Endoscopic Tissue Apposition Device Single Intubation
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Solution Overview
Problem
Conventional endoscopic apposition devices require multiple intubations and are cumbersome, leading to prolonged sedation and increased risk due to multiple esophageal intubations and potential perforations, with issues of suture thread tension and secure tissue retention during stomach tissue suturing.
Innovation Solution
An endoscopic stomach tissue apposition device with a tissue vacuum chamber, nesting carrier and punch needles, and a tag to secure the suture, allowing for simultaneous capture and suturing of multiple tissue sites with a single intubation, reducing the need for multiple insertions and improving tissue retention.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If multiple intubations are used to secure the endoscopic apposition device, then the device can be reliably positioned and sutures can be applied, but the procedural time increases and the risk of esophageal perforation increases
Solution Approach 1:
The endoscopic apposition device incorporates a retention mechanism that is pre-configured to engage with the esophageal wall upon single intubation. The device includes a protrusion that fits into a corresponding recess in the esophageal wall, allowing secure positioning without requiring multiple intubation attempts or additional securing steps during the procedure.
2Reliability
If multiple intubations are performed to secure the device, then tissue suturing can be reliably performed, but the risk of esophageal perforation increases
Solution Approach 1:
The retention mechanism is designed to engage the esophageal wall in a controlled manner during the initial intubation. The protrusion and recess configuration allows the device to secure itself reliably on the first attempt, eliminating the need for repeated intubation attempts that could cause perforation or trauma to the esophageal tissue.
3Ease of manufacture
If conventional endoscopic apposition devices are used, then tissue suturing can be performed, but the device complexity increases and the procedure becomes cumbersome
Solution Approach 1:
The endoscopic apposition device integrates multiple functions into a single unified structure. The retention mechanism, suture delivery system, and tissue approximation capability are combined in one device that can be inserted through a single intubation. This eliminates the need for separate securing procedures and simplifies the overall suturing process.
Solution Approach 2:
The device serves multiple purposes simultaneously: it secures itself to the esophageal wall, delivers sutures for tissue approximation, and maintains positioning throughout the procedure. This multi-functionality reduces the number of separate devices and procedures needed, making the overall treatment less cumbersome.
4Reliability
If conventional endoscopic apposition devices require multiple insertions, then tissue retention can be achieved, but the procedural time and patient sedation duration increase
Solution Approach 1:
The retention mechanism is designed to achieve secure tissue retention during the first intubation attempt. The protrusion-recess engagement is established immediately upon insertion, eliminating the need for multiple insertion cycles and thereby reducing the total duration of required sedation and procedural monitoring.
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 device enables secure and efficient suturing of stomach tissue with reduced procedural time and risk, allowing for a single intubation and faster recovery, with improved tissue retention and reduced complexity in the suturing process.
Implementation Method 1
a tissue vacuum chamber that captures a section of stomach tissue therein
Data Source
AI summary
An endoscopic tissue apposition device that includes a vacuum chamber configured to securely hold a portion of tissue therein, the vacuum chamber being defined by a proximal wall and a distal wall opposite to the proximal wall. Working and vacuum channels are provided in communication with the vacuum chamber. A portion of tissue may be held in the vacuum chamber when vacuum is applied in the vacuum chamber through the vacuum channel. A carrier needle is disposed on a proximal side of the vacuum chamber and is longitudinally advanceable into and across the vacuum chamber, while a punch needle is disposed on a distal side of the vacuum chamber and is configured to receive the carrier needle therein. A hold and release mechanism holds and releases the punch needle to facilitate joining portions of tissue together.