Tissue capture spiral device

Abstract

To provide a tissue grasping device that works with an endoscope or similar device for suturing tissue.SOLUTION: A tissue grasping device for use with an endoscope may include a sheath, a control wire slidably disposed within the sheath, and a helical coil disposed around and attached to the control wire. The helical coil may include a proximal region in which adjacent windings are in contact and a distal region in which adjacent windings are spaced. The helical coil may have a sharpened distal tip.SELECTED DRAWING: None

Description

Technical Field

[0001] The present disclosure is directed to an apparatus for suturing tissue, and more particularly to an apparatus that operates with an endoscope or a similar device for endoscopically suturing tissue.

Background Art

[0002] In various endoscopic surgeries, wounds (or traumas) that are too large for hemostatic clips can result in order to easily bridge and assist in closing the wound. Examples of endoscopic surgeries include the removal of large lesions, submucosal tunneling, removal of the entire tissue layer, treatment of other organs through the outside of the gastrointestinal tract, repair of postoperative problems such as postoperative leakage, staple line surgical failure, and anastomotic leakage, and also include obesity improvement procedures. Devices and methods for closing large wounds using an endoscope are well known, but each has advantages and disadvantages.

Summary of the Invention

[0003] The present disclosure is directed to various alternative designs, materials, and methods for an apparatus for closing large wounds using an endoscope. In one example, a tissue grasping device for use with an endoscope includes a sheath defining a sheath lumen, a control wire slidably disposed within the sheath lumen, a tubular connector attached to the distal portion of the control wire, and a helical coil disposed around and attached to the tubular connector, the tubular connector being positioned between the outer surface of the control wire and the inner surface of the helical coil, the helical coil having a proximal region where adjacent turns contact and a distal region where adjacent turns are spaced apart, the helical coil having a sharp distal tip.

[0004] Instead of or in addition to any of the above examples, the tubular connector is fixed against axial movement with respect to the control wire. In place of or in addition to any of the above examples, the tissue grasping device further comprises an inner sheath slidably disposed within the lumen of the sheath, the inner sheath having a lumen configured to receive the control wire.

[0005] In addition to or instead of any of the above examples, the inner sheath has a star-shaped cross-section. In addition to or instead of any of the above examples, the inner sheath is not attached to the helical coil.

[0006] In lieu of or in addition to any of the above examples, the control wire includes a visual indicator configured to show the rotational motion of the control wire. In place of or in addition to any of the above examples, the sheath lumen includes a proximal portion having a first inner diameter and a distal portion having a second inner diameter larger than the first inner diameter. The helical coil is positioned within the distal portion of the sheath lumen.

[0007] In addition to or instead of any of the above examples, the outer diameter of the helical coil is greater than the inner diameter of the proximal portion. In addition to or instead of any of the above examples, the control wire does not have any structure that secures it to the proximal end of the helical coil.

[0008] In place of or in addition to any of the above examples, the tissue grasping device further comprises a heat-shrinkable tube positioned over at least a portion of the proximal region of the helical coil and over at least a portion of the control wire adjacent to the helical coil.

[0009] In another example, a tissue grasping device used with an endoscope comprises a sheath defining a sheath lumen, a control wire slidably disposed within the sheath lumen, and a helical coil disposed along and attached to the distal end of the control wire, wherein the helical coil includes a proximal region where a plurality of adjacent windings are in contact and a distal region where a plurality of adjacent windings are spaced apart, the helical coil has a sharp distal tip, and the control wire has no structure fixed to the proximal end of the helical coil.

[0010] Alternatively, or in addition to any of the above examples, the helical coil is attached to the control wire by adhesive. In addition to or instead of any of the above examples, the proximal region of the helical coil comprises a first region in which a plurality of adjacent windings are in contact, and a second region located more proximal to the first region, wherein the plurality of adjacent windings in the second region are spaced apart.

[0011] In place of or in addition to any of the above examples, the tissue gripping device further comprises a connecting element located within the second area, the connecting element being configured to connect the helical coil to the control wire.

