Tissue Apposition Clip Application via Steerable Overtube
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Solution Overview
Problem
Current minimally invasive surgical procedures face challenges in securely closing holes or defects in tissue walls, particularly through natural orifices, due to the need for secure closure of the peritoneal access site and efficient closure methods for various tissue types.
Innovation Solution
A clip application device with an elongate clip magazine and grasper lumens is used to position and advance tissue apposition clips, which include upper and lower clip arms to securely clamp and anchor tissue, allowing for efficient closure of openings in tissue walls, even through natural orifices.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional open surgical procedures are used to close tissue openings, then secure closure is achieved, but patient recovery time increases and scarring occurs
Solution Approach 1:
The patent replaces traditional mechanical open surgical closure with a minimally invasive endoscopic clip application system. The clip applicator delivers pre-formed clips through natural orifices using controlled mechanical advancement, eliminating the need for open incisions while maintaining secure tissue closure through the clipping mechanism
Solution Approach 2:
The patent employs flexible endoscopic instruments and thin-profile clip applicators that can navigate through natural body orifices and gastrointestinal tracts. The flexible design allows the device to conform to anatomical structures while delivering closure clips to target sites without requiring open surgical access
2Loss of time
If minimally invasive endoscopic procedures are used, then recovery time is reduced and scarring is minimized, but secure closure of tissue openings becomes difficult
Solution Approach 1:
The patent introduces tissue anchors as intermediary elements that work in conjunction with the clips. The anchors provide additional securing mechanism by embedding into the tissue while the clips clamp the tissue edges, creating a dual-mechanism closure system that enhances reliability compared to clips alone
Solution Approach 2:
The closure system combines different material properties by using clips made of shape-memory alloys or superelastic materials that can deform during application and then maintain constant clamping force. The combination of clip materials and anchor materials creates a composite closure system that adapts to tissue mechanics while ensuring secure closure
3Reliability
If multiple muscle layers are closed separately after laparoscopic procedures, then secure closure is achieved, but the procedure becomes complex and time-consuming
Solution Approach 1:
The patent combines multiple closure functions into a single integrated clip applicator device. The device can apply multiple clips in sequence through a single access point, and the grasper lumens allow simultaneous tissue manipulation and clip application, merging what would otherwise require separate surgical steps into one coordinated procedure
Solution Approach 2:
The clip applicator is designed with universal functionality to handle various tissue types and closure requirements through a single device platform. The grasper lumens can accommodate different grasper devices for manipulating different tissue layers, while the clip magazine system can deliver various clip types, making the device adaptable to multiple closure scenarios without requiring separate specialized instruments
Data Source
AI summary
Surgical methods for closing a gastrotomy. The surgical method for closing an opening in an organ wall comprises positioning a distal end portion of a steerable overtube adjacent a portion of the organ wall through which the opening extends. The surgical method further comprises inserting a flexible clip magazine into the steerable overtube. The surgical method comprises grasping tissue through which the opening extends and drawing a portion of the grasped tissue into a clamping position between upper and lower clip arms of a distal-most tissue apposition clip supported within a distal end of the clip magazine. The surgical method further comprises advancing the distal-most tissue apposition clip onto the portion of grasped tissue.