Systems, devices, and related methods for fastening tissue

Abstract

A medical device may include a shaft extending from a proximal end toward a distal end, the shaft including a cavity extending from the proximal end toward the distal end; a first suture head at the distal end, the first suture head being configured to include one or more suture staples, and the first suture head having a block disposed within the first suture head and movable relative to the first suture head; a second suture head at the distal end; and a push element extending through the cavity, the push element being movable from the first position to the second position, wherein the transition of the push element from the first position to the second position pushes the block toward the second suture head to deploy the one or more suture staples.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit of priority to U.S. Provisional Application No. 62 / 872,290, filed July 10, 2019, which is incorporated herein by reference in its entirety. Technical Field

[0003] Various aspects of the present invention generally relate to tissue fastening, including visualization, retraction, and joining of tissues. More specifically, among other aspects, embodiments of the present invention relate to systems, apparatus, and related methods for suturing tissues. Background Technology

[0004] Tissue stabilization (e.g., suturing) is used in many laparoscopic surgeries. These procedures typically involve removing portions or sections of tissue, followed by closure using staples. A common example is colorectal anastomosis. In hybrid surgeries where surgeons use both laparoscopic and endoscopic platforms, rigid staplers are commonly used. Linear staplers consist of long, rigid components that cannot navigate through tortuous anatomical structures without causing tissue trauma. Surgeons are also moving towards endoscopic, outpatient procedures that will require endoscopic suturing.

[0005] For the reasons mentioned above, improvements to the present invention may be useful. Summary of the Invention

[0006] Various aspects of the present invention relate, among others, to systems, apparatus, and methods for securing tissues, such as flexible endoscopic platforms with suturing capabilities. Each of the aspects disclosed herein may include one or more of the features described in combination with any of the other disclosed aspects.

[0007] In one aspect, the present invention relates to a medical device comprising a shaft extending from a proximal end toward a distal end, the shaft including a cavity extending from the proximal end toward the distal end; a first suture head at the distal end, the first suture head being configured to include one or more suture staples, and the first suture head having a block disposed within the first suture head and movable relative to the first suture head; a second suture head at the distal end; and a pushing element extending through the cavity, the pushing element being movable from a first position to a second position, wherein the transition of the pushing element from the first position to the second position pushes the block toward the second suture head to deploy one or more suture staples.

[0008] The actuating element also includes a third position and a fourth position, wherein movement of the actuating element from the third position to the fourth position before moving from the first position to the second position causes the first suture head to move toward the second suture head. The shaft extends along a longitudinal axis, and the block and the first suture head are each movable toward the second suture head along a trajectory substantially perpendicular to the longitudinal axis. The second suture head includes a plane extending in a plane substantially perpendicular to the trajectory, wherein the plane is an anvil configured to bend one or more sutures into the tissue upon contact with one or more sutures. The medical device includes a first extension extending proximally from the first suture head, the first extension having a first ramp at its proximal end; and a distal end of the actuating element including a second ramp configured to slide against the first ramp as the actuating element moves from the third position to the fourth position. The first ramp extends radially inward in a proximal direction, and the second ramp extends radially outward in a distal direction. The outer surface of the actuating element includes a protrusion configured to directly contact the block. The block includes a third ramp, and the distal end of the protrusion includes a fourth ramp, configured to slide against the third ramp as the actuating element moves from a first position to a second position. The third ramp extends radially inward in a proximal direction, and the fourth ramp extends radially outward in a distal direction. The medical device also includes a first extension extending proximally from a first suture head, the first extension including a longitudinally extending first recess; and movement of the actuating element from a fourth position to a first position causing the protrusion to slide through the first recess. When the actuating element moves from the fourth position to the first position, the block remains fixed relative to the first suture head. The first suture head includes a second recess coaxial with the first recess; and movement of the actuating element from the first position to the second position causes the distal end of the protrusion to extend through the second recess and contact the block. The block is coupled to the inner surface of the first suture head by one or more elastic members. The medical device further includes a second axis movable from a first configuration to a second configuration, wherein: when the second axis is in the first configuration, the first suture and the second suture are spaced apart by a first distance; and when the second axis is in the second configuration, the second axis is distal relative to the first configuration and positions the first suture head and the second suture head at a second distance from each other. The medical device also includes a first extension extending proximally from the first suture head and a second extension extending proximally from the second suture head, wherein the first extension and the second extension are connected to each other at a joint, and wherein the first extension and the second extension are movable between the first configuration and the second configuration: in the first configuration, the first suture head and the second suture head are spaced apart by a first distance; and in the second configuration, the first suture head and the second suture head are spaced apart by a second distance, wherein the second distance is smaller than the first distance.