[0012] In addition to or instead of any of the above examples, the connecting element is welded. In addition to or instead of any of the above examples, the control wire includes a visual indicator configured to show the rotational motion of the control wire.

[0013] In addition to or instead of any of the above examples, the sheath lumen includes a proximal portion having a first inner diameter and a distal portion having a second inner diameter larger than the first inner diameter, and the helical coil is located within the distal portion of the sheath lumen.

[0014] In addition to or instead of any of the above examples, the outer diameter of the helical coil is greater than the inner diameter of the proximal region. In addition to or instead of any of the above examples, the proximal region is fitted to the control wire.

[0015] In a further example, a tissue grasping device used with an endoscope comprises an outer sheath defining a sheath lumen, a control wire slidably disposed within the sheath lumen, and an inner sheath slidably disposed within the sheath lumen, the inner sheath having a lumen configured to receive the control wire, a tubular connector attached to the distal end of the control wire, and a helical coil disposed around and attached to the tubular connector, the tubular connector being located between the outer surface of the control wire and the inner surface of the helical coil, the helical coil including a proximal region where a plurality of adjacent windings are in contact and a distal region where a plurality of adjacent windings are spaced apart, the helical coil having a sharp distal tip, and the tissue grasping device not having any structure fixed to the proximal end of the helical coil.

[0016] The above-described embodiments of the abstract of the invention do not describe each disclosed embodiment or all currently disclosed practices. More detailed examples of these embodiments are given by the following drawings and detailed description. [Brief explanation of the drawing]

[0017] This disclosure will be better understood if the following description is taken into consideration in relation to the attached drawings. [Figure 1] This is a partially cut-out diagram of the side of a specific tissue gripping device according to an example of the present disclosure. [Figure 2] Figure 1 is a cross-sectional view of the distal portion of a specific tissue grasping device. [Figure 3] This is a perspective view of the specific tissue gripping device shown in Figure 1 at an extended position. [Figure 4] Figure 1 is a perspective view of a handle assembly used with a specific tissue gripping device. [Figure 5]Perspective view of a part of a specific tissue grasping device according to another example of the present disclosure. [Figure 6] Cross-sectional view of a specific tissue grasping device taken along line 6-6 of FIG. 5. [Figure 7] View of a part of a specific tissue grasping device according to another example of the present disclosure with a part of the side cut away. [Figure 8] Side view of a part of a specific tissue grasping device according to another example of the present disclosure. [Figure 9] Perspective view of a part of a specific tissue grasping device according to another example of the present disclosure. [Figure 10] Cross-sectional view of the specific tissue grasping device of FIG. 9. [Figure 11] Perspective view of a specific tissue grasping device according to another example of the present disclosure. [Figure 12] Cross-sectional view of the specific tissue grasping device of FIG. 11. [Figure 13] Partial side cross-sectional view of a part of a specific tissue grasping device according to another example of the present disclosure. [Figure 14] Side view of a specific tissue grasping device according to another example of the present disclosure. [Figure 15] An example of using a specific tissue grasping device together with a suturing device in a tangential approach is shown, demonstrating the technique used for suturing thick tissue and / or large wounds as may be found during a fat improvement treatment according to an example of the present disclosure. [Figure 16] An example of using a specific tissue grasping device together with a suturing device in a tangential approach is shown, demonstrating the technique used for suturing thick tissue and / or large wounds as may be found during a fat improvement treatment according to an example of the present disclosure. [Figure 17] An example of using a specific tissue grasping device together with a suturing device in a tangential approach is shown, demonstrating the technique used for suturing thick tissue and / or large wounds as may be found during a fat improvement treatment according to an example of the present disclosure. [Figure 18]The present disclosure provides an example of using a specific tissue grasping device in conjunction with a suturing device in a tangent approach, and demonstrates a technique used for suturing thick tissue and / or large wounds that may be found during obesity correction procedures according to the examples of this disclosure. [Figure 19] The present disclosure provides an example of using a specific tissue grasping device in conjunction with a suturing device in a tangent approach, and demonstrates a technique used for suturing thick tissue and / or large wounds that may be found during obesity correction procedures according to the examples of this disclosure.

