CA2747233C - Clip devices and methods of delivery and deployment - Google Patents

Clip devices and methods of delivery and deployment Download PDF

Info

Publication number
CA2747233C
CA2747233C CA2747233A CA2747233A CA2747233C CA 2747233 C CA2747233 C CA 2747233C CA 2747233 A CA2747233 A CA 2747233A CA 2747233 A CA2747233 A CA 2747233A CA 2747233 C CA2747233 C CA 2747233C
Authority
CA
Canada
Prior art keywords
clip device
distal
arms
proximal
catheter
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CA2747233A
Other languages
French (fr)
Other versions
CA2747233A1 (en
Inventor
John A. Karpiel
Andres F. Aguirre
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cook Medical Technologies LLC
Original Assignee
Cook Medical Technologies LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cook Medical Technologies LLC filed Critical Cook Medical Technologies LLC
Publication of CA2747233A1 publication Critical patent/CA2747233A1/en
Application granted granted Critical
Publication of CA2747233C publication Critical patent/CA2747233C/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B17/083—Clips, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00862—Material properties elastic or resilient

Abstract

The present embodiments provide a clip device (20) for engaging tissue. The clip device comprises at least first (21a) and second arms (21b) having proximal (22a, 22b) and distal ends (24a, 24b). The clip device comprises an open state when the spring member (50) is in a compressed state in which the distal end (54) of the spring member is spaced further apart from the distal ends of the first and second arms. In the open state, the distal ends of the first and second arms tend to be spaced apart from each other. Further, the clip device comprises a closed state when the spring member is in a relaxed state in which the spring member is biased to extend distally towards the distal ends of the first and second arms. In the closed state, the distal ends of the first and second arms are adjacent to each other and may engage tissue and promote hemostatis. A delivery system and methods for deploying one or more clip devices also are provided.

Description

CLIP DEVICES AND METHODS OF DELIVERY AND DEPLOYMENT
PRIORITY CLAIM
[0001] This invention claims the benefit of priority of U.S. Provisional Application Serial No.
61/139,141, entitled "Clip Devices and Methods of Delivery and Deployment,"
filed December 19, 2008.
BACKGROUND
[0002] Conventionally, a clip may be introduced into a body cavity through an endoscope to grasp living tissue of a body cavity for hemostasis, marking, and/or ligating.
In addition, clips are now being used in a number of applications related to gastrointestinal bleeding such as peptic ulcers, Mallory-Weiss tears, Dieulafoy's lesions, angiomas, post-papillotomy bleeding, and small varices with active bleeding.
[0003] Gastrointestinal bleeding is a somewhat common and serious condition that is often fatal if left untreated. This problem has prompted the development of a number of endoscopic therapeutic approaches to achieve hemostasis such as the injection of sclerosing agents and contact thermo-coagulation techniques. Although such approaches are often effective, bleeding continues for many patients and corrective surgery therefore becomes necessary. Because surgery is an invasive technique that is associated with a high morbidity rate and many other undesirable side effects, there exists a need for highly effective, less invasive procedures.
[0004] Mechanical hemostatic devices have been used in various parts of the body, including gastrointestinal applications. Such devices are typically in the form of clamps, clips, staples and sutures, which are able to apply sufficient constrictive forces to blood vessels so as to limit or interrupt blood flow. One of the problems associated with conventional hemostatic devices, however, is that many devices are not strong enough to cause permanent hemostasis. Further, typically once such, mechanical hemostatic devices are at least partially deployed, they cannot be opened and closed repeatedly before the final release of the device, which may result in possible permanent deployment of the device at an undesirable location.
[0005] Still further, mechanical hemostatic devices typically are loaded, one at a time, within an introducer equipped to deliver and deploy the device. A first hemostatic device may be deployed, but if it becomes desirable to deliver and deploy a second hemostatic device, the introducer typically must be removed from the patient's body in order to load the second hemostatic device. The introducer then is loaded back into the patient's body to deploy the second hemostatic device, and the process is repeated for each subsequent device. However, the process of deploying only one hemostatic device at a time may become very time consuming and inconvenient, causing significant delays when it may be imperative to quickly stop bleeding.
SUMMARY
[0006] The present embodiments provide a clip device for engaging tissue. The clip device comprises at least first and second arms, each having proximal and distal ends. A spring member is disposed to surround at least a portion of the first and second arms. The clip device comprises an open state when the spring member is in a compressed state in which a distal end of the spring member is spaced apart from the distal ends of the first and second arms. When the spring member is compressed, the distal ends of the first and second arms tend to be spaced apart from each other.
[0007] Further, the clip device comprises a closed state when the spring member is in a relaxed state in which the spring member is biased to extend distally towards the distal ends of the first and second arms. When the spring member is relaxed, the distal ends of the first and second arms are urged adjacent to each other. The distal ends the first and second arms may penetrate tissue and promote hemostasis when the clip device is in the closed state.
[0008] In one embodiment, the clip device further comprises proximal and distal base members. Proximal and distal ends of the spring member contact the proximal and distal base members, respectively. Further, the spring member is disposed to surround at least a portion of the first and second arms. In this embodiment, the distal base member has an aperture and may slide over the first and second arms. When the spring member is in the relaxed state, the distal base member is advanced distally over the first and second arms and promotes closure of the distal ends of the first and second arms.

=
[0009] A delivery system for deploying at least one clip device may comprise an outer sheath and a catheter, each having a lumen. The catheter is configured for longitudinal movement within the lumen of the outer sheath, and multiple clip devices are configured to be selectively advanced through the lumen of the catheter. Preferably, at least one wedge member is disposed along a flexible distal region of the catheter. The wedge member is configured to form a constriction at a distal end of the catheter when the outer sheath is positioned over the distal end of the catheter. Distal advancement of a first clip device relative to the constriction is configured to cause the distal base member of the first clip device to engage the constriction, and further configured to cause the distal ends of the first and second arms to extend beyond the constriction to assume the open state. At this time, the spring member may be held in the compressed state near the distal end of the catheter.
Subsequent proximal retraction of the outer sheath, beyond the distal end of the catheter and the wedge member, permits radially outward movement of the distal end of the catheter and the wedge member to thereby remove the constriction and permit deployment of the entire clip device from the distal end of the catheter.
[0010] Advantageously, in this manner, any number of clip devices may be sequentially loaded into the lumen of the catheter and deplred, one at a time, without the need to remove the catheter and the outer sheath from the patient's body and individually re-load clip devices, thereby saving important operating time. Further, each of the clip devices advantageously may move between the open and closed states any number of times before final deployment.