[0009] In another aspect, the present invention relates to a medical device comprising a shaft extending along a longitudinal axis from proximal to distal, the shaft comprising: a first catheter extending from proximal to distal; an expandable chamber coupled to the first catheter; and one or more sutures coupled to the expandable chamber, wherein delivery of fluid via the first catheter to the expandable chamber is configured to move the one or more sutures toward a surface to deploy the one or more sutures by contacting the one or more sutures with the surface.

[0010] The shaft also includes a recess at least partially defined by a surface, and expansion of the expandable member causes one or more suture staples to move into the recess. The medical device also includes a second catheter extending proximally toward distally, wherein the distal end of the shaft is configured to hinge relative to a longitudinal axis when the second catheter is filled with fluid. The medical device also includes an electroactive polymer extending along a portion of the shaft, wherein the distal end of the shaft is configured to hinge relative to a longitudinal axis when an electric current is applied to the electroactive polymer.

[0011] In another aspect, the present invention relates to a medical device comprising a shaft extending proximally toward distally along a longitudinal axis, the shaft including a cavity extending proximally toward distally; and a push element extending through the cavity, wherein distal movement of the push element along the longitudinal axis is configured to deploy one or more suture staples in a direction substantially perpendicular to the longitudinal axis of the shaft.

[0012] It is understood that the foregoing general description and the following detailed description are merely exemplary and illustrative of the claimed invention, and not restrictive. Attached Figure Description

[0013] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary aspects of the invention and, together with the description, serve to explain the principles of the invention.

[0014] Figures 1 to 6 This is an illustration of an exemplary suturing method according to various aspects of the present invention.

[0015] Figure 7 This is a perspective view of a medical device according to an embodiment of the present invention.

[0016] Figures 8 to 12 It shows the use Figure 7 A side view of a suturing procedure using a medical device.

[0017] Figure 13 yes Figures 7 to 12 A cross-sectional view of the casing and blocks of a medical device.

[0018] Figure 14 yes Figures 7 to 12 A cross-sectional view of the actuating element of a medical device.

[0019] Figure 15 yes Figures 7 to 12 A cross-sectional view of the extension of a medical device.

[0020] Figure 16 and Figure 17 A diagram showing the deployment of one or more suture staples is provided. Figure 13 The movement of blocks.

[0021] Figure 18 and Figure 19 A medical device according to an alternative embodiment of the present invention is shown.

[0022] Figure 20 and Figure 21 A medical device according to yet another alternative embodiment of the invention is shown.

[0023] Figures 22 to 24 This is an illustration of a medical device according to yet another alternative embodiment of the present invention.

[0024] Figure 25 This is an illustration of a medical device according to yet another alternative embodiment of the present invention. Detailed Implementation

[0025] Among other things, the present invention relates to systems, apparatus, and methods for joining, cutting, and removing tissue. Reference will now be made in detail to various aspects of the invention, examples of which are shown in the accompanying drawings. Wherever possible, the same or similar reference numerals will be used in all the drawings to refer to the same or similar parts. The term “distal” refers to the part furthest from the user when the device is inserted into the subject's body. Conversely, the term “proximal” refers to the part closest to the user when the device is placed into the subject's body. The term “tissue fastening” can refer to, for example, suturing, fixing, attaching, securing, or otherwise combining two parts of tissue. The term “fastener” can include suture staples, clips, elastic bands, sutures, or any other fastener known in the art.

