Suture-based closure devices

Abstract

The suturing device includes a sewing ring defining an arcuate channel extending therethrough, a first arcuate needle feed section slidably disposed within a first side of the arcuate channel, a second arcuate needle feed section slidably disposed within a second side of the arcuate channel, and an arcuate needle transferable between the first and second arcuate needle feed sections, the arcuate needle including a first latch mechanism adapted to releasably secure the arcuate needle to the first arcuate needle feed section, and a second latch mechanism adapted to releasably secure the arcuate needle to the second arcuate needle feed section.

Description

[Technical Field]

[0001] FIELD OF THE DISCLOSURE The present disclosure relates to devices for suturing tissue, and more particularly to devices that cooperate with an endoscope or equivalent device to endoscopically suture tissue. [Background technology]

[0002] Various endoscopic procedures can result in injuries (or wounds) that are too large to be easily closed with hemostatic clips. Examples of such endoscopic procedures include removal of large lesions, tunneling under the mucosal layer, full-thickness tissue removal, treatment of other organs by passing outside the gastrointestinal tract, and repair of post-operative issues such as post-operative leaks, surgical staple line failures, and anastomotic leaks. Endoscopic procedures also include bariatric revision procedures. Known devices and methods for endoscopically closing large defects each have certain advantages and disadvantages. Summary of the Invention

[0003] The present disclosure relates to several alternative designs, materials, and methods of devices for endoscopically closing large wounds. In one example, the suturing device includes a mounting structure adapted to be secured to a distal end of an endoscope, and a suture ring secured to the mounting structure, the suture ring defining an arcuate channel extending therethrough. A first arcuate needle feeder is slidably disposed within a first side of the arcuate channel and includes a working end and a control end. A first control element is operably coupled to the control end of the first arcuate needle feeder, and the arcuate needle is removably securable to the first needle feeder.

[0004] Alternatively or additionally, the suturing device may further include a second arcuate needle feed section slidably disposed within the second side of the arcuate channel and including a working end and a control end. The second control element is operably coupled to the control end of the second arcuate needle feed section. The arcuate needle is transferable between the first arcuate needle feed section and the second arcuate needle feed section and includes a first latch mechanism adapted to releasably secure the arcuate needle to the first arcuate needle feed section and a second latch mechanism adapted to releasably secure the arcuate needle to the second arcuate needle feed section. The first control element and the second control element cross each other upon entering the arcuate channel of the sewing ring.

[0005] Alternatively or additionally, the first latch mechanism may include a first pair of radially spaced apart protrusions located within a first portion of the arcuate needle, and the second latch mechanism may include a second pair of radially spaced apart protrusions located within a second portion of the arcuate needle.

[0006] Alternatively or additionally, the arcuate needle may further include a suture hole disposed between the first latch mechanism and the second latch mechanism. Alternatively or additionally, the first needle feed portion may include a first hole complementary to a first protrusion of the first protrusion pair and a second hole complementary to a second protrusion of the first protrusion pair.

[0007] Alternatively or additionally, the first arcuate needle feed portion may include first pairs of longitudinal alignment slots extending from the working end toward the control end of the first arcuate needle feed portion, each first pair of longitudinal alignment slots extending through one of the first and second holes such that the first arcuate needle feed portion can flex relative to the first and second holes when not constrained by the first side of the arcuate suture ring.

[0008] Alternatively or additionally, the second arcuate needle feed portion may include a first hole complementary to the first protrusion of the second protrusion pair and a second hole complementary to the second protrusion of the second protrusion pair. Alternatively or additionally, the second arcuate needle feed portion may include second pairs of longitudinal alignment slots extending from the working end toward the control end of the second arcuate needle feed portion, each pair of second longitudinal alignment slots extending through one of the first and second holes such that the second arcuate needle feed portion can flex relative to the first and second holes when not constrained by the second side of the arcuate suture ring.

[0009] Alternatively or additionally, the suture ring may extend circularly from a first open end to a second open end, the first and second open ends being spaced apart by a distance that allows tissue to extend between the first and second open ends.