[0018] While this disclosure is open to various modifications and alternative forms, the details of which are illustrated and described in detail by the examples in the drawings. However, it should be understood that there is no intention to limit the invention to the specific embodiments described. Rather, the intention is to protect all modifications, equivalents, and substitutes that fall within the spirit and scope of the disclosure. [Modes for carrying out the invention]

[0019] The terms defined below shall be governed by these definitions unless otherwise provided in the claims or specification. Unless a different definition is given anywhere in the claims or specification, the following clear definitions of terms are provided and apply.

[0020] This patent specification assumes that all numerical values, whether explicitly stated or not, are modified by the term "approximately." The term "approximately" generally refers to a range of numbers, and those skilled in the art will consider the enumerated values ​​(in other words, those having the same function or result) to be equivalent. In various examples, the term "approximately" can indicate that the number includes numbers rounded to the nearest significant figure.

[0021] In an enumeration of a range of numbers with defined endpoints, all numbers within that range are included. (For example, 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5). While several appropriate dimensions, ranges, and / or values ​​for various parts, features, and / or specifications are disclosed, a person skilled in the art, inspired by this disclosure, will understand that desirable dimensions, ranges, and / or values ​​may deviate from those expressly disclosed.

[0022] As used in this patent specification and the attached claims, unless explicitly stated otherwise, the singular forms "a," "an," and "the" refer to plural nouns as well as singular nouns. As used in this patent specification and the attached claims, unless explicitly stated otherwise, the term "or" is generally used to include "and / or."

[0023] Similar elements in different drawings are given the same numbering, and the following detailed description should be read in reference to the drawings. The detailed description and drawings do not require the scale and depiction of specific embodiments and are not intended to limit the scope of disclosure. The specific embodiments depicted are presented only as typical examples. Selected features of some specific embodiments may be incorporated into further embodiments unless explicitly stated to the contrary.

[0024] This disclosure relates to a device configured for use in combination with an endoscope or similar delivery device to close internal wounds. In some examples, the tissue grasping device described in this specification is configured to operate independently or for use within the channel of an available endoscope, and in some examples a second person may be involved, while in others the tissue grasping device can be operated by a single person. In some examples, the tissue grasping device described in this specification can be considered to operate along a single operating line. The device itself may be movable distally and proximal within the working channel, and the handle portion itself may be movable distally and proximal along the same operating line when advancing and retracting the tissue grasping device. The device may be configured to be able to hold tissue in an appropriate position for suturing.

[0025] The tissue grasping device described in this patent specification may be used in conjunction with a suturing device such as the one described in U.S. Patent Publication No. 2018 / 0235604, published on August 23, 2018. All of its contents are incorporated herein by reference. Furthermore, the tissue grasping device may be used outside of a suturing system for various applications requiring tissue grasping and / or capture.

[0026] Figure 1 shows an example of a tissue grasping device 100, which is considered to be configured for use in combination with a delivery system that includes a lumen extending through the delivery system. For example, the delivery system may be an endoscope having a working channel. The delivery system may also be a catheter. The tissue grasping device 100 may be configured to grasp tissue for suturing via the endoscope. It can be seen that the tissue grasping device may stabilize a selected portion of the tissue for suturing. The tissue grasping device 100 may include a sheath 10 having a proximal end 12, a distal end 14, and a sheath lumen 18 extending between them. The sheath 10 is a flexible tube and may be formed and configured to a size for inserting the endoscope. In some examples, the proximal end 12 of the sheath may be widened to connect to a handle, as shown in Figure 1. The distal end 14, which includes the lumen 18, may also be widened (not shown). In other examples, the proximal end 12 may be cylindrical. A control wire 20 may be slidably positioned within the sheath lumen 18. The control wire 20 may be a long, flexible elastic wire, a flexible torque-transmitting multifilament cable, a laser-cut hypotube, or a catheter. The control wire 20 may also have a solid structure. In other examples, the control wire 20 may have a lumen. The control wire 20 is freely slidable and rotatable in the longitudinal direction within the sheath 10. The control wire 20 may be nitinol, stainless steel, or other metal that provides the required flexibility. Nitinol allows for twist-free flexibility.

