C. R. Bard, Inc.

Edward Carlton Page

Richard A Gambale

Peter J Lukin

Michael F Weiser

John E Dimitriou

Harold M Aznoian

Jeffrey P Radziunas

Danial Paul Ferreira

Patrick N Gutelius

Sean J Silva

Richard L Costa

David T Zelonis

Alexander Kolnick

Frank V Patterson

Richard Clark

Paul Dicesare

Steven Louis Lantagne

Theresa Methot

Charles Patterson

Michael E Weiser

Suture clips and suture clip loading, delivery, locking and severing devices in both catheter and endoscopic embodiments are disclosed that permit the delivery and application of suture clips directly in contact with or in close approximation to sutured tissue. The catheter or endoscopic versions incorporate a collet cage with a plurality of flexible collet fingers that captivate a suture clip ring and a suture clip plug for assembly with a suture. An outer sliding sleeve constrains the collet fingers when distally advanced to minimize potential trauma during delivery and assembly of the suture clip in close proximity to the stitched tissue. Proximal retraction of the sliding sleeve coupled with the distal advancement of a pusher against cam surfaces on the inner walls of the collet fingers causes the collet fingers to open. The catheter is designed to hold and assemble the suture clip in a first position and release the suture clip and sever the suture ends proximal to the suture clip in a second position. Single pusher two-step embodiments and double pusher three-step embodiments are disclosed. Suture clip designs with plugs having heads for use with the suture clip delivery catheter are also disclosed. A suture clip loading device for loading suture clip components into the delivery system as well as a threader for threading sutures into the suture clip systems are also disclosed. A method of loading, delivering and deploying suture clips is further disclosed.

Suture clips, delivery devices and methods

A suture lock fastening device to cinch a suture in a suture lock, cut the suture end, and deploy the suture lock in response to a single movement of a user. The fastening device includes a fastening head with a retainer that is configured to hold a suture lock in the fastening head. To release the suture lock from the fastening head, the retainer is irreversibly deformed. The fastening device may include an axially movable cutter with a cutting edge to sever the ends of the suture close to the suture lock. A threading device may be preloaded into the fastening device to facilitate threading the suture through the fastening device.

Suture lock fastening device

An integrated endoscope and accessory treatment device is provided. The device employs a medical treatment device at its distal end that is combined with the endoscope as a complete system. The treatment device is controlled by integrated elements at the proximal end of the endoscope. The treatment devices may include tissue apposition devices, tissue cutting devices, forceps and others.

Integrated endoscope and accessory treatment device

The present invention relates to an improved endoscopic tissue apposition device having multiple suction ports. The invention permits multiple folds of tissue to be captured in the suction ports with a single positioning of the device and attached together by a tissue securement mechanism such as a suture, staple or other form of tissue bonding. The improvement reduces the number of intubations required during an endoscopic procedure to suture tissue or join areas of tissue together. The suction ports may be arranged in a variety of configurations on the apposition device to best suit the desired resulting tissue orientation. The inventive tissue apposition device may also incorporate tissue abrasion means to activate the healing process on surfaces of tissue areas that are to be joined by operation of the device to promote a more secure attachment by permanent tissue bonding.

Endoscopic tissue apposition device with multiple suction ports

Provided herein are suture clips that include a plug, a ring, and a shaft. Also provided is a catheter that includes a collet cage with a plurality of flexible collet fingers that engage a suture clip ring and a suture clip plug for assembly with a suture. The catheter is designed to hold and assemble the suture clip in a first position and release the suture clip and sever the suture ends proximal to the suture clip in a second position.

An improved endoscopic tissue apposition device () having multiple suction ports () permits multiple folds of tissue to be captured in the suction ports () with a single positioning of the device () and attached together by a tissue securement mechanism such as a suture (), staple or other form of tissue bonding. The improvement reduces the number of intubations required during an endoscopic procedure to suture tissue or join areas of tissue together. The suction ports () may be arranged in a variety of configurations on the apposition device () to best suit the desired resulting tissue orientation. The tissue apposition device () may also incorporate tissue abrasion means () to activate the healing process on surfaces of tissue areas that are to be joined by operation of the device to promote a more secure attachment by permanent tissue bonding.

The present invention provides a mechanism for attaching accessory devices to the distal end of an endoscope or catheter. The engagement mechanism comprises a bracing member () that engages a surface of the endoscope () and a ramp surface (), which applies a gripping force to an opposing surface of the endoscope, preferably through a wedge member (). The bracing member () may comprise an elongate element that extends partially into the working channel of the endoscope or may comprise an element that engages a portion of the total circumference of the outside surface of the endoscope. The ramp surface () is inclined at an acute angle from the longitudinal axis of the endoscope and preferably engages with a slidable wedge in a cooperative arrangement that serves to reduce the distance between the wedge () and the bracing member () as the wedge slides on the ramp to engage a portion of the endoscope therebetween.

Endoscopic accessory attachment mechanism

A endoscopic multiple sample biopsy forceps is disclosed having a jaw assembly with a pair of jaws connected to a pair of arms extending from a jaw housing. Each jaw has two shanks oppositely displaced from the longitudinal axis of the device to define a space in the rear of the jaw for storing collected tissue samples. The tissue storage space defined by the jaw shanks opens rearwardly into a tissue storage area defined within the housing. Each shank has a broad outwardly facing planar surface aligned with an inwardly facing planar surface on one of the pair of arms. A cam slot on each jaw shank is slidably engaged by a cam pin on one of the pair of arms. A puller member coaxially positioned in the housing and axially movable relative to the housing supports a pair of pivots, each of which pivotally engages a bore on at least one jaw shank. The puller member is attached to a drive wire coaxially positioned in a tubular shaft. Axial movement of the drive wire actuates the puller member. In response to axial movement of the puller along the longitudinal axis of the outer tube, the cam pins riding in the cam guide slots change the position relative to the fixed jaw pivot axis of the jaw, thus actuating the jaws. None of the jaw assembly elements movable relative to the device, except the jaws, are externally exposed such that they could contact targeted tissue and negatively affect tissue sampling operations. An ejector is provided to push collected samples from the tissue sample storage area.

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Baldwinville, MA, United States of America

Edward Carlton Page