[0010] Alternatively or additionally, the annular channel may have a circular cross-sectional profile except for a first region adjacent the first open end and a second region adjacent the second open end. Alternatively or additionally, the first region and the second region may each have an elliptical cross-sectional profile that allows the first arcuate needle feed portion or the second arcuate needle feed portion to begin to bend as the first arcuate needle feed portion exits the first open end, or as the second arcuate needle feed portion exits the second open end, or as the first arcuate needle feed portion and the second arcuate needle feed portion exit the first open end and the second arcuate needle feed portion exit the second open end.

[0011] Alternatively or additionally, the first control element may enter a first side of the arcuate channel substantially parallel to a tangent to the first arcuate needle feed portion proximate to where the first control element is secured to the first arcuate needle feed portion.

[0012] Alternatively or additionally, the second control element may enter the second side of the arcuate channel substantially parallel to a tangent to the second arcuate needle feed portion proximate to where the second control element is secured to the second arcuate needle feed portion.

[0013] Alternatively or additionally, the suturing device may further include a first tubular member housing the first control element and a second tubular member housing the second control element. In another example, a suturing device adapted for use in combination with an endoscope includes a sewing ring having a first side and a second side, the sewing ring defining an arcuate channel extending therethrough. A first tubular member includes a curved distal portion that curves in a direction opposite to the direction of curvature of the first side of the sewing ring. A second tubular member includes a curved distal portion that curves in a direction opposite to the direction of curvature of the second side of the sewing ring. A first arcuate needle feed portion is slidably disposed within the first side of the arcuate channel, and a second arcuate needle feed portion is slidably disposed within the second side of the arcuate channel. A first control element is disposed within the first tubular member and operably coupled to the first arcuate needle feed portion. A second control element is disposed within the second tubular member and operably coupled to the second arcuate needle feed portion. The arcuate needle can be transferred between the first arcuate needle feed section and the second arcuate needle feed section by operating the first control element and the second control element.

[0014] Alternatively or additionally, the first needle feed portion may include a working end adapted to removably secure the arcuate needle. Alternatively or additionally, the first arcuate needle feed portion may include a first pair of longitudinal alignment slots extending into the working end of the first needle feed portion to allow the working end of the first needle feed portion to flex when not constrained by the first side of the arcuate suture ring.

[0015] Alternatively or additionally, the second arcuate needle feed portion includes a working end adapted to removably secure the arcuate needle. Alternatively or additionally, the second arcuate needle feed portion may include a second pair of longitudinal alignment slots extending into the working end of the second arcuate needle feed portion to allow the working end of the second arcuate needle feed portion to flex when not constrained by the second side of the arcuate suture ring.

[0016] In another example, a suturing device adapted for use in combination with an endoscope includes an end cap ring adapted to be secured to a distal end of the endoscope and a C-shaped sewing ring secured to the end cap ring. The C-shaped sewing ring has a first side and a second side and defines an arcuate channel extending through the sewing ring. A first arcuate needle feed section is slidably disposed within the first side of the arcuate channel, and a second arcuate needle feed section is slidably disposed within the second side of the arcuate channel. A first control element is adapted to enter the first side of the arcuate channel substantially parallel to a tangent to the first needle feed section adjacent to where the first control element is secured to the first needle feed section, and a second control element is adapted to enter the second side of the arcuate channel substantially parallel to a tangent to the second needle feed section adjacent to where the second control element is secured to the second needle feed section. The arcuate needle can be transferred between the first arcuate needle feed section and the second arcuate needle feed section by operating the first control element and the second control element.

[0017] The above summary of some embodiments is not intended to describe each disclosed embodiment or every implementation of the present disclosure, and the figures and the following detailed description more particularly exemplify these embodiments.

