Uni-Directional Anchor Locking for Tissue Plication
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Solution Overview
Problem
Conventional surgical procedures for morbid obesity, such as gastrointestinal reduction, face challenges in securely positioning and anchoring tissue folds within the body, particularly in engaging the muscularis or serosa layers to withstand tensile loads, and require extensive training and multiple intubations, leading to potential complications like tissue puncture and prolonged anesthesia time.
Innovation Solution
A tissue plication apparatus with uni-directional anchor locking mechanisms, including mechanical, friction-based, and knotting techniques, is used to securely grasp and cinch tissue folds, utilizing metallic sutures and anchors that can engage the muscularis and serosa layers, allowing for quick and confident placement of anchors during minimally invasive procedures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional sewing devices are used to suture the stomach wall into folds, then tissue can be secured, but the procedure requires extensive training and multiple intubations, increasing procedure time and complexity
Solution Approach 1:
The device divides the tissue securing function into separate modular components: a plication device for creating folds and a separate anchor deployment device for securing. This segmentation allows each component to be optimized independently and simplifies the overall procedure by allowing the anchor to be deployed after the plication is created, reducing the need for complex multi-step intubations.
Solution Approach 2:
The device enables preliminary creation of tissue folds through plication before final anchor deployment. The plication can be performed and visualized first, allowing the clinician to confirm proper folding before deploying the anchor, thereby simplifying the overall procedure and reducing the need for extensive training.
2Ease of operation
If anchors are placed transesophageally through the stomach wall, then minimally invasive procedure is achieved, but there is high risk of inadvertently puncturing adjacent tissue or organs
Solution Approach 1:
The device introduces an intermediary protective mechanism between the anchor and surrounding tissue. The plication fold acts as a cushioning intermediary that distributes the anchor's engagement force, reducing the risk of puncturing adjacent tissue or organs during transesophageal placement.
Solution Approach 2:
The device creates a cushioning effect beforehand by forming a plication fold before anchor deployment. This pre-formed fold provides a protective cushion that distributes mechanical stresses and prevents direct puncture of adjacent tissues during the anchor placement process.
3Strength
If sutures or staples are used to secure tissue, then tissue approximation can be achieved, but significant force is concentrated over a small surface area, potentially causing the suture or staple to tear through the tissue
Solution Approach 1:
The device distributes the securing force from a point-contact mechanism (conventional sutures/staples) to a surface-area contact mechanism. The anchor engages tissue across a broader surface area of the plication fold, converting concentrated force into distributed force, thereby preventing tissue tearing while maintaining approximation strength.
Solution Approach 2:
The device applies different engagement characteristics to different regions of the tissue. The anchor is designed to engage the muscularis layer specifically, while the plication fold structure provides additional support. This localized quality distribution ensures strong approximation without concentrating force that would cause tearing.
4Strength
If the muscularis or serosa layers are engaged to sustain tensile loads, then proper anchor foundation is achieved, but care must be taken in piercing the tough stomach wall not to inadvertently puncture adjacent tissue or organs
Solution Approach 1:
The plication fold serves as an intermediary structure that facilitates safe engagement of the muscularis layer. By creating a fold first, the device provides a controlled pathway and distribution mechanism that allows the anchor to engage the muscularis without exerting concentrated puncturing forces that could damage adjacent tissues.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The solution enables secure and rapid tissue folding and anchoring, reducing the risk of complications, minimizing anesthesia time, and ensuring durable tissue approximation, even in challenging transesophageal procedures, by utilizing anchors that effectively engage the muscularis and serosa layers and employing advanced locking mechanisms.
Implementation Method 1
locking mechanisms may utilize friction as a primary source for locking
Implementation Method 2
locking mechanisms may utilize knotting techniques
Data Source
AI summary
Apparatus and methods for positioning and securing anchors are adapted to be delivered and implanted into or upon tissue, particularly tissue within the gastrointestinal system of a patient. The anchor is adapted to slide uni-directionally over suture such that a tissue plication may be cinched between anchors. A locking mechanism either within the anchor itself of positioned proximally of the anchor may allow for the uni-directional translation while enabling the anchor to be locked onto the suture if the anchor is pulled, pushed, or otherwise urged in the opposite direction along the suture. This unidirectional anchor locking mechanism facilitates the cinching of the tissue plication between the anchors and it may be utilized in one or several anchors in cinching a tissue fold.