / lumen. Upon deployment, the closure device can assume a configuration that promotes engagement of opposing segments of the target tissue.

[0033] In addition, the present invention may relate to medical devices, such as endoscopes, gastroscopes, bronchoscopes, colonoscopes, ureteroscopes, etc., which have integrated features for obtaining, manipulating and closing openings in target tissues. Although a disposable endoscope is described herein, it should be understood that embodiments of the present invention may also be included in reusable medical devices such as endoscopes. As will be further described below, embodiments herein provide suturing devices, systems and methods including integrated mechanisms that allow a variety of different suturing patterns for closing tissues to be performed more easily. For example, one type of integrated mechanism may be a continuous twisting on a suture, such as a set of anchors connected in series, wherein the suture can be delivered through a channel of an elongated member of the suturing device. During use, each anchor can be compressed or constrained within a delivery tube and expanded or unconstrained when deployed in the tissue. The anchor can be made of shape memory alloys or programmable polymers to achieve both compression and expansion.

[0034] Current endoscopic suturing can be performed according to one or more suturing patterns, which refers to the design or arrangement of the sutures that are traversed in the target tissue during and / or after the suturing procedure. For example, Figure 1A , wherein each of the sutures 5A to 5N can be a discrete or discontinuous portion of suture secured around the perimeter 10 of the target tissue 15. In this case, each of the sutures 5A to 5N represents a suture that has been cut and secured in the arrangement shown. Although not limiting, the sutures 5A to 5N extend substantially parallel to each other through the target tissue 15.

[0035] Figure 1B , in which a single continuous suture 5 may be stitched around the perimeter 10 of the target tissue 15. In this case, the suture 5 may be passed through the target tissue 15 multiple times without cutting or breaking the suture 5. Although not limiting, the suture 5 may extend through the target tissue 15 in a zigzag formation.

[0036] Figure 1C Another example suturing pattern is shown in FIG, in which one or more sutures 5 may be passed around the perimeter 10 of the target tissue 15, for example, in a generally figure-eight configuration. In this case, the sutures 5 may represent a single continuous suture or a plurality of sutures. This figure-eight suture pattern is particularly beneficial for treating, for example, fistulas.

[0037] Now turn Figure 2A , the slender member 102 of the suturing device or system 100 according to an embodiment of the present invention will be described in more detail. As shown, the slender member 102 can be a hollow tube, such as the distal end of an endoscope, a gastroscope, a bronchoscope, a colonoscope, a ureteroscope, etc. The slender member 102 may include a proximal portion 106 opposite the distal end 108. In some embodiments, the slender member 102 can be a flexible material, such as silicone, a thermoplastic elastomer including polyamide and polyether main chain blocks, polyurethane, etc., to allow bending of the scope. In other embodiments, the slender member 102 can be a rigid material, such as polycarbonate, acrylonitrile butadiene styrene (ABS), etc., to provide a more direct positioning response.

[0038] As further shown, the elongated member 102 can have a working channel 110 and a suturing channel 112 extending between the proximal end 106 and the distal end 108. Although not limiting, the working channel and the suturing channel 112 can run substantially parallel to each other within the elongated member 102. The working channel 110 can accommodate instruments such as visualization tools, cutting tools, manipulation tools, etc. In other embodiments, the elongated member 102 can include, for example, one or more integrated visualization devices and / or lighting devices 113 (e.g., wired or wireless cameras and / or LEDs or optical fibers) positioned along its distal surface 114. The suturing channel 112 can include a delivery device 115 extending therethrough, wherein the delivery device 115 is operable to deploy multiple anchor assemblies (not shown) into the target tissue 116. In some embodiments, the delivery device 115 can be a sheath or tube capable of linear movement within the suturing channel 112. Although a single working channel 110 and suturing channel 112 are shown, it should be understood that in other embodiments, there can be more channels within the elongated member 102.