[0027] A helical coil 30 having multiple windings can be positioned around the distal end of a control wire 20 and attached to the distal end of the control wire 20, as shown in Figure 1. The helical coil 30 can be attached to the control wire 20 by welding, adhesive, or other means of connection that provide a long-term bond. The helical coil 30 may include a proximal region 32, a distal region 34, and an intermediate region 36 between them. Multiple adjacent windings in the proximal region 32 may be in contact with each other, while multiple adjacent windings in the distal region 34 may be spaced apart. Multiple windings in contact with each other in the proximal region 32 of the coil provide rigidity and can prevent the helical coil 30 from bending when a vertical load is applied. Multiple windings in the intermediate region 36 have a non-constant pitch, which results in a gradual widening of the gaps, transitioning from multiple adjacent windings in the proximal region 32 being in contact with each other to multiple windings in the distal region 34 being spaced apart. The distal end 24 of the control wire 20 extends into the distal region 34 of the helical coil 30, preventing tissue from being trapped in the small space between the multiple windings of the intermediate region 36. The helical coil 30 may have a sharp distal tip 38. The helical coil 30 is a solid, circular metal wire and may be formed to have a larger diameter than the diameter of the control wire. The helical shape generally provides excellent tissue gripping ability when used with a closure system. The closure device requires gripping the tissue and pulling it into the suture window. The sharp distal tip 38 of the helical coil 30 can easily rotate into the tissue by rotating the control wire 20 in a first direction, and can grip the tissue well when pulled. In some examples, the distal region 34 of the helical coil 30 contains 1 to 10 or 3 to 5 complete helical turns, which can help fix the tissue for suturing. The helical coil 30 is also advantageous compared to standard forceps-type grasping devices for capturing tissue in the presence of bodily fluids, especially in conditions where tissue tends to slip, such as the stomach. After suturing, the helical coil 30 is removed from the tissue by reversing the rotation of the control wire.

[0028] In some examples, the tissue grasping device 100 may include a tubular connector 40 attached to the distal end of the control wire 20, just proximal to the distal end 24. The tubular connector 40 can be fixed against axial movement relative to the control wire 20. In some examples, the tubular connector 40 is obtained by soldering, welding, or adhesively attaching it to the control wire 20. In other examples, the tubular connector 40 can be crimped onto the control wire 20. The helical coil 30 is arranged around and attached to the tubular connector 40, so that the tubular connector 40 is positioned between the outer surface of the control wire 20 and the inner surface of the helical coil 30. The tubular connector 40 may have a length that extends only over the proximal region 32 and the lower portion of the intermediate region 36 of the helical coil 30, as shown in Figure 2. The tubular connector 40 may be a long, hollow tube, or it may be solid and may include holes, notches, recesses, etc. In some examples, the helical coil 30 can be attached to the control wire 20 solely via a tubular connector 40. In other examples, the helical coil 30 may be attached to the tubular connector 40 and also directly to the control wire 20. In some examples, the control wire 20 may not have any structure to be fixed to the control wire 20 proximal to the helical coil 30. In particular, the control wire 20 may not have any structure to be attached to the proximal end of the helical coil 30. In some examples, the helical coil 30 is attached to the distal end of the control wire 20 without any structure such as a tubular element, sleeve, support, or any other additional member positioned in the distal end region of the control wire 20 at the proximal end of the helical coil 30.

[0029] In some examples, the tissue grasping device 100 may include an inner sheath 50 slidably positioned within the sheath lumen 18 and around the control wire 20. The inner sheath 50 may have a lumen configured to receive the control wire 20 in a close fit, such that the control wire 20 can slide and rotate freely longitudinally within the inner sheath 50 with minimal radial movement, while maintaining the control wire 20 in the center of the sheath 10 and suppressing twisting of the control wire 20. The inner sheath 50 may have a length shorter than the distance between the proximal region 32 of the helical coil 30 and the proximal end 12 of the sheath 10. The inner sheath 50 is not attached to the helical coil 30. The inner sheath 50 may be a cylindrical tube having an outer diameter that fits closely with the inner surface of the sheath lumen 18. In other examples, the inner sheath 50 may be formed together with the sheath 10 as a single monolithic element, as described below with reference to Figure 7.