[0018] The present disclosure may be more fully understood from consideration of the following description in conjunction with the accompanying drawings. [Brief explanation of the drawings]

[0019] [Figure 1] 1 is a perspective view of an exemplary assembly including an exemplary suturing device secured relative to an endoscope. [Figure 2] FIG. 2 is an end view of the exemplary assembly of FIG. 1. [Figure 3] 2 is a partial cutaway view of the exemplary suturing device of FIG. 1 showing step-by-step how an arcuate needle is advanced from a first arcuate needle advancement section to a second arcuate needle advancement section; [Figure 4]2 is a partial cutaway view of the exemplary suturing device of FIG. 1 showing step-by-step how an arcuate needle is advanced from a first arcuate needle advancement section to a second arcuate needle advancement section; [Figure 5] 2 is a partial cutaway view of the exemplary suturing device of FIG. 1 showing step-by-step how an arcuate needle is advanced from a first arcuate needle advancement section to a second arcuate needle advancement section; [Figure 6] 2 is a partial cutaway view of the exemplary suturing device of FIG. 1 showing step-by-step how an arcuate needle is advanced from a first arcuate needle advancement section to a second arcuate needle advancement section; [Figure 7] 2 is a perspective view of an arcuate needle feed section usable as either a first arcuate needle feed section or a second arcuate needle feed section in the exemplary assembly of FIG. 1; FIG. [Figure 8] 2 is a perspective view of a portion of the exemplary suturing device of FIG. 1 showing a portion of a suturing ring, an arcuate needle feed section, and an arcuate needle secured relative to the arcuate needle feed section; [Figure 9] 9 is a cross-sectional view of a portion of the exemplary suturing device shown in FIG. 8 taken along line 9-9 of FIG. 8. [Figure 10] 2 is a perspective view of an arcuate needle usable within the exemplary suturing device of FIG. 1; DETAILED DESCRIPTION OF THE INVENTION

[0020] While the present disclosure is susceptible to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit the invention to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the present disclosure.

[0021] For the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification. Definitions of certain terms are provided below and shall apply unless a different definition is given in the claims or elsewhere in this specification.

[0022] All numerical values ​​herein, whether explicitly stated or not, are assumed to be modified by the term "about." The term "about" generally refers to a range of numbers that one of ordinary skill in the art would consider equivalent to the recited numerical value (i.e., having the same function or result). In many instances, the term "about" may be expressed as including numbers that are rounded to the nearest significant figure.

[0023] The recitation of numerical ranges by endpoints includes all numbers within that range (eg, 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5). Although some suitable dimensions, ranges, and / or values ​​relating to various components, features, and / or specifications are disclosed, those skilled in the art prompted by this disclosure will understand that the desirable dimensions, ranges, and / or values ​​may deviate from those expressly disclosed.

[0024] As used in this specification and the appended claims, the singular forms "a," "an," and "the" include or refer to the singular and plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term "or" is generally used to include "and / or" unless the content clearly dictates otherwise.

[0025] The following detailed description should be read with reference to the drawings in which like elements in different drawings are numbered the same. The detailed description and the drawings, which are not necessarily to scale, depict exemplary embodiments and are not intended to limit the scope of the disclosure. The exemplary embodiments shown are intended to be illustrative only. Unless expressly stated otherwise, selected features of any exemplary embodiment may be incorporated into additional embodiments.

[0026] The present disclosure relates to devices configured for use in combination with an endoscope or equivalent delivery device to close wounds within the body. In some cases, the suturing devices described herein may be configured for use in combination with a single or dual working channel endoscope, within a single working channel or available channels of the endoscope, and in some cases may be operated by one person, although in some cases a second person may be involved.

[0027] FIG. 1 is a perspective view of an exemplary assembly 10 including an exemplary suturing device 12 secured relative to an endoscope 14, and FIG. 2 is an end view of the exemplary assembly 10. As shown, the exemplary suturing device 12 includes an end cap ring 16 configured to secure the suturing device 12 relative to the endoscope 14. For example, the end cap ring 16 may be any over-the-scope connector. In some cases, the suturing device 12 may instead include other structures or features (not shown) adapted to secure the suturing device 12 relative to the endoscope 14. The suturing device 12 includes a C-shaped suturing ring 18. As will be shown with respect to subsequent figures, the C-shaped suturing ring 18 is adapted to allow an arc-shaped needle feed section (not shown in FIG. 1 ) to slide within the C-shaped suturing ring 18 to feed an arc-shaped needle (not shown in FIG. 1 ) back and forth between a pair of arc-shaped needle feed sections.