[0039] Now turn Figures 2B to 2C , a user interface or handle 150 for operating the system 100 according to a non-limiting embodiment of the present invention will be described. As shown, the handle 150 may include a body 151 and one or more controls, such as a first rotary dial 152, a second rotary dial 153, and a locking hinge 154. The suture channel 112 and the working channel 110 extend through the body 151, and the suture 120 and the delivery device 115 extend through the suture channel 112. During use, as shown in FIG. Figure 2B As shown, the locking hinge 154 can be released to allow the second rotary dial 153 to move away from the body 151, thereby allowing the delivery device 115 to move, for example, in the direction indicated by arrow 157. Although not shown in detail, the second rotary dial 153 can include one or more mechanical features that are operable to engage / disengage with the delivery device 115.

[0040] like Figure 2CAs shown, after suturing has been performed, the delivery device 115 can be retracted in the direction indicated by arrow 158 to deploy a set of anchors (not shown) twisted on the suture 120. To achieve this, tension can be maintained on the suture 120 by the anchors 159 of the body 151 while the second rotary dial 153 engages the delivery device 115. Rotation of the second rotary dial 153 (e.g., in the direction indicated by arrow 161) causes the delivery device 115 to move axially within the suture channel 112. In some embodiments, the locking hinge 154 can allow for fine advancement of the delivery device 115. For example, the locking hinge 154 can include a lever 163 and one or more detent features (not shown) that can operate in conjunction with a mechanical pawl 165 of the second rotary dial 153 to divide the rotation of the second rotary dial into discrete increments. The embodiments herein are not limited in this context.

[0041] like Figure 3 As shown, the system 100 can also include a suture 120 extending through the suture channel 112. More specifically, the suture 120 can extend through the interior of the delivery device 115 to deploy one or more anchor assemblies 122 into the target tissue 116. The delivery device 115 can extend beyond the distal end 108 of the elongated member 102 to deploy the anchor assemblies 122. In some embodiments, each anchor assembly 122 can include a plurality of legs 124 that can be biased from a first, collapsed configuration when positioned within the delivery device 115 to a second, expanded configuration when deployed from the distal end 126 of the delivery device 115. For example, the plurality of legs 124 can be coupled at a connection point 135 disposed along the suturing axis 123. Each of the plurality of legs 124 can include a fixed end and a free end, wherein the free end extends toward the distal end 108 of the elongated member 102. Once released from the distal end 126 of the delivery device 115, the plurality of legs 124 can pivot about the connection point 135, thereby swinging away from the suturing axis 123. The inner surface 137 of the delivery device 115 can physically constrain the plurality of legs 124 to maintain the anchor assembly 122 in the collapsed configuration prior to deployment.

[0042] During deployment, the plurality of legs 124 of the anchor assembly 122 can initially function as a probe tip, thereby piercing the target tissue 122 upon deployment. In some embodiments, the plurality of legs 124 can extend at least partially beyond the distal end 126 of the delivery device 115 so that the plurality of legs 124 can be the initial point of engagement with the target tissue 116. In other embodiments, the distal end 126 of the delivery device 115 can initially penetrate the target tissue 116 using, for example, a needle or electrocautery. In other embodiments, the distal end 126 of the delivery device 115 can abut or engage the target tissue 116 without penetrating. The anchor assembly 122 can then be deployed into the target tissue 116. Although not limiting, the anchor assembly 122 can be made of a shape memory alloy or a programmable polymer to achieve both compressed and expanded configurations.

[0043] As further shown, the anchor assembly 122 can include an attachment device 128 coupled to the plurality of legs 124, wherein the attachment device 128 is also connected to the suture 120. For example, the attachment device 128 can be a loop extending around the suture 120. The loop can be sized to allow the suture 120 to pass freely therethrough. As further described below, after the plurality of legs 124 engage the target tissue 116, the attachment device 128 can be deformed or curled to secure the attachment device 128 to the suture 120.