[0010a] Provided herein is a clip device for engaging tissue, the clip device comprising a first arm having proximal and distal ends; a second arm having proximal and distal ends; a proximal base member contacting the proximal ends of the first and second arms; and a spring member having proximal and distal ends, wherein the spring member is disposed to surround at least a portion of the first and second arms, and wherein the proximal end of the spring member is attached to the proximal base member, wherein the clip device comprises an open state when the spring member is in a compressed state in which the distal end of the spring member is spaced apart from the distal ends of the first and second arms, and wherein the distal ends of the first and second arms tend to be spaced apart from each other when the clip device is in the open state, wherein the clip device comprises a closed state when the spring member is in a relaxed state in which the spring member is biased to extend distally towards the distal ends of the first and second arms, wherein the distal ends of the first and second arms are adjacent to each other when the clip device is in the closed state, wherein the relaxed state of the spring member causes the arms to close.
[0010b] Also provided herein is a clip device for engaging tissue, the clip device comprising a first arm having proximal and distal ends; a second arm having proximal and distal ends; a proximal base member contacting the proximal ends of the first and second arms; and a spring member having proximal and distal ends, wherein the spring member is disposed to surround at least a portion of the first and second arms, and wherein the proximal end of the spring member is attached to the proximal base member, wherein the clip device comprises an open state when the spring member is in a compressed state in which the distal end of the spring member is spaced apart from the distal ends of the first and second arms, and wherein the distal ends of the first and second arms tend to be spaced apart from each other when the clip device is in the open state, wherein the compressed state of the spring member allows the arms to move to the open state, wherein the clip device comprises a closed state when the spring member is in a relaxed state in which the spring member is biased to extend distally towards the distal ends of the first and second arms, wherein the distal ends of the first and second arms are adjacent to each other when the clip device is in the closed state.
[0010e] Further provided herein is a clip device for engaging tissue, the clip device comprising a first arm having proximal and distal ends; a second arm having proximal and distal ends; a proximal base member contacting the proximal ends of the first and 3a second arms; and a spring member having proximal and distal ends, wherein the spring member is disposed to surround at least a portion of the first and second arms, and wherein the proximal end of the spring member extends from the proximal base member, wherein the clip device comprises an open state when the spring member is in a compressed state in which the distal end of the spring member is spaced apart from the distal ends of the first and second arms, and wherein the distal ends of the first and second arms tend to be spaced apart from each other when the clip device is in the open state, wherein the clip device comprises a closed state when the spring member is in a relaxed state in which the spring member is biased to extend distally towards the distal ends of the first and second arms, wherein the distal ends of the first and second arms are adjacent to each other when the clip device is in the closed state, wherein the first and second arms each extend in generally straight configurations and are angled with respect to one another between their respective proximal ends and tips, wherein the first and second arms crisscross relative to one another between their respective proximal ends and tips, and wherein the tips are bent in radially inward directions and configured to penetrate tissue.
[0011] Other systems, methods, features and advantages of the invention will be, or will become, apparent to one with skill in the art upon examination of the following figures and detailed description. It is intended that all such additional systems, methods, features and advantages be within the scope of the invention, and be encompassed by the following claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] The invention can be better understood with reference to the following drawings and description. The components in the figures are not necessarily to scale, emphasis instead 3b being placed upon illustrating the principles of the invention. Moreover, in the figures, like referenced numerals designate corresponding parts throughout the different views.
[0013] FIG. 1 is a side view of a clip device of a first embodiment in a closed state.
[0014] FIG. 2 is a side view of the clip device of FIG. 1 in an open state.
[0015] FIGS. 3-5 are side-sectional views illustrating an exemplary delivery system and sequence of deployment for at least one clip device provided in accordance with FIGS. 1-2.
[0016] FIG. 6 is a perspective view illustrating features of a distal region of a catheter of a delivery system.
[0017] FIGS. 7-8 are side-sectional views of an alternative embodiment of a delivery system.
[0018] FIG. 9 is a side view of an alternative clip device in a closed state.
[0019] FIG. 10 is a side view of the clip device of FIG. 9 in an open state.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0020] In the present application, the term "proximal" refers to a direction that is generally towards a physician during a medical procedure, while the term "distal" refers to a direction that is generally towards a target site within a patient's anatomy during a medical procedure.
[0021] Referring now to FIG. 1, a first embodiment of a clip device 20 is shown. In this embodiment, the clip device 20 comprises a first arm 21a and a second arm 21b.
The first arm 21a has a proximal end 22a and a distal end 24a, while the second arm 21b has a proximal end 22b and a distal end 24b. The clip device 20 further comprises a proximal base member 30 having proximal and distal surfaces 32 and 34. Optionally, the clip device 20 may comprise a distal base member 40 having proximal and distal surfaces 42 and 44, and an aperture 47 formed therein, as shown in FIG. 1.
[0022] The clip device 20 further comprises a spring member 50 having a proximal end 52, a distal end 54, and a plurality of turns 51 disposed therebetween. The spring member 50 circumferentially surrounds at least a portion of the first and second arms 21a and 21b. In the embodiment of FIGS. 1-2, the spring member 50 is disposed between the proximal and distal base members 30 and 40. In particular, the proximal end 52 of the spring member 50 contacts the distal surface 34 of the proximal base member 30, while the distal end 54 of the spring member 50 contacts the proximal surface 42 of the distal base member 40. The spring member 50 may be secured to the proximal and distal base members 30 and 40 using an adhesive, solder, weld, mechanical attachment device, or any other suitable mechanism.
Alternatively, the spring member 50 may be disposed in an abutting relationship with the proximal and distal base members 30 and 40.
[0023] As shown in FIG. 1, the proximal end 22a of the first arm 21a contacts the proximal base member 30 at a location spaced apart from the proximal end 22b of the second arm 21b.
The first and second arms 21a and 21b are angled with respect to one another and crisscross between their respective proximal and distal ends. By crisscrossing one another, the arms 21a and 22b may be more inclined to move radially outward and apart from one another in an open state, as shown in FIG. 2. However, as will be explained in FIGS. 9-10 below, the arms alternatively may not cross paths with respect to each other.
[0024] The distal ends 24a and 24b of the arms 21a and 21b are preferably bent in radially inward directions to form tips 28a and 28b, respectively, as shown in FIGS. 1-2. The tips 28a and 28b are configured to grasp and/or pierce tissue. While two arms 21a and 2 lb are depicted in the embodiment of FIGS. 1-5, it is contemplated that fewer or greater arms may be used. For example, as explained in FIGS. 9-10 below, an alternative clip device 120 comprises three arms 121a-121c.
[0025] The first and second arms 21a and 21b may be made from any suitable resilient material such as stainless steel, nitinol, plastic, and the like. In addition, the arms may have a cross-sectional shape that is round, square, rectangular, triangular, pie-shaped, truncated cone, and the like. The proximal and distal base members 30 and 40 also may be formed from stainless steel, nitinol, plastic, and the like, although the proximal and distal base members 30 and 40 preferably comprise an enhanced rigidity relative to the first and second arms 21a and 21b.
[0026] The clip device 20 may be moved between closed and open states by selectively actuating the spring member 50 between relaxed and compressed states, as shown in FIGS. 1-2, respectively. The spring member 50 comprises a first length L1 in the relaxed state, as shown in FIG. 1. In the relaxed state, the spring member 50 is longitudinally expanded and the distal base member 40 may engage the distal ends 24a and 24b of the arms 21a and 2 lb, thereby urging the distal ends 24a and 24b of the arms 21a and 2 lb adjacent to one another.
At this time, the clip device 20 is in a closed state, in which the arms 21a and 21b are configured for delivery within a lumen 78 of a catheter 70, as shown below.
Further, in the closed state of FIG. 1, the tips 28a and 28b are configured to grasp tissue and facilitate tissue closure and hemostasis.
[0027] It should be noted that the aperture 47 of the distal base member 40 may be sized so that it will not slide distally over the distal ends 24a and 24b of the arms 21a and 21b when the spring member 50 is relaxed and the clip device 20 is in the closed state of FIG. 1.
Optionally, distal stop members, such as a solder, may be disposed on the arms 21a and 22b at a location proximal to the tips 28a and 28b, to limit distal advancement of the distal stop member 40.
[0028] The spring member 50 further comprises a second length Ly in the compressed state, as shown in FIG. 2. The second length Ly is less than the first length L1 due to compression of the spring member 50, and therefore, the distal base member 40 is spaced further apart from the distal ends 24a and 24b of the arms 21a and 21b. When the spring member 50 is in the compressed state of FIG. 2, the clip device 20 is in an open state in which the distal ends 24a and 24b of the first and second arms 21a and 21b, and more specifically the tips 28a and 28b, are spaced apart a distance L3 that is configured to at least partially surround one or more desired tissue segments prior to closure of the first and second arms 21a and 21b. In particular, since the distal ends 24a and 24b of the arms 21a and 2 lb are not radially constrained by the spring member 50 and/or the distal base member 40, the distal ends 24a and 24b of the arms 21a and 21b may move in a radially outward direction, as shown in FIG.
2. The arms may move in a radially outward direction due to inherent resilient properties of the material forming the arms 21a and 21b, or alternatively, the arms 21a and 2 lb may be heat-set to assume the deployed configuration shown in FIG. 2.
[0029] While the distal base member 40 is depicted as approximately halfway between the proximal base member 30 and the distal ends 24a and 24b of the arms 21a and 2 lb in the open state of FIG. 2, the distal base member 40 may be positioned closer to or further from the proximal base member 30 when the spring member 50 is in a compressed state. For example, if the spring member 50 is further compressed, the second length Ly will be shortened and the spacing L3 may be increased. By contrast, if the spring member 50 is further expanded, the second length Ly will be increased and the spacing L3 may be reduced.
[0030] The spring member 50 may comprise any suitable material, such as stainless steel.
Further, the spring member 50 may comprise a shape and configuration that may be tailored based on a given application. In particular, the diameter, wire thickness, stiffness and/or other features of the spring member 50 may be varied as needed for a particular procedure to meet anatomical constraints and/or vary the force imposed on tissue segments.
For example, a substantially stiff spring member 50 may provide an increased force upon the distal ends 24a and 24b of the arms 21a and 21b to reduce the likelihood of the clip device 20 becoming disengaged from tissue after deployment.
[0031] In the embodiment of FIGS. 1-2, the proximal and distal base members 30 and 40 comprise generally cylindrical shapes, which may facilitate insertion through a lumen 78 of a catheter 70, as explained further below. However, the proximal and distal base members 30 and 40 alternatively may comprise different shapes. Further, as will be explained further below, the distal base member 40 preferably comprises an outer diameter sized to selectively engage a constriction 79 of the catheter 70, but the proximal base member 30 and the spring member 50 may comprise reduced diameter profiles relative to the distal base member 40.