[0026] The foregoing general description and the following detailed description are merely exemplary and illustrative of the claimed features, and not restrictive. As used herein, the terms “comprising,” “containing,” “having,” “including,” or other variations thereof are intended to cover non-exclusive contents such that a process, method, article, or apparatus that comprises a list of elements includes not only those elements but may include other elements not expressly listed or not inherent to such process, method, article, or apparatus. Additionally, the term “exemplary” is used herein in the sense of “example” rather than “model.” As used herein, the terms “about,” “substantially,” and “approximately” indicate a range of values ​​within + / - 5% of the stated value, unless otherwise stated.

[0027] Figures 1 to 6 An exemplary medical device 100 that can be used to suture tissue 20 is shown. In some embodiments, the medical device 100 may be a surgical suturing device configured to engage body tissue 20, apply one or more surgical fasteners thereto, and optionally form an incision in the fastened body tissue during minimally invasive surgical procedures, such as endoscopic procedures. The medical device 100 may be used to apply surgical clips or other fasteners, but will be discussed primarily in the case of applying suture staples.

[0028] The medical device 100 may include an elongated member or shaft 102 extending from a proximal end (not shown) toward a distal end 104. A suture assembly 110 may be disposed at the distal end 104. For clarity, in... Figure 1 The medical device shown does not have an attached suture assembly 110. In some embodiments, the suture assembly 110 can be mounted from a first position, such as... Figure 2 The transport location shown is moved to a second location, such as... Figure 3 The operating position is shown. In some examples, the suture assembly 110 may include one or more struts 112 coupled to the distal end 104, or movable through the cavity 108 of the medical device 100. The suture assembly 110 is in Figure 2 It may not be operational at the indicated transport location and can be configured to be in operation when... Figure 3 When in the operating position, only suture staples are delivered to the tissue. In other words, even if a suture staple or tissue fastening element is deployed in response to an action from the operator (e.g., pressing a button on the actuator) when the medical device 100 is in the operating position, the medical device 100 may not be able to deploy suture staples or other tissue fastening elements when it is in the transport position.

[0029] Axis 102 can be any suitable endoscopic component configured to bend and articulate to pass through tortuous anatomical structures within the body. Axis 102 can be formed from one or more biocompatible materials, such as HDPE, silicone, polyurethane, ETFE, SIBS, PIB-PUR, or any other suitable medical-grade polymer, and can be flexible and configured to extend through tortuous anatomical structures. Axis 102 can extend to any length suitable for endoscopic or laparoscopic surgery and can be configured to be positioned within the working channel of an endoscope. Alternatively, axis 102 can be positioned within the body without an endoscope. Axis 102 may include illumination / optics assembly 106 and one or more lumens 108. Although endoscopes are referenced herein, references to endoscopes or endoscopic examinations should not be construed as limiting the possible applications of the disclosed aspects. For example, the disclosed aspects can be used with duodenoscopy, bronchoscopy, ureteroscopy, colonoscopy, catheters, diagnostic or therapeutic instruments or devices, or other types of medical devices.

[0030] Component 106 may include an illumination device and an optical device. For example, the illumination device may include one or more of an optical fiber device (e.g., fiber optic cable) or a light-emitting diode (LED) to provide illumination light to a location within the body of the subject distal to distal end 104. The optical device may include any suitable means configured to provide a visual image of the internal location of the subject's body. For example, the optical device may include one or more optical elements (e.g., a lens, a camera, etc.).

[0031] One or more cavities 108 may be arranged at any suitable location around the distal end face of shaft 102. In some arrangements, one or more cavities 108 may be configured to provide flushing and / or aspiration fluid. In this case, one or more cavities 108 may be fluidly coupled to one or more ports (not shown) of a handle (not shown). Such ports may then be fluidly coupled to one or more sources of flushing and / or aspiration fluid for delivery via one or more cavities 108. Furthermore, one or more cavities 108 may be arranged to receive one or more articulated wires (not shown), etc., to selectively articulate at least the distal end 104 of shaft 102. In one embodiment, tool 114 may extend through cavity 108. Tool 114 may be configured to grasp tissue 20 and position tissue 20 within or near suture assembly 110. For example, tool 114 may include a grasper, forceps, snare, clamp, tissue loop, spiral coil, or applicator, or any other tool for performing medical procedures.

