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Applicator and tissue fastening method through natural orifice

Applicator and tissue fastening method through natural orifice description/claims

1. Field of the Invention

The present invention relates to an applicator and tissue fastening method to perform the procedure for fastening tissues through a natural orifice.

2. Description of Related Art

Transcutaneous insertion of medical instruments as a treatment of body organs is well known. This method is less invasive compared to incising the abdomen, and quick recovery is anticipated.

A medical instrument used for transcutaneous procedures has a shaft made of hard material inserted in the body transcutaneously, with a forceps and so on provided at the front end of the shaft. For instance, a treatment instrument used in applications such as connecting hollow organs is disclosed in Japanese Unexamined Patent Application, First Publication No. 2005-193044. This intraluminal anastomosis device has a grasper fitted to the front end of the shaft that can freely open and close, and an anastomosis clamp inserted in the shaft. The anastomosis clamp can be pushed out from the front end of the shaft by the protruding device located at proximally to the operator. The anastomosis clamp is formed by annealing shape memory alloy into flat coil shape and inserting it in the shaft in the elongated condition. When the anastomosis clamp is used, the clamp is pushed out from the protruding device and inserted into the body. The surgical clamp is heated by body temperature and restored to its original coil shape. The hollow organs are joined by the restored anastomosis clamp.

Other examples of dispensing the anastomosis clamp are disclosed in the international publication number WO2002/019923. Here, the anastomosis clamp is pushed out from the needle and dispensed to the tissue. For this reason, a stopper is provided to control the depth to which the needle pierces the tissue and the amount of the anastomosis clamp is dispensed into the tissue. When performing the procedure, the instrument containing the anastomosis clamp and the needle is deployed to the tissue. The needle is advanced to pierce the blood vessel, and the position of the anastomosis clamp is fixed by the stopper. Thereafter, the needle is pulled out of the blood vessel and the tissue. The anastomosis clamp does not move because of the stopper; therefore, its front end part remains inside the blood vessel. When the instrument is removed from the tissue, the rest of the anastomosis clamp remains outside the tissue. When the coil shape of the anastomosis clamp is restored, the blood vessel and layers of the tissue are anastomosed.

The main object of the present invention is to fasten tissues through a natural orifice in comparison to the conventional procedures of fixing tissues transcutaneously so that invasiveness is reduced further and quick recovery can be anticipated.

The applicator related to the first aspect of the present invention is provided with: a flexible sheath longer than the overall length of an instrument channel of a flexible endoscope; an operation part used outside the instrument channel; a deployed section that can be made to protrude from the front end of the sheath by operating the operation part and to pierce tissues; a tissue fastening tool made of a superelastic wire formed in coil shape and housed inside the deployed section in a substantially extended condition; and a pusher that pushes out the tissue fastening tool from the deployed section when the operation part is operated.

The tissue fastening method through a natural orifice related to the second aspect of the present invention includes: inserting a deployed section housed in a substantially extended condition in a tissue fastening tool made of a superelastic wire formed in coil shape into the body through a flexible endoscope; piercing the deployed section into a tissue to be fastened; penetrating a tissue with a part of the tissue fastening tool housed in the deployed section and thereafter pushing it out of the deployed section to restore its original coil shape; and pulling out the deployed section from the tissue and thereafter pushing out the remaining part of the tissue fastening tool to restore its original coil shape.

The method of manufacture of double coil spring related to the third aspect of the present invention includes: winding an element wire on the core; covering the element wire wound on the core by a spacer with a slit; pulling out the element wire from the slit to the outer periphery of the spacer and winding the element wire around the periphery of the spacer; and heat treating the element wire wound over the core and the spacer.

FIG. 1 shows the usage status of applicator inserted in an endoscope.

FIG. 2 is a cross sectional view showing the applicator configuration.

FIG. 3 is an external view of the tissue fastening tool.

FIG. 4 shows an endoscope inserted in the duodenum.

FIG. 5 is a cross sectional view showing the deployed section protruding from the front end of the applicator.

FIG. 6 shows the penetrated deployed section extending from the duodenum toward the common bile duct.

FIG. 7 shows the view when the stylet has been advanced to push out the tissue fastening tool halfway.

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• Utility Patent

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