[0032] Referring now to FIGS. 3-5, an exemplary system is described for delivery and deployment of at least one of the clip devices 20 of FIGS. 1-2. The delivery system comprises a catheter 70 having a lumen 78, and further comprises an outer sheath 80 having a lumen 88. In the embodiment of FIGS. 3-5, first and second clip devices 20a and 20b are provided for sequential deployment.
[0033] The catheter 70 comprises an outer diameter that is less than an inner diameter of the outer sheath 80, thereby allowing the catheter 70 to be longitudinally advanced within the lumen 88 of the outer sheath 80. The catheter 70 further comprises an inner diameter that is generally larger than an outer diameter of the first and second clip devices 20a and 20b, thereby allowing the first and second clip devices 20a and 20b to be loaded within the lumen 78 of the catheter 70, as shown in FIG. 3.
[0034] The catheter 70 comprises a distal end 74 and a flexible distal region 75. The flexible distal region 75 may be selectively moved in radially inward and outward directions, for purposes described further below. Preferably, a plurality of slits 77 are formed in the distal end 74, as shown in FIG. 6, to permit the radial flexibility along the distal region 75.
[0035] At least one wedge member 92 may be used to form a constriction 79 at the distal end 74 of the catheter 70. In the embodiment of FIGS. 3-5, the at least one wedge member 92 has a triangular shape are is disposed between the catheter 70 and the outer sheath 80, causing the flexible distal region 75 of the catheter 70 to move radially inward to form the constriction 79, as shown in FIGS. 3-4. The wedge member 92 may comprise a biocompatible glue, plastic, metal or other suitable material, and may comprise other shapes besides the triangular shape depicted to accomplish the objectives described below. Alternatively, one or more wedge members 92 may be formed as an integral portion of the catheter 70 at the distal region 75.
[0036] The outer sheath 80 may comprise a rigid or substantially rigid material, such as stainless steel or plastic materials, which substantially prohibits radial outward movement of the wedge member 92 and the flexible distal region 75 of the catheter 70, when a distal end 84 of the outer sheath 80 covers these regions, as shown in FIGS. 3-4.
However, when the distal end 84 of the outer sheath 80 is retracted proximally beyond the wedge member 92 and the flexible distal region 75 of the catheter 70, the flexible distal region 75 may move radially outward and the constriction 79 may be removed, as depicted in FIG. 5 below.
[0037] In one exemplary method, the first and second clip devices 20a and 20b may be loaded sequentially such that the first clip device 20a is loaded distal to the second clip device 20b within the lumen 78 of the catheter 70, as shown in FIG. 3. A stylet 90 may be positioned in the lumen 78 at a location proximal to the second clip device 20b. It should be noted that while two clip devices are shown in this example, any number may be used and sequentially loaded into the catheter 70 in an abutting manner distal to the stylet 90.
[0038] The outer sheath 80 is positioned over the catheter 70 such that the constriction 79 is formed via the wedge member 92, as shown in FIG. 3. The constriction 79 forms an inner diameter that is less than an outer diameter of the distal base member 40, as shown in FIG. 3.
Accordingly, the distal base member 40 cannot be advanced through the distal end 74 of the catheter 70. When the spring member 50 of the first clip device 20a is in the relaxed state shown in FIG. 3, the distal ends 24a and 24b of the arms 21a and 2 lb may extend partially into the constriction 79, but preferably do not extend beyond the distal end 74 of the catheter 70 to reduce the likelihood of inadvertent piercing.
[0039] Referring to FIG. 4, in a next step, the stylet 90 is advanced distally, relative to the catheter 70 and the outer sheath 80, to cause distal advancement of the second clip device 20b and corresponding distal advancement of the first clip device 20a in an abutting manner. The stylet 90 is advanced while the outer sheath 80 continues to cover the distal end 74 of the catheter 70, thereby retaining the constriction 79. As the first clip device 20a is advanced distally, the distal base member 40 of the first clip device 20a is retained by the constriction 79. However, the proximal base member 30 and the arms 21a and 21b of the first clip device 20a are advanced distally relative to the constriction 79, and the spring member 50 becomes compressed between the proximal and distal base members 30 and 40, as depicted in FIG. 4.
At this time, the distal ends 24a and 24b of the arms 21a and 2 lb of the first clip device 20a are advanced distally beyond the distal end 74 of the catheter 70, and when unconstrained, tend to bow in a radially outward direction spaced apart from one another. The spacing L3 shown in FIG. 2 therefore is formed between the distal ends 24a and 24b of the first and second arms 21a and 21b. The length of the spacing L3 may be varied based on the amount of distal advancement of the stylet 90 and corresponding compression of the spring member 50. Further, the length of the spacing L3 may be sufficient to capture one or more desired segments of tissue between the distal tips 28a and 28b of the arms 21a and 21b.
[0040] In accordance with one aspect, a physician need not deploy the first clip device 20a at this time, even through the first clip device 20a is in the open state.
Rather, the first clip device 20a may be moved between the open and closed states, shown in FIGS. 3-4, any number of times before final deployment. For example, if it becomes desirable to recapture the distal ends 24a and 24b of the arms 21a and 21b when in the open state of FIG. 4, a physician may proximally retract the stylet 90, which reduces the force upon the spring member 50 of the first clip device 20a. The spring member 50 assumes the relaxed state shown in FIG. 3, and the proximal base member 30 and the arms 21a and 21b move in a proximal direction, causing the distal ends 24a and 24b of the arms 21a and 21b to move in radially inward directions back into the catheter 70. Advantageously, in this manner, each of the individual clip devices may move between the open and closed states any number of times before final deployment.
[0041] Referring now to FIG. 5, in a next step, if the physician wishes to proceed with deployment of the first clip device 20a in the open state of FIG. 4, the outer sheath 80 is proximally retracted with respect to the catheter 70, such that the distal end 84 of the outer sheath 80 is positioned proximal to the wedge member 92. At this time, the wedge member 92 is no longer radially constrained and may move in a radially outward direction, as shown in FIG. 5. The flexible distal region 75 of the catheter 70 also may move radially outward and the constriction 79 may be removed, as depicted in FIG. 5. In this configuration, an inner diameter at the distal end 74 of the catheter 70 is equal to or greater than the outer diameter of the first clip device 20a. Therefore, the first clip device 20a may be ejected from the distal end 74 of the catheter 70. It should be noted that, when no longer constrained by the constriction 79, the spring member 50 is biased towards the relaxed state of FIG. 1 and the distal base member 40 is advanced towards the distal ends 24a and 24b of the arms 21a and 21b, causing the tips 28a and 28b to securely engage tissue, e.g., to promote hemostasis. The second clip device 20b then is positioned for deployment near the distal end 74 of the catheter 70.
[0042] After deployment of the first clip device 20a, but before deployment of the second clip device 20b, the outer sheath 80 may be distally advanced with respect to the catheter 70, thereby urging the wedge member 92 in a radially inward direction and causing the flexible distal region 75 to move radially inward and form the constriction 79, as shown in FIG. 3 above. Subsequently, the same sequence of deployment for the first clip device 20a, as explained with respect to FIGS. 3-5, may be used to deploy the second clip device 20b.
Advantageously, in this manner, any number of clip devices may be sequentially loaded into the lumen 78 of the catheter 70 and deployed, one at a time, without the need to remove the catheter 70 and outer sheath 80 from the patient's body and individually re-load clip devices thereby saving important operating time.
[0043] It should be noted that the distal base member 40 optionally may be omitted. In this case, substantially identical method steps may be used to deploy the first and second clip devices 20a and 20b, however, the distal end 54 of the spring member 50 would be configured to be retained by the constriction 79 of the catheter 70, and further configured to directly apply a compressive force directly upon the distal ends 24a and 24b of the arms 21a and 21b in the closed state of FIG. 1.
[0044] Referring to FIG. 6, and as noted above, the flexible distal region 75 of the catheter 70 may be selectively moved in a radially inward and outward direction by providing a plurality of slits 77 formed in the flexible distal region 75. In the embodiment shown, four slits 77 are formed in the distal end 74 of the catheter 70 and extend in tapered manner in a distal to proximal direction. The four slits 77 may be radially spaced apart around the circumference of the catheter 70. One or more of the wedge members 92 may be attached to the flexible distal region 75 at one or more locations between the slits 77. While four illustrative tapered slits 77 are shown in FIG. 6, it will be appreciated that greater or fewer slits may be employed, and they may comprise different shapes and configurations than depicted.
[0045] Referring now to FIGS. 7-8, the clip device 20 is deployed in the same manner as FIGS. 3-5, with the main exception that one or more alternative wedge members 92' are disposed internal to the catheter 70. Preferably, the alternative wedge members 92' comprise a triangular shape and are attached to an inner surface of the catheter 70 along the flexible distal region 75, or are formed integrally with the distal region 75. When the outer sheath 80 is distally advanced to cover the distal end 74 of the catheter 70, the wedge member 92' is moved radially inward to form the constriction 79, as shown in FIG. 7. At this time, the spring member 50 of the clip device 20 may be compressed by distal advancement of the stylet 90, as explained in FIG. 4 above.
[0046] When it becomes desirable to release the clip device 20, the outer sheath 80 may be proximally retracted with respect to the catheter 70 to a location proximal to the wedge member 92'. At this time, the wedge member 92' is no longer radially constrained and may move in a radially outward direction to form a substantially flush extension to the catheter 70, while the flexible distal region 75 moves radially outward, as shown in FIG.
8. At this time, the constriction 79 is removed and the clip device 20 may be ejected from the distal end 74 of the catheter 70.
[0047] Referring now to FIGS. 9-10, an alternative clip device 120 is shown.
The clip device 120 is substantially identical to the clip device 20 of FIGS. 1-5, with the main exceptions that the clip device 120 comprises three arms 121a-121c having proximal ends 122a-122c and distal ends 124a-124c, respectively. Unlike the embodiment of FIGS. 1-5, the arms 121a-121c do not cross paths with each other between their respective proximal and distal ends.
Distal tips 128a-128c of the three arms 121a-121c tend to be radially spaced apart when the clip device 120 is in the open state, as shown in FIG. 10. The distal ends 124a-124c of the arms 121a-121c may be biased to assume the open state of FIG. 10, either due to the inherent resilient properties of the material forming the arms 121a-121c, or alternatively, the arms 121a-121c may be heat-set to assume the deployed configuration shown in FIG.
10.
Preferably, the alternative clip device 120 is deployed in an identical manner to the clip device 20, as described with respect to FIGS. 3-5 above.
[0048] In further alternative embodiments, the apparatus and methods described herein may be used for engaging a layer of material, and are not restricted to methods for treatment of a human or animal body by surgery or therapy. For example, first and second clip devices may be provided and loaded within a lumen of a catheter, as described above. The first clip device may be positioned to engage a layer of material at a desired location in the open state, and then a compressive force is removed to allow the first spring member to be biased towards the relaxed state and cause the distal ends of the first and second arms of the first clip device to be adjacent to each other and engage the layer of material, as generally described above.
[0049] While various embodiments of the invention have been described, the invention is not to be restricted except in light of the attached claims and their equivalents.
Moreover, the advantages described herein are not necessarily the only advantages of the invention and it is not necessarily expected that every embodiment of the invention will achieve all of the advantages described.