[0030] The control wire 20 may be movable both longitudinally and rotationally within the sheath 10. As shown in Figure 3, pushing the control wire 20 longitudinally moves at least a portion of the helical coil 30 outside the distal end 14 of the sheath 10. When the control wire 20 is rotated in the first direction with at least the distal region 34 of the helical coil 30 positioned distal to the distal end 14 of the sheath 10 and in contact with the tissue, the sharp distal tip 38 of the helical coil punctures the tissue. When the helical coil 30 is positioned substantially perpendicular to the tissue, continued rotation of the helical coil 30 in the first direction can helically drive the sharp distal tip 38 into deeper parts of the tissue. If the helical coil 30 is positioned tangent to the tissue, continuous rotation in the first direction can repeatedly move the sharp distal tip 38 in and out of the tissue, making it possible to temporarily grasp two adjacent ends of the tissue together. By holding the tissue in either position, the suturing device can suture the tissue together. Subsequently, the control wire 20 can be rotated in the reverse direction to pull the helical coil 30 away from the tissue. The presence of the control wire 20 through the intermediate region 36 can prevent the tissue from becoming trapped between multiple densely packed windings.

[0031] Figure 4 shows an example of a user interface handle 90 for operating the tissue gripping device 100 to move and rotate the control wire 20 longitudinally. The handle 90 may include a handle portion 92 having a proximal finger loop 94 and a conversion handle 95 connected to the control wire 20. The moving handle 95 is slidable along the handle portion 92 to advance and retract the helical coil 30 from the sheath 10. As shown in Figure 4, the moving handle 95 is in the forward position, and as shown in Figure 3, the helical coil 30 is in the extended position. By sliding the moving handle 95 toward the finger loop 94, the helical coil 30 can be moved proximal into the sheath 10, as shown in Figure 1. Storing the helical coil 30 within the sheath 10 when advancing downward through the working channel protects the sharp distal tip 38 from damage and protects the tissue periphery from sharp tips. The handle 90 may also include a rotatable control knob 96. The control knob is directly connected to the control wire 20. By rotating the control knob 96, the control wire 20 and the helical coil 30 at the distal end of the device are rotated.

[0032] In some examples, the inner sheath may have a non-circular cross-section. For example, the inner sheath 150 may have a star-shaped cross-section, as shown in Figures 5 and 6. A star-shaped inner sheath 150 can reduce friction against the inner surface of the sheath 10 for improved sliding properties. In other examples, the outer and / or inner surfaces of the inner sheath 150 may include a lubricating coating. The cross-sectional view shown in Figure 6 illustrates the widened region 15 at the proximal end 12 of the sheath 10.

[0033] In another example, the tissue grasping device 200 may have an inner and outer sheath defined by a single monolithic component. As shown in Figure 7, the sheath 210 includes a proximal portion 212 and a distal portion 214, the inner diameter of the distal portion 214 may be larger than the inner diameter of the proximal portion 212. The sheath 210 may include a step 211 from the inner diameter of the proximal portion 212 to the larger inner diameter of the distal portion 214, as shown in Figure 7. This step may be a gradually flattening slope or a steep step 211. The tissue grasping device 200 shown in Figure 7 has a steep step 211. The proximal portion 212 of the sheath 210 has an inner diameter that precisely fits around the control wire 220, providing smooth operation and rotation of the control wire 220. The helical coil is located inside the distal portion 214. In some examples, the distal portion 214 includes a widened distal end 215 with an enlarged lumen 218, as shown in Figure 7, which makes it possible to reinsert the coil 230 proximal into the sheath 210 after the coil 230 has extended distally and completely out of the sheath 210. It will be understood that the widened distal end may be incorporated into some of the devices described in this patent specification.

