Suture clips, delivery devices and methods

Abstract

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.