[0032] exist Figure 4 In the image, tool 114 is shown extending toward tissue 20. Figure 5 In this diagram, tool 114 is shown positioning tissue 20 between adjacent suture heads of suture assembly 110. Figure 6 In the diagram, the first tissue portion 22 is shown having a first row of sutures 244 disposed therein, while the second tissue portion 24 is shown having a second row of sutures 244 disposed therethrough. The separate suture heads of the suture assembly 110 can be moved together by an actuation button or other mechanism that ejects sutures from one suture head toward the other. The medical device 100 may also include one or more tools, such as scalpels, for separating the sutured tissue portions.

[0033] exist Figures 7 to 12 The image shows a medical device 200. The medical device 200 may include, for example: Figures 1 to 6 The shaft 102 described herein. The medical device 200 may include one or more sutures 244 ( Figure 11 and Figure 12The medical device 200 is configured to be deployed along a trajectory substantially perpendicular to the longitudinal axis of axis 102. The medical device 200 may include navigation states. Figure 2 The suture staple 244 can be positioned proximally to the hinge portion of shaft 102. In the navigation state, the suture head of the suture assembly 110 is positioned distally to the elongated member 102. The suture device is designed close to the face of the elongated member 102 to facilitate easier passage through anatomical structures when not using the suture function. The suture head of the suture assembly can be rested in an open position (in both the navigation and operating states) to maintain visibility. The suture head can be propelled forward using a mechanical drive mechanism (e.g., drive line, sheath, etc.) that can be attached to the support. The drive mechanism can extend proximally through the endoscope for actuation by a medical professional in the handle. Once the medical device 200 is moved to the desired position, tissue features, such as reference features, located inside or outside shaft 102, are harvested. Figures 1 to 6 The tool 114 can be used to collect and locate tissue for suturing.

[0034] In some embodiments, the medical device 200 may include a suture assembly 202 disposed at a distal end 104. The suture assembly 202 may include a first suture head 204 that can be fixed to the distal end 104, and a second suture head 206 that can be movable relative to the distal end 104. In other embodiments, the first suture head 204 and the second suture head 206 may be as described above. Figures 1 to 6 The manner described is similar to that of moving between a transport configuration and an operable configuration. The first suture head 204 may include a plane 214 extending substantially perpendicular to the longitudinal axis of shaft 102. The plane 214 may include one or more recesses 212 and may act as an anvil for the legs of the suture staples 244. The first suture head 204 may be coupled to shaft 102 via a support member 210. It is contemplated that the support member 210 may extend through one or more cavities of shaft 102 (i.e., via the attachment to a mirror), may be coupled to the exterior of shaft 102 (i.e., via the attachment to a mirror), or may include a combination of such attachments. The first suture head 204 may also include a radially outwardly curved surface opposite the plane 214 and may typically be crescent-shaped; however, other suitable shapes are also contemplated.

[0035] The second suture head 206 may be disposed within the housing 220 coupled to the distal end 104. In some embodiments, the housing 220 may be secured to the distal end 104 by attachment to a mirror, attachment to a mirror, or a combination of attachment types. An extension 222 may extend proximally from the second suture head 206. The proximal end of the extension 222 may include an inclined surface 224 extending radially inward in a proximal direction. The extension 222 may also include a recess 222a formed in its outer surface. Figure 15The actuating element 226 may extend through the cavity 108 of the shaft 102. The distal end of the actuating element 226 may include an inclined surface 228 extending radially outward in a distal direction. The inclined surface 228 may be configured in any manner to engage a corresponding inclined surface 224 of the extension 222. The actuating element 226 may also include a protrusion 230 extending from its outer surface. The distal end of the protrusion 230 may include an inclined surface 232 extending radially outward in a distal direction (as with inclined surface 228). The inclined surface 232 may be continuous with the inclined surface 228 (i.e., may be coaxial or collinear) and may be proximal to the entire inclined surface 228. A recess 222a may be configured to receive the protrusion 230 and may have a radial dimension b that is slightly longer or substantially equal to the dimension c of the protrusion 230 extending from the outer surface of the actuating element 226 (see reference). Figure 14 and Figure 15 ).