[0044] Now turn Figures 4A to 9B , a non-limiting example of the operation of the display system 100 will be described in more detail. It should be understood that Figure 4A 、 5A , 6A, 7A, 8A and 9A depict side views of the system 100 during use, while Figure 4B 、 5B , 6B, 7B, 8B and 9B depict the corresponding stitching patterns that can be achieved. Figures 4A to 4B As first shown, the elongated member 102 can be brought into position proximate to a target tissue 116, which can correspond to a region of tissue containing a tear, defect, or opening to be closed by the suture 120. The delivery device 115 can extend from the distal end 108 of the elongated member 102, where it contacts or is positioned directly adjacent to the target tissue 116, such as along a perimeter 134 surrounding the target tissue 116. Although not limiting, the delivery device 115 can be relatively upright (i.e., perpendicular) relative to the target tissue 116 to enable better delivery of the anchor assembly 122.

[0045] Next, if Figures 5A to 5BAs shown, the first distal-most anchor assembly 122A can be deployed from the delivery device 115 as the delivery device 115 traverses the perimeter 134. In some embodiments, the delivery device 115 is retracted into the suture channel 112 of the elongated member 102. As shown, the suture 120 can extend adjacent to the first anchor assembly 122A, thereby extending inside and outside the delivery device 115. Figures 6A to 6B As shown, the elongated member 102 can continue to move along the perimeter 134, thereby allowing the first anchor assembly 122A to be fully deployed from the delivery device 115. More specifically, the plurality of legs 124 expand to secure the first anchor assembly 122A in place within the target tissue 116. Additionally, the suture 120 can extend through the opening of the attachment device 128. Figures 7A to 7B As shown, one or more additional anchor assemblies 122B to 122E can be further deployed at desired locations in or around the target tissue 116. In the non-limiting embodiment shown, the suture 120 can be patterned in a "W" configuration around the perimeter 134 of the target tissue 116. However, it should be understood that many alternative suture and anchor assembly configurations are possible within the scope of the present invention.

[0046] Next, if Figures 8A to 8B As shown, the first tool 140 can extend from the working channel 110 of the slender member 102 and engage any one of the anchor assemblies 122A to 122E. For example, the first tool 140 can be a crimping tool that can be operated to deform the attachment device 128 around the suture 120 to prevent the suture 120 from moving relative to the attachment device 128. In some embodiments, once the final anchor assembly (e.g., anchor assembly 122E) has been deployed, the suture 120 can be tightened to close the defect in the target tissue 116. The anchor assembly 122E can then be crimped and the suture 120 cut, as shown. Figures 9A to 9B In some embodiments, a second tool 144 (e.g., a cutting tool) can be inserted through the working channel 110 to sever the suture 120 in the area between the anchor assembly 122E and the distal end 108 of the elongated member 102. Figures 10A to 10B As shown, the first tool 140 can be extended through the working channel 110 again to crimp one or more of the anchor assemblies 122A to 122D. In other embodiments, some or all of the anchor assemblies 122A to 122E can be crimped before cutting the suture 120. In other words, it may be more efficient to crimp all of the anchor assemblies 122A to 122E before removing the first tool 140 from the working channel 110 and inserting the second tool 144. In other embodiments, more than one working channel can be present, thereby allowing both the first and second tools 140, 144 to be used sequentially.

[0047] Figure 11 2 is a flow chart of a method 200 according to an embodiment of the present invention. At block 201, the method 200 may include inserting a suturing device into a patient to treat a target tissue, wherein the suturing device includes an elongated member having a working channel and a suturing channel, the elongated member having a proximal end and a distal end; a delivery device extending through the suturing channel; a plurality of anchor assemblies coupled to a suture, and wherein the plurality of anchor assemblies and the suture are disposed within the delivery device.

[0048] At block 203, method 200 can include deploying a suture and one or more anchor assemblies of the plurality of anchor assemblies to engage the target tissue. In some embodiments, the delivery device can be extended toward the target tissue to position the most distal anchor assembly of the plurality of anchor assemblies adjacent to the target tissue. Subsequently, the delivery device can be retracted toward the proximal end of the elongated member to deploy the most distal anchor assembly of the plurality of anchor assemblies.