[0028] The C-shaped sewing ring 18 may be thought of as describing a circle, except for the missing portion of the circle as shown between the first open end 20 and the second open end 22. The missing portion of the circle may be thought of as defining an area 24 within which the tissue to be sutured can be accommodated. In some cases, the relative dimensions of the C-shaped sewing ring 18, including the relative distance between the first open end 20 and the second open end 22, may be varied to accommodate different tissues, different relative needle feed sizes, etc. Additionally, as shown, the C-shaped sewing ring 18 may be thought of as forming a particular arc angle with respect to the end cap ring 16. This is merely exemplary, as the C-shaped sewing ring 18 may be positioned at any desired angle with respect to the end cap ring 16. The C-shaped sewing ring 18 may be attached to any desired location with respect to the end cap 16. In some cases, the relative location of the C-shaped sewing ring 18 may be adjusted after delivery. In some cases, as best shown in FIG. 2 , suturing device 12 may be secured relative to endoscope 14 so that region 24 is centered, or at least substantially centered, relative to main working channel 26 of endoscope 14, although this is not necessary in all cases. While no additional instruments are required for use of suturing device 12, in some cases it may be desirable to provide instruments that can reach region 24 through working channel 26. For example, it may be desirable to use grasping forceps to help pull tissue toward or hold tissue against region 24 during suturing. Thus, region 24 may also be considered the working space of suturing device 12.

[0029] The C-shaped sewing ring 18 may be considered to include a first side 28 and a second side 30. The suturing device 12 includes a first tubular member 32 and a second tubular member 34. The first side 28 of the C-shaped sewing ring 18 is on the right side (in the orientation shown) and the second side 30 of the C-shaped sewing ring is on the left side, while the first tubular member 32 is on the left side and the second tubular member 34 is on the right side (see, for example, FIG. 3 where the first and second control elements are visible). The first tubular member 32 may be shown as including a curved portion 36 and a proximally extending liner portion 38. Similarly, the second tubular member 34 may be shown as including a curved portion 40 and a proximally extending liner portion 42. It will be appreciated that the curved portion 36 of the first tubular member 32 curves in a direction opposite to the direction in which the first side 28 of the C-shaped sewing ring 18 curves, and the curved portion 40 of the second tubular member 34 curves in a direction opposite to the direction in which the second side 30 of the C-shaped sewing ring 18 curves. In some cases, the relative curvatures of the sides of the C-shaped sewing ring 18 and the first and second tubular members 32, 34 aid in aligning a control element with an arcuate needle feed (not shown in FIGS. 1 and 2).

[0030] 3-6 are partial cutaway views of suturing device 12 in which a portion of suturing ring 12, curved portion 36 of first tubular member 32, and curved portion 40 of second tubular member 34 have been cut open to reveal further details of suturing device 12. Suturing device 12 includes a first arcuate needle feed section 44 operably associated with a first control element 46 and a second arcuate needle feed section 48 operably associated with a second control element 50. It will be appreciated that control element 46 and control element 50 intersect at location 52 proximate where first control element 46 is secured to first arcuate needle feed section 44 and second control element 50 is secured to second arcuate needle feed section 48. In some cases, crossing the first control element 46 and the second control element 50 over one another may result in better alignment of the control elements 46, 50 with their corresponding arcuate needle feed sections 44, 48, resulting in a reduction in the effort required to move the first control element 46 and the second control element 50. Although the second control element 50 is shown passing over the first control element 46, this is by way of example only. The arcuate needle 54 may be shown as being fed between the first arcuate needle feed section 44 and the second arcuate needle feed section 48.