[0036] refer to Figure 13 The second suture head 206 may include a recess 206a that is substantially coaxial with the recess 222a. The second suture head 206 may also include an opening 206b that, during suturing, may be positioned near the plane 214 of the first suture head 204. A block 240 may be disposed within the second suture head 206 and movable within the second suture head 206, at least partially passing through the opening 206b. A staple may be positioned below the block 240 (e.g., in a cassette) and, when the block 240 is pushed downwards, may be forced into an anvil on the opposing suture head. The recess 206a may have a length / width dimension a smaller than the dimension c of the protrusion 230, such that the protrusion 230 can extend through the recess 206a to contact the block 240. The block 240 may be oriented towards... Figure 13 The first type of bias shown is achieved, for example, by one or more elastic members or springs 213 attached to the inner surface of block 240 and the second stitch head 206. Figure 13 The diagram shows two springs 213 compressed in a stationary state; however, more or fewer springs are also conceivable. Springs 213 can extend when the protrusion 230 of the actuating element 226 contacts and pushes the block 240 toward the plane 214 to deploy the stitch 244. The block 240 may also include an inclined surface 242 at its proximal end, which extends radially inward in a proximal direction. Inclined surfaces 232 and 242 can engage in a manner substantially similar to that of inclined surfaces 224 and 228.

[0037] The various steps of operating the medical device 200 will now be described. Inclined surfaces 224 and 228 can cooperate such that when the actuating element 226 is pushed distally along or parallel to the longitudinal axis of shaft 102, the inclined surface 228 moves along a longitudinal axis substantially perpendicular to shaft 102 (see...). Figure 8 and Figure 9 The radially inward path of the pushing element 226 pushes the second suture head 206. After the second suture head 206 reaches the end of its travel path and has traveled a predetermined first distance (towards the first suture head 204 in a direction perpendicular to the longitudinal axis of axis 102), further distal movement of the pushing element 226 can extend the protrusion 230 through the recess 222a of the extension 222 (e.g., Figure 11 For at least the second predetermined distance, further distal movement of the actuating element 226 may cause the protrusion 230 to slide, translate, or move relative to and / or through the recess 222a without causing any movement of the block 240 relative to the second suture head 206. Figure 11 In some embodiments, the second predetermined distance may correspond to or be substantially equal to the length of the recess 222a. However, after the actuating element 226 has traveled the second predetermined distance, further distal movement of the actuating element may deploy a block 240 containing one or more suture pins 244. Figure 10 and Figure 12 Specifically, the further distal movement of the actuating element 226 causes the protrusion 230 to move through the recess 206a and contact the block 240. Specifically, the inclined surface 232 can slide against the inclined surface 242 to push the block 240 toward the first suture head 204 (particularly toward the plane 214). The spring 213 can extend from a resting state during this movement of the block 240. The block 240 can travel along a trajectory substantially similar to the initial trajectory of the second suture head 206 (i.e., in a direction perpendicular to the longitudinal axis of axis 102 and toward the first suture head 204).

[0038] The push block 240 towards plane 214 can cause the legs of the staple 244 to contact plane 214 (see...). Figure 16 and Figure 17 This deploys the suture staple 244 into the tissue located between the first suture head 204 and the second suture head 206. Figure 10 and Figure 12After the deployment of the suture staples is completed, the distal force acting on the actuating element 226 can be released (or reversed), causing the spring 213 to return to its stationary compressed state and the block 240 to retract into the housing 206. Furthermore, releasing (or reversing) the distal force acting on the actuating element 226 can cause the entire second suture head 206 to move radially outward along the longitudinal axis perpendicular to shaft 102 back to its original position.