[0049] In some embodiments, the anchor assemblies can each include a plurality of legs connected to an attachment device. When the anchor assemblies are deployed from a delivery device and into target tissue, the plurality of legs can be biased from a first collapsed configuration to a second expanded configuration within the target tissue. In some embodiments, the attachment device can connect the anchor assembly to a suture. In some embodiments, the suture can extend through the attachment device, for example, where the attachment device includes a loop or passageway.

[0050] At block 205, method 200 may optionally include pulling the suture to close the defect. In some embodiments, the target tissue may be tightened inward to close an opening or tear. At block 207, method 200 may optionally include deforming an attachment device of one or more anchor assemblies. In some embodiments, a first tool, such as a crimper, may be positioned within a working channel of the elongated member. The crimper may extend from the distal end of the elongated member and crimp the attachment device to secure the anchor assembly in place along the suture.

[0051] At block 209, method 200 may optionally include cutting the suture to complete the suturing procedure. In some embodiments, a second tool, such as a knife or blade, may be extended from the working channel to cut the suture between one of the anchor assemblies and the elongated member. With the suture secured by the anchor assembly, the suture will not unravel.

[0052] It will be understood that a variety of different materials can be used to form the devices described herein. In some cases, a variety of different metals can be used. Illustrative, non-limiting examples of suitable metals include titanium, stainless steel, magnesium, cobalt chromium, and the like. In some embodiments, for example, the devices described herein can include any suitable polymeric material, including biocompatible materials such as polyurethane or silicone. Other suitable polymers include, but are not limited to, polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, e.g., commercially available from DuPont), and polyoxymethylene (POM). ), polyether block esters, polyurethanes (e.g., polyurethane 85A), polypropylene (PP), polyvinyl chloride (PVC), polyether esters (e.g., available from DSMEngineering Plastics ), ether or ester based copolymers (e.g., butylene / poly(alkylene ether) phthalate and / or other polyester elastomers such as those available from DuPont ), polyamide (e.g., available from Bayer Or available from Elf Atochem ), elastomeric polyamides, block polyamide / ethers, polyether block amides (PEBA, for example, available under the trade name commercially available), ethylene vinyl acetate copolymer (EVA), silicone, polyethylene (PE), Marlex high-density polyethylene, Marlex low-density polyethylene, linear low-density polyethylene (e.g., ), polyester, polybutylene terephthalate (PBT), polyethylene terephthalate (PET), polypropylene terephthalate, polyethylene naphthalate (PEN), polyetheretherketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS)), polyphenylene oxide (PPO), polyparaphenylene terephthalamide (e.g., ), polysulfone, nylon, nylon-12 (such as available from EMS American Grilon ), perfluoro(propyl vinyl ether) (PFA), ethylene vinyl alcohol, polyolefins, polystyrene, epoxy resins, polyvinylidene chloride (PVdC), poly(styrene-b-isobutylene-b-styrene) (e.g., SIBS and / or SIBS 50A), polycarbonate, ionomers, biocompatible polymers, other suitable materials or mixtures, combinations, copolymers, polymer / metal composites, etc. thereof.

[0053] The expressions "coupled" and "connected," and their derivatives, may be used to describe some embodiments. These terms are not intended to be synonymous with each other. For example, some embodiments may be described using the terms "connected" and / or "coupled" to indicate that two or more elements are in direct physical or electrical contact with each other. However, the term "coupled" may also mean that two or more elements are not in direct contact with each other, but still cooperate or interact with each other.

[0054] All directional references (e.g., proximal, distal, upper, lower, upward, downward, left, right, lateral, longitudinal, front, back, top, bottom, above, below, vertical, horizontal, radial, axial, clockwise, and counterclockwise) are used for identification purposes only to assist the reader in understanding the present invention and are not intended to be limiting, particularly with respect to the position, orientation, or use of the present invention. Although non-limiting, as used herein with respect to an elongated member, the term "proximal portion" may refer to the portion of the endoscope that is closest to the handle or user interface of the system, while the term "distal end" may refer to the portion of the endoscope that is farthest from the handle or user interface of the system.