[0031] In some cases, the first control element 46 enters the first side 28 of the arcuate channel 56 of the C-shaped sewing ring 18 in a direction substantially parallel to a tangent to the first arcuate needle feed section 44 proximate where the first control element 46 is secured to the first arcuate needle feed section 44. In some cases, the second control element 50 enters the second side 30 of the arcuate channel 56 of the C-shaped sewing ring 18 in a direction substantially parallel to a tangent to the second arcuate needle feed section 48 proximate where the second control element 50 is secured to the second arcuate needle feed section 48.

[0032] The C-shaped sewing ring 18 defines an arcuate channel 56 extending therein from the first open end 20 to the second open end 22. As will be described in more detail with respect to Figures 8 and 9, the arcuate channel 56 has a constant inner diameter and inner cross-sectional profile that is approximately the same as the outer diameter and outer cross-sectional profile of the first and second arcuate needle feed sections 44, 48, respectively, except for a first region 58 adjacent the first open end 20 and a second region 60 adjacent the second open end 22. In some cases, as shown, the first region 58 includes a slot 62 that accommodates a suture secured to the arcuate needle 54 when the arcuate needle 54 is positioned within the first region 58, and the second region 60 includes a slot 64 that accommodates a suture secured to the arcuate needle 54 when the arcuate needle 54 is positioned within the second region 60.

[0033] Although a proximal handle or other mechanism is not shown, it will be understood that a user can selectively advance the first arcuate needle feeder 44 by actuating the first control element 46 in a first direction and selectively retract the first arcuate needle feeder 44 by actuating the first control element 46 in a second, opposite direction. A user can selectively advance the second arcuate needle feeder 48 by actuating the second control element 50 in a first direction and selectively retract the second arcuate needle feeder 48 by actuating the second control element 50 in a second, opposite direction. A user may also hold either the first arcuate needle feeder 44 or the second arcuate needle feeder 48 in a particular location simply by preventing movement of the appropriate control element 46, 50.

[0034] Beginning with FIG. 3, the first arcuate needle feed portion 44 may be shown retracted into the first side 28 of the C-shaped sewing ring 18, and the second arcuate needle feed portion 48 may be shown retracted into the second side 30 of the C-shaped sewing ring 18. The arcuate needles 54 may be shown secured to the first arcuate needle feed portion 44. Further details regarding how the arcuate needles 54 are secured to the first arcuate needle feed portion 44 will be described later in FIGS. 7 and 8. Proceeding to FIG. 4, by advancing the first control element 46 in the appropriate direction, it can be seen that the first arcuate needle feed portion 44 has exited the first side 28 of the C-shaped sewing ring 18 and advanced partially into the region 24. Proceeding to FIG. 5, the first arcuate needle feed portion 44 has been further advanced such that the arcuate needles 54 contact the second arcuate needle feed portion 48. In some cases, the second arcuate needle feeder 48 may be held in place by holding the second control element 50 in a predetermined location while the first arcuate needle feeder 44 is further advanced to advance the arcuate needle 54 into the second arcuate needle feeder 48. Finally, in Figure 6, the arcuate needle 54 may be shown secured to the second arcuate needle feeder 48 after the first arcuate needle feeder 44 has been removed by moving the first control element 46 in the appropriate direction.

[0035] It will be understood that the steps illustrated in Figures 3-6 result in the placement of a suture in tissue present within the area or working area 24. The next suture may be placed by reversing the steps illustrated in Figures 3-6 by moving the suturing apparatus 12 (which is secured to the distal end of the endoscope 14) laterally. As noted, in some cases, a grasping forceps or other instrument may be provided through the working channel 16 of the endoscope 14, although this is not necessary for the operation of the suturing apparatus 12.