[0039] It can be envisioned that the driving element 226 is driven from... Figure 8 The position shown to Figure 10 and Figure 12 The movement of the indicated position (after the deployment of suture staple 244) can be performed with a single smooth motion. However, in some embodiments, a stop may be included so that at any time after the second suture head 206 has traveled a predetermined first distance (towards the end of the travel path of the first suture head 204), a medical professional needs to perform some action to allow the actuating element 226 to continue driving the distally actuating block 240. For example, the stop may be incorporated into the recess 222a and may block movement of the protrusion 230. In some embodiments, applying additional force to the actuating element 226 may cause the stop to deform and move out of the path of the actuating element 226. In other embodiments, the movement of the stop may be controlled by an actuator, button, etc., on the handle of the medical device. Including a stop allows a medical professional to hold the tissue with only suture heads 204 and 206 before it is necessary to drive the suture staple 244 through the tissue. This can help the medical professional readjust the held tissue slice, for example, when grasping the wrong tissue slice.

[0040] exist Figure 18 and Figure 19 A medical device 300 is shown. The medical device 300 includes an alternative mechanism for moving two suture heads closer together, wherein an outer shaft slides on the suture heads to force them toward each other. For example, the medical device 300 may include a shaft 302 extending from a proximal end (not shown) toward a distal end 304. A shaft 310 may extend within a cavity of the shaft 302. Two suture heads 312a and 314a may extend from the distal end of the shaft 310 via supports 312 and 314, respectively. Supports 312 and 314 may extend distally and radially outward from the distal end of the shaft 310 (e.g., relative to the longitudinal axis of the shaft 310). As the shaft 302 moves distally relative to the axial direction (or the shaft 310 and supports 312 and 314 move proximally relative to the shaft 302), the suture heads 312a and 314a move toward each other along a radially inward path. Figure 19Once the suture heads 312a and 314a have reached the end of their travel paths, making them substantially adjacent to each other, a second and separate suture deployment step can be performed. It is conceivable that the medical device 300 may include any other suture deployment mechanism disclosed herein. For example, a pusher element 226 may extend through the support 312 and cause the block 240 (within, for example, the first suture head 312a) to drive the suture head 244 into the surface of the suture head 314a. Alternatively, the following description may be used... Figures 22 to 24 The fluid delivery mechanism is described above. In yet another embodiment, the closure of the suture heads 312a and 314a can itself deploy the suture staples 244.

[0041] exist Figure 20 and 21 A medical device 400 is shown. The medical device 400 includes an alternative mechanism for closing two suture heads, wherein the thread is connected to a scissor-shaped connector attached to the suture heads. For example, the medical device 400 may include a shaft 402 extending from a proximal end (not shown) toward a distal end. Two suture heads 404 and 406 may extend from the distal end of the shaft 402 via supports 408 and 410, respectively. Supports 408 and 410 may extend proximally from their respective suture heads, cross each other, and connect to each other at a connector 412 (e.g., a scissor-shaped connector, pivot, etc.). A thread or other actuating member 414 may extend proximally from each support 408 and 410. Actuation of the thread 414 may cause the suture heads 404 and 406 to move toward each other. Figure 21 More specifically, a proximal and radially inward force can be applied to each suture 414. Because the working channel is small, pulling the suture backward may be sufficient to create the necessary radially inward force (provided there is enough space for the suture to travel inward when pulled). The suture can be connected to a button or other actuation mechanism in the handle so that the user does not pull the suture directly. Once the suture heads 404 and 406 have reached the end of their travel paths and are adjacent to each other, a second and separate suture deployment step can be performed. It is conceivable that the medical device 400 may include any other suture deployment mechanism disclosed herein. For example, the following regarding Figures 22 to 24 The fluid delivery mechanism described above. For example, fluid can be delivered to, for example, the suture head 404 via a conduit 416 to an expandable member (not shown) disposed within the suture head 404. In yet another embodiment, the closure of the suture heads 404 and 406 can itself deploy the suture staple 244.

[0042] Figures 22 to 24An exemplary medical device 500 that can be used to suture tissue 20 is shown. The medical device 500 may include an elongated member or shaft 501 extending from a proximal end (not shown) toward a distal end 502. The medical device 500 may include a distally facing surface or end face 503 at the distal end 502. The medical device 500 may also include a first fluid conduit 504 and a second fluid conduit 506. The second fluid conduit 506 may terminate at its distal end in an expandable chamber 508.

