Endoscopic Closure Device Helical Needle Tissue Approximation
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Natural Orifice Transluminal Endoscopic Surgery (NOTES) faces challenges in reliably closing luminal defects due to space constraints within the endoscope, and there is a risk of leaks when creating incisions through the gastrointestinal tract, which can lead to catastrophic problems.
Innovation Solution
An endoscopic closure device with a helical needle and plunger assembly that deploys grasping needles to draw tissue together and pierce it with a suture, using a combination of manual or motorized rotation to secure the closure, facilitating the creation of a 'purse string' suture for effective defect closure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If suture closure is used to close luminal defects in NOTES procedures, then closure reliability is improved, but the technical difficulty and space constraints within the endoscope increase
Solution Approach 1:
The closure device is divided into separate functional modules: a helical needle for piercing and suture deployment, a plunger assembly for advancing and retracting, and grasping needles for tissue approximation. This segmentation allows each component to perform its specific function independently, reducing the overall technical difficulty while maintaining closure reliability.
Solution Approach 2:
The plunger assembly is housed within the coupling member, and the grasping needles are positioned within the needle housing. This nested arrangement minimizes the device footprint within the endoscope while allowing sequential deployment of functions - first the helical needle pierces, then the plunger advances to deploy grasping needles, and finally the suture is tied.
2Ease of operation
If incisions are created through the gastrointestinal tract to access the abdominal cavity, then surgical access is improved, but the risk of leaks and catastrophic problems increases
Solution Approach 1:
The device performs preliminary actions to ensure secure closure before the incision is fully created. The helical needle is advanced to pierce the tissue and deploy the suture through the luminal defect, and the grasping needles are deployed to approximate the tissue edges, creating a secure closure that prevents leaks before the surgical access is fully established.
Solution Approach 2:
The device incorporates feedback mechanisms through the plunger assembly that provides tactile feedback on tissue approximation and suture tension. This allows the surgeon to adjust the closure force in real-time to ensure adequate sealing without creating leaks, while maintaining easy surgical access through the gastrointestinal tract.
Data Source
AI summary
An endoscopic closure device comprises: a coupling member; a helical needle mounted to the coupling member and carrying a suture; and a plurality of grasping needles, each of said plurality of grasping needles moveable between a storage position and a deployed position. The plurality of grasping needles is configured to be (a) advanced in the storage position into a luminal defect, (b) moved into the deployed position, and (c) then refracted from the luminal defect, thus pulling and drawing tissue surrounding the luminal defect together. Then, upon rotation of the coupling member and the helical needle, the helical needle is driven into and pierces the tissue, carrying the suture through the tissue.