Claims (21)

WHAT IS CLAIMED IS:
1. A clip device for engaging tissue, the clip device comprising:
a first arm having proximal and distal ends;
a second arm having proximal and distal ends;
a proximal base member contacting the proximal ends of the first and second arms; and a spring member having proximal and distal ends, wherein the spring member is disposed to surround at least a portion of the first and second arms, and wherein the proximal end of the spring member is attached to the proximal base member, wherein the clip device comprises an open state when the spring member is in a compressed state in which the distal end of the spring member is spaced apart from the distal ends of the first and second arms, and wherein the distal ends of the first and second arms tend to be spaced apart from each other when the clip device is in the open state, wherein the clip device comprises a closed state when the spring member is in a relaxed state in which the spring member is biased to extend distally towards the distal ends of the first and second arms, wherein the distal ends of the first and second arms are adjacent to each other when the clip device is in the closed state, wherein the relaxed state of the spring member causes the arms to close.
2. The clip device of claim 1 further comprising a distal base member having an aperture configured to permit movement of the distal base member at least partially over the first and second arms, wherein the distal end of the spring member contacts a proximal surface of the distal base member.
3. The clip device of claim 1, wherein the distal ends the first and second arms are bent in radially inward directions to form tips configured to penetrate tissue.
4. The clip device of claim 1, wherein the first and second arms are angled with respect to one another and crisscross between their respective proximal and distal ends.
5. The clip device of claim 1 further comprising a third arm having proximal and distal ends, wherein the first, second and third arms tend to be spaced apart from each other when the clip device is in the open state, wherein the distal ends of the first, second and third arms are adjacent to each other when the clip device is in the closed state, and wherein the first, second and third arms do not cross paths with respect to each other when the clip device is in the open state.
6. The clip device of claim 1 further comprising:
a catheter having a lumen, wherein the clip device is configured to be selectively advanced through the lumen of the catheter; and a constriction formed at a distal end of the catheter, wherein the constriction facilitates selective deployment of the clip device through the distal end of the catheter.
7. The clip device of claim 6, wherein multiple clip devices are configured to be loaded in a sequential manner within the lumen of the catheter at the same time, and further are configured to be individually and selectively deployed from the distal end of the catheter.
8. The clip device of claim 6 further comprising:
an outer sheath having a lumen, wherein the catheter is configured for longitudinal movement within the lumen of the outer sheath; and at least one wedge member disposed along a flexible distal region of the catheter, wherein the wedge member forms the constriction at the distal end of the catheter when the outer sheath is positioned over the distal end of the catheter.
9. The clip device of claim 8, further comprising:
a distal base member having an aperture configured to permit movement of the distal base member at least partially over the first and second arms, wherein the distal end of the spring member contacts a proximal surface of the distal base member, and wherein the constriction comprises a diameter smaller than an outer diameter of the distal base member, such that distal advancement of the clip device relative to the constriction is configured to cause the distal base member to engage the constriction, and further configured to cause the distal ends of the first and second arms to extend distally beyond the distal end of the catheter and assume the open state, and further cause the spring member to assume the compressed state.
10. The clip device of claim 9, wherein proximal retraction of the outer sheath, beyond the distal end of the catheter and the wedge member, is adapted to permit radially outward movement of the distal end of the catheter and the wedge member to thereby remove the constriction and permit deployment of the entirety of the clip device from the distal end of the catheter.
11. A clip device for engaging tissue, the clip device comprising:
a first arm having proximal and distal ends;
a second arm having proximal and distal ends;
a proximal base member contacting the proximal ends of the first and second arms; and a spring member having proximal and distal ends, wherein the spring member is disposed to surround at least a portion of the first and second arms, and wherein the proximal end of the spring member is attached to the proximal base member, wherein the clip device comprises an open state when the spring member is in a compressed state in which the distal end of the spring member is spaced apart from the distal ends of the first and second arms, and wherein the distal ends of the first and second arms tend to be spaced apart from each other when the clip device is in the open state, wherein the compressed state of the spring member allows the arms to move to the open state, wherein the clip device comprises a closed state when the spring member is in a relaxed state in which the spring member is biased to extend distally towards the distal ends of the first and second arms, wherein the distal ends of the first and second arms are adjacent to each other when the clip device is in the closed state.
12. The clip device of claim 11 further comprising a distal base member having an aperture configured to permit movement of the distal base member at least partially over the first and second arms, wherein the distal end of the spring member contacts a proximal surface of the distal base member.
13. The clip device of claim 11, wherein the distal ends the first and second arms are bent in radially inward directions to form tips configured to penetrate tissue.
14. The clip device of claim 11, wherein the first and second arms are angled with respect to one another and crisscross between their respective proximal and distal ends.
15. The clip device of claim 11 further comprising:
a catheter having a lumen, wherein the clip device is configured to be selectively advanced through the lumen of the catheter; and a constriction formed at a distal end of the catheter, wherein the constriction facilitates selective deployment of the clip device through the distal end of the catheter.
16. A clip device for engaging tissue, the clip device comprising:
a first arm having proximal and distal ends;
a second arm having proximal and distal ends;
a proximal base member contacting the proximal ends of the first and second arms; and a spring member having proximal and distal ends, wherein the spring member is disposed to surround at least a portion of the first and second arms, and wherein the proximal end of the spring member extends from the proximal base member, wherein the clip device comprises an open state when the spring member is in a compressed state in which the distal end of the spring member is spaced apart from the distal ends of the first and second arms, and wherein the distal ends of the first and second arms tend to be spaced apart from each other when the clip device is in the open state, wherein the clip device comprises a closed state when the spring member is in a relaxed state in which the spring member is biased to extend distally towards the distal ends of the first and second arms, wherein the distal ends of the first and second arms are adjacent to each other when the clip device is in the closed state, wherein the first and second arms each extend in generally straight configurations and are angled with respect to one another between their respective proximal ends and tips, wherein the first and second arms crisscross relative to one another between their respective proximal ends and tips, and wherein the tips are bent in radially inward directions and configured to penetrate tissue.
17. The clip device of claim 16 further comprising a distal base member having an aperture configured to permit movement of the distal base member at least partially over the first and second arms, wherein the distal end of the spring member contacts a proximal surface of the distal base member.
18. The clip device of claim 16 further comprising:
a catheter having a lumen, wherein the clip device is configured to be selectively advanced through the lumen of the catheter; and a constriction formed at a distal end of the catheter, wherein the constriction facilitates selective deployment of the clip device through the distal end of the catheter.
19. The clip device of claim 18, wherein multiple clip devices are configured to be loaded in a sequential manner within the lumen of the catheter at the same time, and further are configured to be individually and selectively deployed from the distal end of the catheter.
20. The clip device of claim 18 further comprising:
an outer sheath having a lumen, wherein the catheter is configured for longitudinal movement within the lumen of the outer sheath; and at least one wedge member disposed along a flexible distal region of the catheter, wherein the wedge member forms the constriction at the distal end of the catheter when the outer sheath is positioned over the distal end of the catheter.
21. The clip device of claim 20, further comprising:
a distal base member having an aperture configured to permit movement of the distal base member at least partially over the first and second arms, wherein the distal end of the spring member contacts a proximal surface of the distal base member, and wherein the constriction comprises a diameter smaller than an outer diameter of the distal base member, such that distal advancement of the clip device relative to the constriction is configured to cause the distal base member to engage the constriction, and further configured to cause the distal ends of the first and second arms to extend distally beyond the distal end of the catheter and assume the open state, and further cause the spring member to assume the compressed state.
CA2747233A 2008-12-19 2009-12-15 Clip devices and methods of delivery and deployment Active CA2747233C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US13914108P 2008-12-19 2008-12-19
US61/139,141 2008-12-19
PCT/US2009/067992 WO2010080386A2 (en) 2008-12-19 2009-12-15 Clip devices and methods of delivery and deployment