[0043] The expandable chamber 508 can be expanded from the first form ( Figure 22 and Figure 23 (As shown) Move to the second form ( Figure 24 (As shown). The expandable chamber 508 in the first embodiment may have a first volume, which is smaller than the second volume in the second embodiment. The second volume may be 1.5, 2, 3 or more times larger than the first volume, but other suitable ratios are also conceivable. The exterior of the expandable chamber may be formed of an expandable and elastic material, such as, for example, rubber, polymer, etc.

[0044] The medical device 500 may also include a recess 509 formed in the distally facing surface 503. However, it is also conceivable that the recess 509 may alternatively or additionally be formed in the circumferential side surface of the shaft 501. The recess 509 may be partially defined by a flat surface 510 (which may act as an anvil during suturing). An expandable chamber 508 may be coupled to one or more sutures 244 and may be arranged within the distal end 502 such that expansion of the expandable chamber 508 is in the direction of the recess. For example, a solid and relatively rigid material may surround a large portion of the expandable chamber 508, while an opening 511 is provided between the expandable member 508 and the recess 509. In this configuration, expansion of the expandable chamber 508 must pass through the opening 511 and into the recess 509. Alternatively, the expandable chamber 508 itself may not expand into the recess 509, but the sutures 244 may be driven into the recess 509 and / or toward the plane 510 through the recess 509. Driving the staple 244 into the plane 510 can occur along a trajectory that is substantially perpendicular to the plane 510.

[0045] First conduit 504 and second conduit 506 may be coupled to fluid source 507, which is configured to drive fluid through the conduits. Fluid source 507 may be a pump controlled by a controller. The pump may be any suitable pump, such as, for example, a peristaltic pump, piston pump, motorized pump, microfluidic pump, infusion pump, etc. The pump may be powered by electricity, mechanical power, chemical power, or another suitable mechanism. Fluid source 507 may include a source of fluid (e.g., a reservoir) to be circulated through conduits 504, 506. In some examples, fluid source 507 may include multiple reservoirs, and fluid may be delivered from a dedicated reservoir through each conduit 504, 506. Alternatively, the same reservoir may supply both conduits 504, 506, and the fluid may be controlled via one or more valves (not shown). The fluid circulated through conduits 504 and 506 may be any suitable biocompatible fluid, such as, for example, sterile water or saline (in case of leakage). The controller may include a processor, which is typically configured to receive information from the medical device and its components, and process the information according to various algorithms to generate control signals for controlling the fluid source 507. For example, the processor may receive information from the system and its components, process the information according to various algorithms, and generate information signals that can be directed to, for example, a visual indicator, digital display, audio generator, or other indicator in a user interface to notify the user of system status, component status, surgical status, or any other information being monitored by the system. The processor may be a digital IC processor, an analog processor, or any other suitable logic or control system that executes control algorithms. One or more pressure sensors may be coupled to each fluid conduit 504 and 506, and the controller may control the flow of fluid through conduits 504 and 506 by receiving and analyzing the outputs from one or more pressure sensors.

[0046] The articulation of the medical device 500 can be at least partially achieved by filling the first conduit 504 with fluid. Alternatively, the medical device 500 can be configured to have non-uniform stiffness. That is, the medical device 500 may exhibit a tendency to bend in one or more directions, rather than in one or more other directions. In other words, the medical device 500 can be pre-configured to be hinged along a specific trajectory away from the longitudinal axis of the shaft 501. This tendency to bend away from the longitudinal axis, or the pre-configuration, can be achieved by forming the shaft 501 with at least two materials having different hardness or different stiffness. In this embodiment, when the first conduit 504 is filled with fluid, the portion of the shaft 501 with higher stiffness will resist movement, and the portion of the shaft 501 with lower stiffness will bend (e.g., as...). Figure 23 and Figure 24(As shown). In another embodiment, surface modifications, such as cuts, slits, recesses, etc., can be made only along a portion of the outer circumference of shaft 501. Similarly, material can be removed from certain internal portions of shaft 501. When the first conduit 504 is filled with fluid in these embodiments, portions of shaft 501 with surface modifications or otherwise removed material can bend, while portions of shaft 501 without such surface modifications or removed material can resist movement. Increasing the pressure within the first conduit 504 can increase the articulation of shaft 501, while maintaining any particular pressure level can maintain a particular articulation angle.