[0055] As used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will also be understood that when used herein, the terms "comprises" and / or "includes" or "includes" and / or "includes" specify the presence of stated features, regions, steps, elements and / or components, but do not preclude the presence or addition of one or more other features, regions, integers, steps, operations, elements, components and / or groups.

[0056] In addition, the terms "substantially" or "substantially" and the terms "approximately" or "approximately" can be used interchangeably in some embodiments and can be described using any relevant measurement value acceptable to a skilled person. For example, these terms can be used as a comparison to a reference parameter to indicate a deviation that will still provide the intended function. Although not limiting, the deviation from the reference parameter can be, for example, less than 1%, less than 3%, less than 5%, less than 10%, less than 15%, less than 20%, etc.

[0057] Although specific embodiments have been shown and described herein, it should be understood that any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. The present invention is intended to cover any and all adaptations or modifications of the various embodiments. It should be understood that the above description is provided in an illustrative manner, not a restrictive manner. Upon reviewing the above description, combinations of the above embodiments and other embodiments not specifically described herein will be apparent to those skilled in the art. Therefore, the scope of the various embodiments includes any other applications in which the above compositions, structures, and methods are used.

[0058] Furthermore, although the illustrative method 200 is described above as a series of actions or events, unless otherwise specified, the present invention is not limited by the illustrated ordering of these actions or events. For example, according to the present invention, some actions may occur in a different order and / or concurrently with other actions or events other than those shown and / or described herein. Furthermore, not all illustrated actions or events are required to implement a method according to the present invention.

[0059] Although the subject matter has been described in language specific to structural features and / or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described above. Rather, the specific features and acts described above are disclosed as example forms of implementing the claims.

Claims

1. A suturing device, comprising: an elongated member having a working channel and a suturing channel, the elongated member having a proximal end and a distal end; a suture extending through the suture channel; a plurality of anchor assemblies coupled to the suture, wherein the suture and the plurality of anchor assemblies are deployable from the elongated member to engage target tissue; Each of the plurality of anchor assemblies comprises: a plurality of legs biasable from a first collapsed configuration to a second expanded configuration; as well as An attachment device is coupled to the plurality of legs, the attachment device engaging the suture.

2. The suturing device of claim 1 further comprising a delivery device extending within the suturing channel.

3. The suturing device of claim 2, wherein the delivery device is axially movable within the suturing channel toward the proximal end and the distal end of the elongated member.

4. A suturing device according to claim 3, wherein the attachment device comprises a ring surrounding the suture.

5. The suturing device of claim 4, further comprising an instrument within the working channel, the instrument operable to deform the loop to secure the anchor assembly to the suture.

6. The suturing device of claim 5, wherein the instrument extends beyond the distal end of the elongated member to engage the attachment device.

7. The suturing device of claim 4, wherein the plurality of legs partially extend beyond the distal end of the delivery device to enable the plurality of legs to initially engage the target tissue.

8. The suturing device of claim 4, wherein the plurality of legs are coupled together at connection points disposed along a suturing axis.

9. The suturing device of claim 8, wherein the plurality of legs expand away from the suturing axis when deployed.

10. The suturing device according to any one of claims 8 to 9, wherein each of the plurality of anchor assemblies is disposed within the delivery device along the suturing axis prior to deployment.

11. The suturing device of claim 2, wherein the delivery device extends beyond the distal end of the elongated member.

12. The suturing device of claim 11, wherein an inner surface of the delivery device abuts the plurality of anchor assemblies to retain the plurality of anchor assemblies in the collapsed configuration within the elongated member.

13. The suturing device according to any one of claims 1-9, 11, and 12, wherein the plurality of anchoring components comprise a shape memory material.

14. The suturing device according to any one of claims 1-9, 11, and 12, wherein the slender member further includes a visualization device along the distal side.

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