Publications (2)

Publication Number Publication Date
CA2747233A1 CA2747233A1 (en) 2010-07-15
CA2747233C true CA2747233C (en) 2014-08-12

Family

ID=41716544

Family Applications (1)

Application Number Title Priority Date Filing Date
CA2747233A Active CA2747233C (en) 2008-12-19 2009-12-15 Clip devices and methods of delivery and deployment

Country Status (6)

Country Link
US (1) US8491610B2 (en)
EP (1) EP2389122B1 (en)
JP (1) JP5565881B2 (en)
AU (1) AU2009335901B2 (en)
CA (1) CA2747233C (en)
WO (1) WO2010080386A2 (en)

Families Citing this family (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2015681B1 (en) 2006-05-03 2018-03-28 Datascope Corp. Tissue closure device
CN102076271B (en) * 2008-05-05 2014-07-09 尼蒂外科设备有限公司 Endoscopic compression clip and system and method for use thereof
CA2780122C (en) 2009-10-30 2014-08-19 Cook Medical Technologies Llc Apparatus for maintaining a force upon tissue using a loop member
WO2012021350A1 (en) * 2010-08-10 2012-02-16 Cook Medical Technologies Llc Clip devices and methods of delivery and deployment
JP2012166003A (en) * 2011-01-28 2012-09-06 Nobuyuki Sakurazawa Medical clip reloadable after separation and delivery system
KR101201083B1 (en) 2011-06-15 2012-11-13 국립암센터 Medical Multiple Clips, Clip Gun applying the same, Clipping Method using the same
US9078645B2 (en) * 2011-12-19 2015-07-14 Edwards Lifesciences Corporation Knotless suture anchoring devices and tools for implants
JP6298886B2 (en) * 2013-07-10 2018-03-20 ボストン サイエンティフィック サイムド，インコーポレイテッドＢｏｓｔｏｎ Ｓｃｉｅｎｔｉｆｉｃ Ｓｃｉｍｅｄ，Ｉｎｃ． Tissue grasping and wound closure clip device
WO2015077356A1 (en) 2013-11-19 2015-05-28 Wheeler William K Fastener applicator with interlock
JP6244975B2 (en) * 2014-02-25 2017-12-13 住友ベークライト株式会社 Endoscopic clip device and endoscope clip device kit
CN107809963B (en) * 2015-06-23 2019-12-24 心脏器械股份有限公司 Barbed anchors or nails
JP6810254B2 (en) * 2016-11-03 2021-01-06 ボストン サイエンティフィック サイムド，インコーポレイテッドＢｏｓｔｏｎ Ｓｃｉｅｎｔｉｆｉｃ Ｓｃｉｍｅｄ，Ｉｎｃ． User-operated reloadable clip cartridge
CN108703783B (en) * 2018-03-16 2019-06-14 李妍 A kind of operating robot Clip Applier
US11653928B2 (en) 2018-03-28 2023-05-23 Datascope Corp. Device for atrial appendage exclusion
WO2023028250A1 (en) 2021-08-25 2023-03-02 GastroLogic LLC Endoscopic clip apparatus and methods

