Endoscopic Tissue Anchor Sliding Knot Mechanism
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Solution Overview
Problem
Existing knot-secured tissue anchor systems for endoscopic use face challenges in securing gastrointestinal tissue folds reliably due to difficulties in controlling the tightening process, leading to poorly secured anchors that may loosen over time, especially in the small dimensions required for minimally invasive procedures.
Innovation Solution
The proposed solution involves a tissue anchor assembly with a sliding knot configuration where the knot is located between two anchors, with one anchor featuring a transverse through hole to prevent the knot from passing through, and an endoscopic knot tightening instrument with a slit to control the knot's movement, reducing twisting and ensuring both thread limbs remain under tension.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of manufacture
If a knot-secured tissue anchor system is used for securing gastrointestinal tissue folds, then the system can be implemented with simple configurations and widely tested knot designs, but the tightening process becomes difficult to control leading to additional uncontrollable knots and potential anchor loosening
Solution Approach 1:
The patent introduces a knot pusher as an intermediary device between the operator and the knot. This pusher allows controlled advancement of the knot along the suture thread without direct manual manipulation, preventing unwanted twisting and additional knot formation while maintaining the simplicity of the anchor configuration itself
Solution Approach 2:
The sliding knot design allows the knot to advance along the suture thread through its own structural mechanics when tension is applied. The knot self-regulates its position and tightening force through the interaction between the suture thread loops and the anchor tags, reducing the need for complex external control mechanisms
2Strength
If the thread is passed twice through each anchor tag as in prior art configurations, then the anchor can be secured with a knot, but twisting of the thread occurs during tightening which increases friction and prevents proper sliding of the thread and knot
Solution Approach 1:
The patent divides the suture thread into separate limbs (first limb and second limb) that are routed through different paths. The first limb passes through the first anchor tag while the second limb passes through the second anchor tag, preventing the threads from twisting around each other and reducing friction during the sliding and tightening process
3Strength
If the distal anchor makes multiple turns on itself during tightening, then the anchor can be secured, but this twisting increases friction between thread limbs and hinders sliding of the thread along the anchor tag
Solution Approach 1:
The patent creates an asymmetric routing arrangement where the first and second suture thread limbs follow different paths through the anchor tags. This asymmetric configuration prevents the threads from symmetrically wrapping around each other and the anchor, thereby minimizing twisting and reducing friction forces during tightening
Data Source
AI summary
Assembly for endoscopically securing gastrointestinal tissue folds, comprising a first tissue anchor and a second tissue anchor, a first suture thread part and a second suture thread part, each of the first and second thread parts having a connected end and a free end opposite the connected end. The first thread part and the second thread part are tied to each other through a sliding knot, such that the first thread part firms a post of the sliding knot along which the sliding knot is arranged to slide during tightening of the assembly and such that the second thread part wraps around the post to create the sliding knot. The first thread part extends from the first anchor to past the sliding knot where the first thread part's free end forms a post free end, and the second thread part extends from the second anchor to past the sliding knot where the second thread part's free end is free, such that the sliding knot is interposed between the first and second anchors. The first or the second anchor comprises a knot retaining through hole, wherein the post free end slidingly passes through the knot retaining through hole, the knot retaining through hole having a size preventing the sliding knot to pass through the knot retaining through hole, such that the anchor can be used as a knot retainer during tightening.