[0047] exist Figure 25 In yet another embodiment shown, the hinge of shaft 601 can be achieved by using an electroactive polymer 604 instead of a pressurized fluid. For example, this polymer 604 may comprise a cationic material that is randomly dispersed and unoriented. The surface on the side of shaft 601 adjacent to polymer 604 may comprise anionic material 605. When a current is activated in a generator 607 coupled to polymer 604, the cationic ions in polymer 604 can orient and migrate toward anionic material 605. This can then cause polymer 604 to bend. If current flows through polymer 604, shaft 601 retains its bent shape. In other words, the hinge of shaft 601 can be maintained during any “on” cycle of the generator coupled to the polymer. It is also conceivable that polymer 604 may comprise a randomly dispersed and unoriented anionic material, while material 605 comprises a cationic material. In a further example, the hinge can be achieved using magnetic attraction between polymer 604 and material 605.

[0048] It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed apparatus and methods without departing from the scope of the invention. Other aspects of the invention will be apparent to those skilled in the art based on consideration of the description and practice of the features disclosed herein. The description and examples are intended to be illustrative only.

Claims

1. A medical device, comprising: A shaft extending from a proximal end toward a distal end, the shaft including a cavity extending from the proximal end toward the distal end; A first suture head at the distal end, the first suture head being configured to include one or more suture staples, and the first suture head having a block disposed within the first suture head and movable relative to the first suture head; The second suture head at the distal end; as well as An actuating element extending through the cavity is movable from a first position to a second position, wherein the transition of the actuating element from the first position to the second position actuates the block toward the second suture head to deploy the one or more suture staples, and wherein the movement of the actuating element causes the first suture head to translate toward the second suture head along a radially inward trajectory substantially perpendicular to the longitudinal axis of the axis; wherein the actuating element further includes a third position and a fourth position, wherein the movement of the actuating element from the third position to the fourth position before the actuating element moves from the first position to the second position causes the first suture head to move toward the second suture head; wherein the second suture head includes a plane extending in a plane substantially perpendicular to the trajectory, wherein the plane is an anvil configured to bend the one or more suture staples into the tissue upon contact with the one or more suture staples.

2. The medical device of claim 1, wherein the trajectory is a first trajectory, and wherein the block translates toward the second suture head along a second trajectory substantially perpendicular to the longitudinal axis.

3. The medical device according to claim 1, wherein: The medical device includes a first extension extending proximally from the first suture head, the first extension having a first ramp at a proximal end; and The distal end of the actuating element includes a second ramp, which is configured to slide against the first ramp as the actuating element moves from the third position to the fourth position.

4. The medical device according to claim 3, wherein: The first ramp extends radially inward in the direction toward the proximal side; and The second slope extends radially outward in the direction toward the distal side.

5. The medical device according to any one of claims 2 to 4, wherein the outer surface of the actuating element includes a protrusion, wherein the protrusion is configured to directly contact the block.

6. The medical device of claim 5, wherein the block includes a third ramp and the distal end of the protrusion includes a fourth ramp configured to slide against the third ramp as the push element moves from the first position to the second position.

7. The medical device of claim 6, wherein the third ramp extends radially inward in a proximal direction and the fourth ramp extends radially outward in a distal direction.

8. The medical device according to claim 5, wherein: The medical device further includes a first extension extending proximally from the first suture head, the first extension including a longitudinally extending first recess; and The movement of the pushing element from the fourth position to the first position causes the protrusion to slide through the first recess.

9. The medical device of claim 8, wherein when the pushing element moves from the fourth position to the first position, the block remains fixed relative to the first suture head.

10. The medical device according to claim 9, wherein: The first suture head includes a second recess coaxial with the first recess; and The movement of the pushing element from the first position to the second position causes the distal end of the protrusion to extend through the second recess and contact the block.

11. The medical device of claim 1, wherein the block is connected to the inner surface of the first suture head by one or more elastic members.

Images