[0036] FIG. 7 is a perspective view of an arcuate needle feed section 70, which can be used, for example, as either the first arcuate needle feed section 44 or the second arcuate needle feed section 48. The arcuate needle feed section 70 has a curvature that matches the curvature of the C-shaped sewing ring 18 so that the arcuate needle feed section 70 can easily slide relative to the arcuate channel 56 within the C-shaped sewing ring 18. While the arcuate needle feed section 70 is shown as having a circular cross-sectional shape, this is not necessary in all cases. For example, the arcuate needle feed section 70 can have a non-circular cross-sectional shape, such as a square or rectangular shape. The arcuate needle feed section 70 can be considered to have a working end 72 and a control end 74. The working end 72 is adapted to removably secure the arcuate needle 54, and the control end 74 is adapted to be secured to a control element, such as the first control element 46 or the second control element 50. The arcuate needle feed section 70 has a body 76 extending from the working end 72 to the control end 74. In some cases, the body 76 is formed from a hypotube and is therefore hollow.

[0037] The working end 72 includes a pair of apertures 78 spaced radially apart by approximately 180 degrees. As will be described, the apertures 78 may be adapted to removably secure corresponding complementary latch mechanisms present on the arcuate needles 54. The arcuate needle feeder 70 includes a pair of slots 80, which may also be spaced radially apart by approximately 180 degrees, such that each slot 80 passes through one of the apertures 78. It will be appreciated that when the arcuate needle feeder 70 is disposed within the arcuate channel 56 of the C-shaped suturing ring 18, the relative dimensions between the arcuate needle feeder 70 and the arcuate channel 56 limit movement, thereby securing the arcuate needles 54 relative to the arcuate needle feeder 70. When the working end 72 extends out of the arcuate channel 56 of the C-shaped suturing ring 18, the slots 80 are adapted to allow the working end 72 to fully flex relative to the apertures 78, thereby allowing the arcuate needle feeder 70 to release the arcuate needles 54.

[0038] FIG. 8 is a perspective view showing a portion 90 of a C-shaped sewing ring 18, an arcuate needle feed portion 70, and an arcuate needle 54. The portion 90 of the C-shaped sewing ring 18 includes a region 99 corresponding to the first region 58 and / or the second region 60, having a non-circular cross-sectional profile as shown in FIG. 9, a cross-section taken along line 9-9 in FIG. 8. One of the slots 80 can be seen extending through one of the holes 78, but the other slot 80 and the other hole 78 are on the opposite side and therefore not visible in this view. The arcuate needle 54 includes a protrusion 98 that engages the visible hole 78. It will be understood that there is a second protrusion 98 radially spaced approximately 180 degrees apart that can engage the other hole 78. 9, the inner contour of region 99 is larger than the outer contour of arcuate needle feeder 70, which allows working end 72 of arcuate needle feeder 70 to bend sufficiently when working end 72 is positioned within region 99 to push arcuate needle 54 into alignment with working end 72 and move arcuate needle 54 from one arcuate needle feeder to the other arcuate needle feeder. In the location shown in FIG. 8, arcuate needle feeder 70 is positioned to move arcuate needle 54 to another arcuate needle feeder.

[0039] It will be appreciated that the arcuate needle 54 is always held by at least one of the first arcuate needle feed section 44 and the second arcuate needle feed section 48. When the working end 72 of the arcuate needle feed section 70 (representing either the first arcuate needle feed section 44 or the second arcuate needle feed section 48) is disposed within region 99 (shown in FIG. 8 ), there is sufficient flex within the arcuate needle feed section 70 to move the arcuate needle 54 from the other arcuate needle feed section. When the working end 72 of the arcuate needle feed section 70 is advanced beyond region 99, there is sufficient flex relative to the holes 78 and slots 80 to allow the arcuate needle feed section 70 to move the arcuate needle 54 to the other arcuate needle feed section. Thus, because the arcuate needle 54 is always fixed relative to one of the arcuate needle feed sections 44, 48, the arcuate needle 54 cannot fall off.