[0034] In a further example of the tissue grasping device 300, as shown in Figure 8, there is no inner sheath, stepped extruded material, or outer sheath. This device consists only of a control wire 320, a tubular connector 40, and a helical coil 30, but because there is no sheath, the control wire 320 and the helical coil 30 are always exposed. The tissue grasping device 300 would operate by descending the working channel of the endoscope and advancing the helical coil 330 outward from the working channel. The working channel acts as the outer sheath.

[0035] In the examples shown in Figures 9 and 10, the tissue grasping device 500 may include an outer cannula 560 fixed to the proximal end of the helical coil 530. The outer cannula 560 extends proximal to the proximal region 532 and can be fixed to the control wire 520 by a connector 562. The connector 562 may be an adhesive such as epoxy resin, welded, soldered, or a separate tubular connector. The tubular connector 540 may extend proximal to the helical coil 530 so as to extend into the lumen of the outer cannula 560, as shown in Figure 10. The outer cannula 560 may be attached to the tubular connector 40 by adhesive, soldering, or welding. The combination of the outer cannula 560 and the tubular connector 40 may provide additional support to the helical coil 530 when in an extended position.

[0036] In the above example, the transition between the proximal end of the helical coil and the control wire may be a steep step. In other examples, the tissue grasping device 600 may have a smooth transition provided by arranging heat-shrink tubing or packaging 670 covering at least the proximal region 632 of the helical coil 630, a portion of the tubular connector 640 extending proximal to the helical coil 630, and a portion of the control wire 620 adjacent to the proximal end of the helical coil 630, as shown in Figures 11 and 12. The heat-shrink packaging 670 may provide a gradually smooth transition slope 672 between the outer diameter of the helical coil 630 and the outer diameter of the control wire 620. If the helical coil 630 extends too far outward from the catheter, the heat-shrink packaging 670 can act as a smooth transition slope when housing the helical coil 630 in the sheath 610.

[0037] In some examples, the control wire 620 may also include marks or other visual indicators to aid in the visualization of rotation. As shown in Figure 11, the control wire 620 has a visual indicator that includes two contrasting colored helical stripes, which indicate how much the control wire 620 is rotating, and therefore the degree of rotation of the helical coil 630. In some examples, the marks may include different colored helical stripes extending at least along the proximal portion of the control wire 620. In other examples, the marks may be arranged along the entire length of the control wire 620. When heat shrink packaging 670 is present, the marks may be placed on the heat shrink packaging 670.

[0038] In some examples of the tissue gripping device 700, as shown in Figure 13, the tubular connector 40 may have its contraction force of the helical coil around the control wire 720 eliminated by a helical coil 730 configured to fix the helical coil 730 to the control wire 720. In this example, the tissue gripping device 700 consists only of the control wire 720 and the attached helical coil 730. The helical coil 730 may have a structure similar to the helical coil 30 shown in Figure 1, including a proximal region 732 where several adjacent windings are in contact with each other and a distal region 734 where several adjacent windings are spaced apart. The control wire 720 may have features that assist in the interlocking of the helical coil 730. For example, the control wire 720 may include one or more grooves or projections (not shown) configured to receive several windings of the control wire 720. In some examples, soldering or adhesive may be applied to fix the helical coil 730. Alternatively, direct welding may be used to secure the helical coil 730 to the control wire 720, if the material allows. In some examples, the tissue gripping device 700 may include a sheath 10 and / or the inner sheath 50 discussed above.

[0039] As shown in Figure 14, in order to increase the bonding surface area for bonding by soldering or adhesive, the proximal region 832 of the helical coil 830 may be separated into a first region 833 and a second region 835 located proximal to the first region 833. Similar to the multiple windings of the distal region 834 which are spaced apart, the multiple windings of the second region 835 may be separated, while the multiple windings of the first region 833 may remain in contact with each other. A bonding element such as soldering or adhesive 839 may be applied to the second region 835, as shown in Figure 14.