Family Cites Families (267)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2199025A (en) 1936-06-08 1940-04-30 Carl E Conn Means and method of closing surgical incisions
US2671444A (en) 1951-12-08 1954-03-09 Jr Benjamin F Pease Nonmetallic mesh surgical insert for hernia repair
US3209422A (en) 1963-12-23 1965-10-05 Dritz Arthur Fastening device
US3399432A (en) 1965-12-08 1968-09-03 Dennison Mfg Co Button attachment
US3556079A (en) 1967-05-16 1971-01-19 Haruo Omizo Method of puncturing a medical instrument under guidance of ultrasound
US3470834A (en) 1968-03-08 1969-10-07 Dennison Mfg Co Fastener attaching device
US3814104A (en) 1971-07-05 1974-06-04 W Irnich Pacemaker-electrode
US3954108A (en) 1972-11-03 1976-05-04 Davis Hugh J Occlusion clip and instrument for applying same
US3856016A (en) 1972-11-03 1974-12-24 H Davis Method for mechanically applying an occlusion clip to an anatomical tubular structure
JPS5320957Y2 (en) 1973-11-14 1978-06-01
US4006747A (en) 1975-04-23 1977-02-08 Ethicon, Inc. Surgical method
SU715082A1 (en) 1977-01-24 1980-02-15 Всесоюзный научно-исследовательский и испытательный институт медицинской техники Surgical suturing apparatus
US4217902A (en) 1977-05-02 1980-08-19 March Alfred L Hemostatic clip
US4235238A (en) 1978-05-11 1980-11-25 Olympus Optical Co., Ltd. Apparatus for suturing coeliac tissues
US4485816A (en) 1981-06-25 1984-12-04 Alchemia Shape-memory surgical staple apparatus and method for use in surgical suturing
US4621639A (en) 1982-02-03 1986-11-11 Ethicon, Inc Surgical instrument with hydraulic actuator
US5417691A (en) 1982-05-20 1995-05-23 Hayhurst; John O. Apparatus and method for manipulating and anchoring tissue
CH668691A5 (en) 1985-05-31 1989-01-31 Alice Dr Med Utz WIND CLASP.
US5123914A (en) 1986-05-19 1992-06-23 Cook Incorporated Visceral anchor for visceral wall mobilization
US4791707A (en) 1986-08-26 1988-12-20 Tucker Wilson H Clip applicator, spreadable clips and method for applying the clips
US4796627A (en) 1986-08-26 1989-01-10 Tucker Wilson H Clip applicator and spreadable clips for use therein
US4749114A (en) 1986-11-10 1988-06-07 United States Surgical Corporation Purse string applicator and method of affixing a purse string
US5100418A (en) * 1987-05-14 1992-03-31 Inbae Yoon Suture tie device system and applicator therefor
US4898156A (en) 1987-05-18 1990-02-06 Mitek Surgical Products, Inc. Suture anchor
US4773420A (en) 1987-06-22 1988-09-27 U.S. Surgical Corporation Purse string applicator
US4821939A (en) 1987-09-02 1989-04-18 United States Surgical Corporation Staple cartridge and an anvilless surgical stapler
SE460455B (en) 1987-09-30 1989-10-16 Astra Meditec Ab SURGICAL INSTRUMENT FOR BONDING INTERNAL WEAVES
US5100420A (en) 1989-07-18 1992-03-31 United States Surgical Corporation Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures
US5084057A (en) 1989-07-18 1992-01-28 United States Surgical Corporation Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures
FR2632848A1 (en) 1988-06-21 1989-12-22 Lefebvre Jean Marie FILTER FOR MEDICAL USE
AU4312189A (en) * 1988-09-16 1990-04-02 P. Kevin Maughan Surgical clip
US5059205A (en) 1989-09-07 1991-10-22 Boston Scientific Corporation Percutaneous anti-migration vena cava filter
DE3941108C1 (en) 1989-12-13 1991-06-27 Richard Wolf Gmbh, 7134 Knittlingen, De
US5049153A (en) 1989-12-26 1991-09-17 Nakao Naomi L Endoscopic stapling device and method
US5015249A (en) 1989-12-26 1991-05-14 Nakao Naomi L Endoscopic stapling device and method
US5156609A (en) 1989-12-26 1992-10-20 Nakao Naomi L Endoscopic stapling device and method
US5324307A (en) 1990-07-06 1994-06-28 American Cyanamid Company Polymeric surgical staple
US5203787A (en) 1990-11-19 1993-04-20 Biomet, Inc. Suture retaining arrangement
US5366480A (en) 1990-12-24 1994-11-22 American Cyanamid Company Synthetic elastomeric buttressing pledget
CA2079057A1 (en) 1991-10-18 1993-04-19 Stanley H. Remiszewski Surgical stapling apparatus
US5242456A (en) 1991-11-21 1993-09-07 Kensey Nash Corporation Apparatus and methods for clamping tissue and reflecting the same
EP0876793B1 (en) 1992-01-21 2007-12-26 Regents Of The University Of Minnesota Septal Defect Closure Device
US5333624A (en) 1992-02-24 1994-08-02 United States Surgical Corporation Surgical attaching apparatus
US5484451A (en) 1992-05-08 1996-01-16 Ethicon, Inc. Endoscopic surgical instrument and staples for applying purse string sutures
US5766246A (en) 1992-05-20 1998-06-16 C. R. Bard, Inc. Implantable prosthesis and method and apparatus for loading and delivering an implantable prothesis
US5437266A (en) 1992-07-02 1995-08-01 Mcpherson; William Coil screw surgical retractor
IL103737A (en) 1992-11-13 1997-02-18 Technion Res & Dev Foundation Stapler device particularly useful in medical suturing
US5368602A (en) 1993-02-11 1994-11-29 De La Torre; Roger A. Surgical mesh with semi-rigid border members
US5342396A (en) 1993-03-02 1994-08-30 Cook Melvin S Staples
US5350385A (en) 1993-04-28 1994-09-27 Christy William J Surgical stab wound closure device and method
US6241747B1 (en) 1993-05-03 2001-06-05 Quill Medical, Inc. Barbed Bodily tissue connector
US5403348A (en) 1993-05-14 1995-04-04 Bonutti; Peter M. Suture anchor
US5368600A (en) 1993-07-23 1994-11-29 Ethicon, Inc. Steerable bulldog clamp applier
EP0673229A4 (en) 1993-08-25 1996-09-11 Life Surgery Inc Surgical ligation clip.
US5411522A (en) 1993-08-25 1995-05-02 Linvatec Corporation Unitary anchor for soft tissue fixation
AU1011595A (en) 1994-01-13 1995-07-20 Ethicon Inc. Spiral surgical tack
IT1269443B (en) 1994-01-19 1997-04-01 Stefano Nazari VASCULAR PROSTHESIS FOR THE REPLACEMENT OR INTERNAL COATING OF MEDIUM AND LARGE DIAMETER BLOOD VESSELS AND DEVICE FOR ITS APPLICATION WITHOUT INTERRUPTION OF BLOOD FLOW
CH687060A5 (en) 1994-02-11 1996-09-13 Alice Walder Utz Dr Piece surgical clip.
US5824044A (en) 1994-05-12 1998-10-20 Endovascular Technologies, Inc. Bifurcated multicapsule intraluminal grafting system
US5582616A (en) 1994-08-05 1996-12-10 Origin Medsystems, Inc. Surgical helical fastener with applicator
US5573542A (en) 1994-08-17 1996-11-12 Tahoe Surgical Instruments-Puerto Rico Endoscopic suture placement tool
EP1304085A3 (en) 1994-09-16 2004-01-21 Ethicon Endo-Surgery, Inc. Biodegradable tissue marking device
JPH08196538A (en) 1994-09-26 1996-08-06 Ethicon Inc Tissue sticking apparatus for surgery with elastomer component and method of attaching mesh for surgery to said tissue
US5904697A (en) 1995-02-24 1999-05-18 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US5976159A (en) 1995-02-24 1999-11-02 Heartport, Inc. Surgical clips and methods for tissue approximation
US6110187A (en) 1995-02-24 2000-08-29 Heartport, Inc. Device and method for minimizing heart displacements during a beating heart surgical procedure
US6132438A (en) 1995-06-07 2000-10-17 Ep Technologies, Inc. Devices for installing stasis reducing means in body tissue
US5690656A (en) 1995-06-27 1997-11-25 Cook Incorporated Method and apparatus for creating abdominal visceral anastomoses
US5662683A (en) 1995-08-22 1997-09-02 Ortho Helix Limited Open helical organic tissue anchor and method of facilitating healing
EP0955894A4 (en) 1995-08-25 2001-02-28 R Thomas Grotz Stabilizer for human joints
US5674231A (en) 1995-10-20 1997-10-07 United States Surgical Corporation Apparatus and method for vascular hole closure
US5582615A (en) 1995-10-30 1996-12-10 Pilling Weck, Incorporated Handle for surgical clip applicator systems
US5810848A (en) 1996-08-21 1998-09-22 Hayhurst; John O. Suturing system
US5868763A (en) 1996-09-16 1999-02-09 Guidant Corporation Means and methods for performing an anastomosis
US6036702A (en) 1997-04-23 2000-03-14 Vascular Science Inc. Medical grafting connectors and fasteners