[0040] 10 is a perspective view of the arcuate needle 54. The arcuate needle 54 includes a curved body 92 having a curvature that matches the curvature of the first and second arcuate needle feed sections 44, 48 such that, with the arcuate needle 54 secured to either the first and second arcuate needle feed sections 44, 48, the first and second arcuate needle feed sections 44, 48 can move freely within the arcuate channel 56 in response to relative movement of the control elements 46, 50. The curved body 92 has a pair of protrusions 96, which can be considered latching mechanisms. The latching mechanisms are removably engageable with corresponding holes 78 in one of the first and second arcuate needle feed sections 44, 48. The curved body 92 has a pair of protrusions 98, which can be considered latching mechanisms. The latch mechanism can removably engage a corresponding aperture 78 in the other of the first and second arcuate needle feed sections 44, 48. While the protrusions 96, 98 are shown as being circular in cross section, other shapes are contemplated. The aperture 78 can vary depending on the contours of the protrusions 96, 98. A suture aperture 94 extends within the curved body 92 to accommodate a suture. The curved body 92 has pointed ends 100, 102 to allow the arcuate needle 54 to pass through tissue in either direction.

[0041] It will be understood that a variety of different materials may be used to form the devices described herein. In some cases, a variety of different metals may be used. Illustrative, but non-limiting, examples of suitable metals include titanium, stainless steel, magnesium, cobalt chrome, and others. In some cases, the first control element 46 and the second control element may be made of nitinol. In some embodiments, for example, the devices described herein may include any suitable polymeric material, including biocompatible materials such as polyurethane or silicone. Suitable polymers include PEEK (polyetheretherketone) and polycarbonate. Other suitable polymers include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, e.g., DELRIN® available from DuPont), polyether block esters, polyurethanes (e.g., polyurethane 85A), polypropylene (PP), polyvinyl chloride (PVC), polyether-esters (e.g., ARNITEL® available from DSM Engineering Plastics), ether- or ester-based copolymers (e.g., butylene / poly(alkylene ether) phthalates and / or other polyester elastomers such as HYTREL® available from DuPont), polyamides (e.g., DURETHAN® or Elf Atochem® available from Bayer), and the like.CRISTAMID® available from Atochem), elastomeric polyamides, block polyamide / ethers, polyether block amides (PEBA, e.g., available under the trade name PEBAX®), ethylene vinyl acetate copolymers (EVA), silicones, polyethylene (PE), Marlex high density polyethylene, Marlex low density polyethylene, linear low density polyethylene (e.g., REXELL®), ), polyester, polybutylene terephthalate (PBT), polyethylene terephthalate (PET), polytrimethylene terephthalate, polyethylene naphthalate (PEN), polyether ether ketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polyparaphenylene terephthalamide (e.g., KEVLAR®), polysulfone, nylon, nylon-12 (EMS American Grillon (EMS) The preferred materials include, but are not limited to, GRILAMID® available from American Grillon, perfluoro(propyl vinyl ether) (PFA), ethylene vinyl alcohol, polyolefins, polystyrene, epoxies, polyvinylidene chloride (PVdC), poly(styrene-b-isobutylene-b-styrene) (e.g., SIBS and / or SIBS 50A), polycarbonates, ionomers, biocompatible polymers, other suitable materials, or mixtures, combinations, copolymers, polymer / metal composites, and the like.

[0042] Those skilled in the art will recognize that the present disclosure may be manifested in a variety of forms other than the specific embodiments described and contemplated herein. Accordingly, departures in form and detail may be made without departing from the scope and spirit of the present disclosure as set forth in the appended claims.

Claims

1. a mounting structure adapted to be secured relative to the distal end of the endoscope; a sewing ring secured to the mounting structure, the sewing ring defining an arcuate channel extending therethrough; a first arcuate needle feed portion slidably disposed within a first side of the arcuate channel and including a working end and a control end; a second arcuate needle feed portion slidably disposed within a second side of the arcuate channel, the second arcuate needle feed portion including a working end and a control end; a first control element operably coupled to the control end of the first arcuate needle feed portion; a second control element operably coupled to the control end of the second arcuate needle feed portion; Equipped with the first control element and the second control element cross each other upon entering the arcuate channel of the sewing ring; a suturing device comprising an arcuate needle configured to be detached from the second arcuate needle feed section and removably secured to the first arcuate needle feed section within the first side, and configured to be detached from the first arcuate needle feed section and secured to the second arcuate needle feed section within the second side.