[0040] Figures 15 to 19 provide, but are not limited to, specific examples of distal assemblies 14c used to repair tissue using a tangential approach. For example, a tangential approach may be used when repairing large wounds that require suturing through thick or large tissue. Obesity correction procedures are an example of a procedure for which the tangential approach can be beneficial. The distal component 14c and associated suture transfer assemblies are described in U.S. Patent Publication No. 2018 / 0235604, the entirety of which is incorporated herein by reference. When performing the described procedures, the distal assembly 14c can be fixed to the distal end of an endoscope or other delivery device and used in combination with some of the suture transfer assemblies described in the aforementioned patent publication.

[0041] Figure 15 shows a wound 400 within tissue 402. In some cases, the wound 400 may include an open portion 404 along a staple or suture line 405. In some cases, a portion of the wound 400 has already been closed with staples 406, and in some cases, suturing is desired to close the wound 400 when the open portion 404 is in a position where the use of staples is inappropriate or difficult.

[0042] Starting with Figure 16, the distal assembly 14c is positioned relative to the wound 400. The tissue gripping device 100 extends through a tubular member 412 fixed to the guide structure 27a and may be positioned so that the sharp distal tip 38 of the helical coil 30 can rotate into the tissue 414 proximal to one side of the open portion 404 of the wound 400. With the helical coil 30 embedded in the tissue 414, the tissue 414 can be pulled upward by retracting the tissue gripping device 100 as indicated by arrow 416. As the tissue 414 is pulled upward, suturing may begin as shown in Figure 17. In Figure 18, it can be seen that the helical coil 30 rotates in the reverse direction and withdraws from the tissue, the needle 16 penetrates the tissue 414 and is grasped by the rear end cap 34a, thereby pulling the suture thread 420 through the tissue 414. As shown in Figure 19, the suture 420 now extends through the tissue 414 on the first side 430 of the open portion 404 of the wound 400. The suturing process can be continued by repeating the above steps on the second side 432 of the open portion 404 of the wound 400.

[0043] It is conceivable that various different materials could be used to form the apparatus described in this patent specification. In some examples, various different metals could be used. Examples of suitable metals include, but are not limited to, titanium, stainless steel, magnesium, cobalt-chromium, and others. For example, in some embodiments, the apparatus described in this patent specification could include several suitable polymer materials, including biocompatible materials such as polyurethane and silicone. Other suitable polymers include, but are not limited to, polytetrafluoroethylene (PTFE), ethylenetetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, e.g., DELRIN, a registered trademark available from DuPont), polyether block esters, polyurethane (e.g., Polyurethane 85A), polypropylene (PP), polyvinyl chloride (PVC), polyether esters (e.g., ARNITEL, a registered trademark available from DSM Engineering Plastics), ether and ester copolymers (e.g., butylene / poly(alkylene ether) phthalates and / or other polyester elastomers such as HYTREL, a registered trademark available from DuPont), and polyamides (e.g., DURETHAN, a registered trademark available from Bayer, Elf (CRISTAMID, a registered trademark available from Atochem), elastomer polyamides, block polyamides / ethers, polyether block amides (e.g., PEBAX, a registered trademark available from PEBA), ethylene vinyl acetate copolymer (EVA), silicone, polyethylene (PE), high-concentration polyethylene Marlex, low-concentration polyethylene Marlex, linear low-concentration polyethylene (e.g., REXELL, a registered trademark), 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), poly-p-phenylene terephthalamide (e.g., KEVLAR, a registered trademark), polysulfone, nylon, nylon-12 (EMS) This includes materials such as GRILAMID (a registered trademark available from 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), polycarbonates, ionomers, biocompatible polymers, other suitable materials, or mixtures, combinations thereof, copolymers thereof, polymer / metal composites, etc.

[0044] Those skilled in the art will recognize that the present disclosure may appear in a variety of other forms than the specific embodiments described and conceivable in this patent specification. Accordingly, developments in form and detail may not deviate from the scope and spirit of the present disclosure, as described in the appended claims.