US6447530B1 (en) 1996-11-27 2002-09-10 Scimed Life Systems, Inc. Atraumatic anchoring and disengagement mechanism for permanent implant device
CA2224366C (en) 1996-12-11 2006-10-31 Ethicon, Inc. Meniscal repair device
US6149658A (en) 1997-01-09 2000-11-21 Coalescent Surgical, Inc. Sutured staple surgical fasteners, instruments and methods for minimally invasive vascular and endoscopic surgery
US5891159A (en) 1997-05-02 1999-04-06 Cardiothoratic Systems, Inc. Automatic purse string suture device
US6071292A (en) 1997-06-28 2000-06-06 Transvascular, Inc. Transluminal methods and devices for closing, forming attachments to, and/or forming anastomotic junctions in, luminal anatomical structures
US5984949A (en) 1997-10-06 1999-11-16 Levin; John M. Tissue hooks and tools for applying same
US6994713B2 (en) 1998-01-30 2006-02-07 St. Jude Medical Atg, Inc. Medical graft connector or plug structures, and methods of making and installing same
US6638234B2 (en) 1998-03-03 2003-10-28 Senorx, Inc. Sentinel node location and biopsy
EP1079740B1 (en) 1998-05-21 2007-08-29 Christopher J. Walshe A tissue anchor system
US20040087985A1 (en) 1999-03-19 2004-05-06 Amir Loshakove Graft and connector delivery
US20050283188A1 (en) 1998-05-29 2005-12-22 By-Pass, Inc. Vascular closure device
US7060084B1 (en) 1998-05-29 2006-06-13 By-Pass, Inc. Vascular closure device
US5972002A (en) 1998-06-02 1999-10-26 Cabot Technology Corporation Apparatus and method for surgical ligation
US6165183A (en) 1998-07-15 2000-12-26 St. Jude Medical, Inc. Mitral and tricuspid valve repair
US6206913B1 (en) 1998-08-12 2001-03-27 Vascular Innovations, Inc. Method and system for attaching a graft to a blood vessel
US6679851B2 (en) 1998-09-01 2004-01-20 Senorx, Inc. Tissue accessing and anchoring device and method
US6113612A (en) 1998-11-06 2000-09-05 St. Jude Medical Cardiovascular Group, Inc. Medical anastomosis apparatus
US6152937A (en) 1998-11-06 2000-11-28 St. Jude Medical Cardiovascular Group, Inc. Medical graft connector and methods of making and installing same
US6371963B1 (en) 1998-11-17 2002-04-16 Scimed Life Systems, Inc. Device for controlled endoscopic penetration of injection needle
US7410460B2 (en) 1998-11-23 2008-08-12 Benderev Theodore V System for securing sutures, grafts and soft tissue to bone and periosteum
US6592559B1 (en) 1998-12-09 2003-07-15 Cook Incorporated Hollow, curved, superlastic medical needle
US6110183A (en) 1998-12-22 2000-08-29 Cook Incorporated Suture anchor device
US9295581B2 (en) 1999-01-05 2016-03-29 Second Sight Medical Products, Inc. Medical tack with a variable effective length
US6193732B1 (en) 1999-01-08 2001-02-27 Cardiothoracic System Surgical clips and apparatus and method for clip placement
US6228097B1 (en) 1999-01-22 2001-05-08 Scion International, Inc. Surgical instrument for clipping and cutting blood vessels and organic structures
US6159223A (en) 1999-01-26 2000-12-12 Endoscopic Concepts, Inc. Surgical clip applicator
US7226467B2 (en) 1999-04-09 2007-06-05 Evalve, Inc. Fixation device delivery catheter, systems and methods of use
CA2620783C (en) 1999-04-09 2011-04-05 Evalve, Inc. Methods and apparatus for cardiac valve repair
US6482178B1 (en) 1999-05-21 2002-11-19 Cook Urological Incorporated Localization device with anchoring barbs
US6699256B1 (en) 1999-06-04 2004-03-02 St. Jude Medical Atg, Inc. Medical grafting apparatus and methods
US7618426B2 (en) 2002-12-11 2009-11-17 Usgi Medical, Inc. Apparatus and methods for forming gastrointestinal tissue approximations
US7955340B2 (en) 1999-06-25 2011-06-07 Usgi Medical, Inc. Apparatus and methods for forming and securing gastrointestinal tissue folds
US7416554B2 (en) 2002-12-11 2008-08-26 Usgi Medical Inc Apparatus and methods for forming and securing gastrointestinal tissue folds
US6368328B1 (en) 1999-09-16 2002-04-09 Scimed Life Systems, Inc. Laser-resistant medical retrieval device
US6231561B1 (en) 1999-09-20 2001-05-15 Appriva Medical, Inc. Method and apparatus for closing a body lumen
US6428548B1 (en) 1999-11-18 2002-08-06 Russell F. Durgin Apparatus and method for compressing body tissue
US6911032B2 (en) 1999-11-18 2005-06-28 Scimed Life Systems, Inc. Apparatus and method for compressing body tissue
US6635073B2 (en) 2000-05-03 2003-10-21 Peter M. Bonutti Method of securing body tissue
US6623492B1 (en) 2000-01-25 2003-09-23 Smith & Nephew, Inc. Tissue fastener
GB2359024A (en) 2000-02-09 2001-08-15 Anson Medical Ltd Fixator for arteries
US6387114B2 (en) 2000-04-28 2002-05-14 Scimed Life Systems, Inc. Gastrointestinal compression clips
US6468290B1 (en) 2000-06-05 2002-10-22 Scimed Life Systems, Inc. Two-planar vena cava filter with self-centering capabilities
IL136702A (en) 2000-06-12 2005-11-20 Niti Alloys Tech Ltd Surgical clip
US6572629B2 (en) 2000-08-17 2003-06-03 Johns Hopkins University Gastric reduction endoscopy
US6746458B1 (en) 2000-09-07 2004-06-08 William G. Cloud Mesh material to repair hernias
US20060106279A1 (en) 2004-05-14 2006-05-18 Ample Medical, Inc. Devices, systems, and methods for reshaping a heart valve annulus, including the use of a bridge implant having an adjustable bridge stop
US6736828B1 (en) 2000-09-29 2004-05-18 Scimed Life Systems, Inc. Method for performing endoluminal fundoplication and apparatus for use in the method
JP4472217B2 (en) * 2000-10-16 2010-06-02 オリンパス株式会社 Biological tissue clip device
US6551333B2 (en) 2000-10-19 2003-04-22 Ethicon Endo-Surgery, Inc. Method for attaching hernia mesh
US6425900B1 (en) 2000-10-19 2002-07-30 Ethicon Endo-Surgery Method for attaching hernia mesh
US7485124B2 (en) 2000-10-19 2009-02-03 Ethicon Endo-Surgery, Inc. Surgical instrument having a fastener delivery mechanism
US7232445B2 (en) 2000-12-06 2007-06-19 Id, Llc Apparatus for the endoluminal treatment of gastroesophageal reflux disease (GERD)
US7211101B2 (en) 2000-12-07 2007-05-01 Abbott Vascular Devices Methods for manufacturing a clip and clip
US6623510B2 (en) 2000-12-07 2003-09-23 Integrated Vascular Systems, Inc. Closure device and methods for making and using them
US6695867B2 (en) 2002-02-21 2004-02-24 Integrated Vascular Systems, Inc. Plunger apparatus and methods for delivering a closure device
US6719777B2 (en) 2000-12-07 2004-04-13 Integrated Vascular Systems, Inc. Closure device and methods for making and using them
US7806904B2 (en) 2000-12-07 2010-10-05 Integrated Vascular Systems, Inc. Closure device
US20020173803A1 (en) 2001-05-01 2002-11-21 Stephen Ainsworth Self-closing surgical clip for tissue
CA2447514C (en) 2001-05-18 2010-07-06 University College London A flexible device for transfixing and joining tissue
US6808491B2 (en) 2001-05-21 2004-10-26 Syntheon, Llc Methods and apparatus for on-endoscope instruments having end effectors and combinations of on-endoscope and through-endoscope instruments
JP4037072B2 (en) * 2001-08-21 2008-01-23 ペンタックス株式会社 Endoscopic clip device
US7727248B2 (en) 2001-06-25 2010-06-01 Ethicon Endo-Surgery, Inc. Surgical clip
US6524887B2 (en) * 2001-07-20 2003-02-25 Intel Corporation Embedded recess in polymer memory package and method of making same
US20080015633A1 (en) 2001-09-06 2008-01-17 Ryan Abbott Systems and Methods for Treating Septal Defects
US20070129755A1 (en) 2005-12-05 2007-06-07 Ovalis, Inc. Clip-based systems and methods for treating septal defects
US7094245B2 (en) * 2001-10-05 2006-08-22 Scimed Life Systems, Inc. Device and method for through the scope endoscopic hemostatic clipping
US7331968B2 (en) 2004-06-14 2008-02-19 Ethicon Endo-Surgery, Inc. Endoscopic clip applier with threaded clip
US6699263B2 (en) 2002-04-05 2004-03-02 Cook Incorporated Sliding suture anchor
US7494496B2 (en) 2002-05-17 2009-02-24 Ucl Biomedica Plc Device for transfixing and joining tissue
ES2279156T3 (en) 2002-06-11 2007-08-16 Tyco Healthcare Group Lp MALE TIGHTS FOR HERNIAS.
EP1519687B1 (en) 2002-06-19 2010-01-20 Tyco Healthcare Group Lp Apparatus for anastomosis