2. the arcuate needle is transferable between the first arcuate needle feed section and the second arcuate needle feed section, and includes a first latch mechanism adapted to removably secure the arcuate needle to the first arcuate needle feed section, and a second latch mechanism adapted to removably secure the arcuate needle to the second arcuate needle feed section; The suturing device of claim 1 .

3. 3. The suturing device of claim 2, wherein the first latch mechanism comprises a first pair of radially spaced apart protrusions disposed within a first portion of the arcuate needle, and the second latch mechanism comprises a second pair of radially spaced apart protrusions disposed within a second portion of the arcuate needle.

4. The suturing device of claim 2 , wherein the arcuate needle further includes a suture hole disposed between the first latch mechanism and the second latch mechanism.

5. 4. The suturing device of claim 3, wherein the first arcuate needle feed portion includes a first hole complementary to a first protrusion of the first protrusion pair and a second hole complementary to a second protrusion of the first protrusion pair.

6. 6. The suturing device of claim 5, wherein the first arcuate needle feed section includes a first pair of longitudinal alignment slots extending from the working end toward the control end of the first arcuate needle feed section, each of the first pair of longitudinal alignment slots extending through one of the first and second holes such that the first arcuate needle feed section can flex relative to the first and second holes when not constrained by the first side of the sewing ring.

7. 4. The suturing device of claim 3, wherein the second arcuate needle feed portion includes a first hole complementary to a first protrusion of the second protrusion pair and a second hole complementary to a second protrusion of the second protrusion pair.

8. 8. The suturing device of claim 7, wherein the second arcuate needle feed portion includes a second pair of longitudinal alignment slots extending from the working end toward the control end of the second arcuate needle feed portion, each of the second pair of longitudinal alignment slots extending through one of the first and second holes such that the second arcuate needle feed portion can flex relative to the first and second holes when not constrained by the second side of the sewing ring.

9. 9. The suturing device according to claim 1, wherein the suturing ring extends circularly from a first open end to a second open end, the first open end and the second open end being spaced apart by a distance that allows tissue to extend between the first open end and the second open end.

10. The suturing device of claim 9, wherein the arcuate channel has a circular cross-sectional profile except for a first region adjacent the first open end and a second region adjacent the second open end.

11. 11. The suturing device of claim 10, wherein the first region and the second region each have an elliptical cross-sectional profile that allows the first arcuate needle feed portion or the second arcuate needle feed portion to begin to bend as the first arcuate needle feed portion exits the first open end, or the second arcuate needle feed portion to begin to bend as the second arcuate needle feed portion exits the second open end, or the first arcuate needle feed portion and the second arcuate needle feed portion to begin to bend as the first arcuate needle feed portion and the second arcuate needle feed portion exit the first open end and the second open end, respectively.

12. 12. The suturing device of claim 1, wherein the first control element enters the first side of the arcuate channel substantially parallel to a tangent to the first arcuate needle feed section proximate to where the first control element is secured to the first arcuate needle feed section.

13. 13. The suturing device of claim 1, wherein the second control element enters the second side of the arcuate channel substantially parallel to a tangent to the second arcuate needle feed section proximate to where the second control element is secured to the second arcuate needle feed section.

14. a first tubular member housing the first control element; a second tubular member housing the second control element; and Further provided with the first tubular member has a curved distal portion that curves in a direction opposite to the direction of curvature of the first side of the sewing ring, and the second tubular member has a curved distal portion that curves in a direction opposite to the direction of curvature of the second side of the sewing ring. The suturing device according to any one of claims 1 to 13.

15. The suturing device according to any one of claims 1 to 14, wherein the sewing ring is C-shaped.

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