Claims

1. Control wires and A tubular connector is attached to the distal end of the control wire and fixed against axial movement of the control wire, A tissue grasping device for use in an endoscope, comprising a helical coil arranged around and attached to the tubular connector, wherein the tubular connector is located between the outer surface of the control wire and the inner surface of the helical coil, and the helical coil is attached to the control wire solely by the tubular connector.

2. Control wires and A tubular connector is attached to the distal end of the control wire and fixed against axial movement of the control wire, The system comprises a helical coil arranged around the tubular connector and attached to the tubular connector, wherein the tubular connector is located between the outer surface of the control wire and the inner surface of the helical coil, and the helical coil is attached to the control wire solely by the tubular connector. The aforementioned helical coil has a sharp distal tip, and is a tissue grasping device for use in an endoscope.

3. Control wires and A tubular connector is attached to the distal end of the control wire and fixed against axial movement of the control wire, The system comprises a helical coil arranged around the tubular connector and attached to the tubular connector, wherein the tubular connector is located between the outer surface of the control wire and the inner surface of the helical coil, and the helical coil is attached to the control wire solely by the tubular connector. A tissue grasping device for use in an endoscope, wherein the helical coil includes a proximal region where multiple adjacent windings are in contact and a distal region where multiple adjacent windings are spaced apart.

4. Control wires and A tubular connector is attached to the distal end of the control wire and fixed against axial movement of the control wire, The system comprises a helical coil arranged around the tubular connector and attached to the tubular connector, wherein the tubular connector is located between the outer surface of the control wire and the inner surface of the helical coil, and the helical coil is attached to the control wire solely by the tubular connector. A tissue grasping device for use in an endoscope, wherein the helical coil has a sharp distal tip and includes a proximal region where multiple adjacent windings are in contact and a distal region where multiple adjacent windings are spaced apart.

5. Control wires and A tubular connector is attached to the distal end of the control wire and fixed against axial movement of the control wire, The system comprises a helical coil arranged around the tubular connector and attached to the tubular connector, wherein the tubular connector is located between the outer surface of the control wire and the inner surface of the helical coil, and the helical coil is attached to the control wire solely by the tubular connector. The helical coil includes a proximal region where multiple adjacent windings are in contact, a distal region where multiple adjacent windings are spaced apart, and an intermediate region located between the proximal region and the distal region, having a non-constant pitch. A tissue grasping device for use in an endoscope, wherein the tubular connector extends only to the inside of the proximal region and the intermediate region.

6. Control wires and A tubular connector is attached to the distal end of the control wire and fixed against axial movement of the control wire, The system comprises a helical coil arranged around the tubular connector and attached to the tubular connector, wherein the tubular connector is located between the outer surface of the control wire and the inner surface of the helical coil, and the helical coil is attached to the control wire solely by the tubular connector. The helical coil has a sharp distal tip and includes a proximal region where multiple adjacent windings are in contact, a distal region where multiple adjacent windings are spaced apart, and an intermediate region that exists between the proximal region and the distal region and has a non-constant pitch. A tissue grasping device for use in an endoscope, wherein the tubular connector extends only to the inside of the proximal region and the intermediate region.

7. The tissue gripping device according to any one of claims 1 to 6, wherein the tubular connector comprises a hollow tube.

8. The tissue gripping device according to claim 7, wherein the hollow tube includes one or more openings through its walls.

9. The tissue gripping device according to any one of claims 1 to 6, wherein the tubular connector is fixed to the control wire by soldering, welding, adhesive, or crimping.

10. A tissue grasping device according to any one of claims 1 to 6, further comprising an outer cannula fixed to the helical coil and the control wire.

11. The tissue grasping device according to claim 10, wherein the outer cannula is fixed to the proximal end of the helical coil and extends proximal thereto.

12. The tissue gripping device according to claim 11, wherein the tubular connector extends proximal to the proximal end of the helical coil.

13. The tissue grasping device according to claim 12, wherein the tubular connector extends into the lumen defined by the outer cannula.

14. The tissue grasping device according to claim 10, wherein the outer cannula is fixed to the control wire by a connector.

15. The tissue gripping device according to claim 14, wherein the connector is formed by adhesive, welding, soldering, or an independent tubular connector.

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