US7112214B2 (en) 2002-06-25 2006-09-26 Incisive Surgical, Inc. Dynamic bioabsorbable fastener for use in wound closure
JP4373146B2 (en) 2002-07-11 2009-11-25 オリンパス株式会社 Endoscopic suturing device
US6746460B2 (en) 2002-08-07 2004-06-08 Satiety, Inc. Intra-gastric fastening devices
US7351250B2 (en) 2002-08-21 2008-04-01 Kci Licensing, Inc. Circumferential medical closure device and method
US7727247B2 (en) 2002-08-21 2010-06-01 Olympus Corporation Living tissue ligation device
US20040044364A1 (en) 2002-08-29 2004-03-04 Devries Robert Tissue fasteners and related deployment systems and methods
US8454628B2 (en) 2002-09-20 2013-06-04 Syntheon, Llc Surgical fastener aligning instrument particularly for transoral treatment of gastroesophageal reflux disease
US20060025788A1 (en) 2002-09-25 2006-02-02 By-Pass, Inc. Anastomotic leg arrangement
US6966916B2 (en) 2002-09-26 2005-11-22 Kumar Sarbjeet S Device and method for surgical repair of abdominal wall hernias
US8105345B2 (en) 2002-10-04 2012-01-31 Medtronic, Inc. Anastomosis apparatus and methods
US20060015125A1 (en) 2004-05-07 2006-01-19 Paul Swain Devices and methods for gastric surgery
WO2004069055A2 (en) 2003-02-04 2004-08-19 Ev3 Sunnyvale Inc. Patent foramen ovale closure system
JP4145200B2 (en) 2003-06-06 2008-09-03 オリンパス株式会社 Suture device
EP2314241B1 (en) 2003-06-13 2013-08-07 Covidien LP Multiple member interconnect for surgical instrument and absorbable screw fastener
US8308765B2 (en) 2004-05-07 2012-11-13 Usgi Medical, Inc. Apparatus and methods for positioning and securing anchors
DE10336734A1 (en) 2003-08-11 2005-03-10 Siemens Ag Tissue anchor for endorobots
US20050043749A1 (en) 2003-08-22 2005-02-24 Coalescent Surgical, Inc. Eversion apparatus and methods
US7361180B2 (en) 2004-05-07 2008-04-22 Usgi Medical, Inc. Apparatus for manipulating and securing tissue
US20050251189A1 (en) 2004-05-07 2005-11-10 Usgi Medical Inc. Multi-position tissue manipulation assembly
US7618427B2 (en) 2003-12-29 2009-11-17 Ethicon Endo-Surgery, Inc. Device and method for intralumenal anastomosis
JP4643451B2 (en) 2004-01-08 2011-03-02 オリンパス株式会社 Anastomosis
US8828025B2 (en) 2004-02-13 2014-09-09 Ethicon Endo-Surgery, Inc. Methods and devices for reducing hollow organ volume
JP4643328B2 (en) 2004-04-07 2011-03-02 オリンパス株式会社 Medical ligature suturing device
US7833238B2 (en) 2004-04-19 2010-11-16 Granit Medical Innovations, Llc Endoscopic anchoring device and associated method
US8114099B2 (en) 2004-04-27 2012-02-14 Tyco Healthcare Group Lp Absorbable anchor for hernia mesh fixation
US7758612B2 (en) 2004-04-27 2010-07-20 Tyco Healthcare Group Lp Surgery delivery device and mesh anchor
US7390329B2 (en) 2004-05-07 2008-06-24 Usgi Medical, Inc. Methods for grasping and cinching tissue anchors
WO2005110280A2 (en) 2004-05-07 2005-11-24 Valentx, Inc. Devices and methods for attaching an endolumenal gastrointestinal implant
US7736374B2 (en) 2004-05-07 2010-06-15 Usgi Medical, Inc. Tissue manipulation and securement system
US7785348B2 (en) 2004-05-14 2010-08-31 Ethicon Endo-Surgery, Inc. Devices and methods of locking and cutting a suture in a medical procedure
US20080091059A1 (en) 2004-05-14 2008-04-17 Ample Medical, Inc. Devices, systems, and methods for reshaping a heart valve annulus, including the use of a bridge implant having an adjustable bridge stop
US20060004409A1 (en) 2004-05-14 2006-01-05 Nobis Rudolph H Devices for locking and/or cutting a suture
US8475476B2 (en) 2004-06-01 2013-07-02 Cook Medical Technologies Llc System and method for accessing a body cavity
US7678135B2 (en) 2004-06-09 2010-03-16 Usgi Medical, Inc. Compressible tissue anchor assemblies
US7695493B2 (en) 2004-06-09 2010-04-13 Usgi Medical, Inc. System for optimizing anchoring force
US7736379B2 (en) 2004-06-09 2010-06-15 Usgi Medical, Inc. Compressible tissue anchor assemblies
US8206417B2 (en) 2004-06-09 2012-06-26 Usgi Medical Inc. Apparatus and methods for optimizing anchoring force
US7931661B2 (en) 2004-06-14 2011-04-26 Usgi Medical, Inc. Apparatus and methods for performing transluminal gastrointestinal procedures
US20090326578A1 (en) 2004-09-30 2009-12-31 Usgi Medical, Inc. Interlocking tissue anchor apparatus and methods
JP4833988B2 (en) 2004-10-08 2011-12-07 タイコ ヘルスケア グループ リミテッド パートナーシップ Endoscopic surgical clip applier
US20060106405A1 (en) 2004-11-16 2006-05-18 Fann James I Systems and methods for delivering fastener to opposed tissue structures
ATE501673T1 (en) 2004-11-29 2011-04-15 Granit Medical Innovations Llc ROTATING FINE NEEDLE FOR COLLECTION OF TISSUE BIOPSY SAMPLES
JP4758173B2 (en) * 2004-12-24 2011-08-24 オリンパス株式会社 Ligation device
US20060207612A1 (en) 2005-02-08 2006-09-21 Jasper Jackson Tissue anchoring system for percutaneous glossoplasty
US20060241691A1 (en) 2005-04-12 2006-10-26 Wilk Patent, Llc Medical treatment method and device utilizing magnetic elements
US20060237023A1 (en) 2005-04-26 2006-10-26 Usgi Medical Inc. Transgastric tubal ligation
US8663236B2 (en) 2005-04-26 2014-03-04 Usgi Medical Inc. Transgastric abdominal access
US9585651B2 (en) 2005-05-26 2017-03-07 Usgi Medical, Inc. Methods and apparatus for securing and deploying tissue anchors
US8628541B2 (en) 2005-05-26 2014-01-14 Usgi Medical, Inc. Methods and apparatus for securing and deploying tissue anchors
US7641836B2 (en) 2005-06-23 2010-01-05 Ethicon, Inc. Tissue repair device and fabrication thereof
US7622068B2 (en) 2005-06-23 2009-11-24 Ethicon, Inc. Tissue repair device and fabrication thereof
CA2614292C (en) 2005-07-06 2014-05-20 Endogun Medical Systems Ltd. Surgical fasteners and fastening devices
US8679154B2 (en) * 2007-01-12 2014-03-25 Ethicon Endo-Surgery, Inc. Adjustable compression staple and method for stapling with adjustable compression
US8062309B2 (en) 2005-08-19 2011-11-22 Boston Scientific Scimed, Inc. Defect occlusion apparatus, system, and method
US7875041B2 (en) 2005-09-28 2011-01-25 Olympus Medical Systems Corp. Suturing method for penetrating hole
US20070123840A1 (en) 2005-10-18 2007-05-31 Usgi Medical, Inc. Instrument assisted abdominal access
US20070112362A1 (en) 2005-11-14 2007-05-17 Olympus Medical Systems Corp. Perforation suturing method
US7815659B2 (en) 2005-11-15 2010-10-19 Ethicon Endo-Surgery, Inc. Suture anchor applicator
US20070156175A1 (en) 2005-12-29 2007-07-05 Weadock Kevin S Device for attaching, relocating and reinforcing tissue and methods of using same
US8721657B2 (en) 2006-01-13 2014-05-13 Olympus Medical Systems Corp. Medical instrument
US20080255422A1 (en) 2006-01-13 2008-10-16 Olympus Medical Systems Corp. Medical device
US20070219411A1 (en) 2006-01-13 2007-09-20 Olympus Medical Systems Corp. Overtube and endoscopic treatment system
US7815652B2 (en) 2006-03-21 2010-10-19 Ethicon Endo-Surgery, Inc. Surgical fastener and instrument
JP4590371B2 (en) * 2006-04-12 2010-12-01 オリンパス株式会社 Ligating device and endoscope system
BRPI0711615A2 (en) 2006-05-18 2011-12-06 Aponos Medical Corp introducer to access a site on a mammal's body, and method of making a high-torsion folding tubular introducer
US8932348B2 (en) 2006-05-18 2015-01-13 Edwards Lifesciences Corporation Device and method for improving heart valve function
US7758598B2 (en) 2006-05-19 2010-07-20 Ethicon Endo-Surgery, Inc. Combination knotting element and suture anchor applicator
WO2007142977A2 (en) * 2006-06-01 2007-12-13 Wilson-Cook Medical Inc. Release mechanisms for a clip device
US8147515B2 (en) 2006-06-30 2012-04-03 Jichi Medical University Medical holding apparatus and method of using medical holding apparatus
US7736376B2 (en) 2006-07-05 2010-06-15 Olympus Medical Systems Corp. Living body wall fixing tool used in endoscope
EP2076166A4 (en) * 2006-10-03 2015-03-11 Virtual Ports Ltd Lens cleaning device, system and method for surgical procedures
JP4584230B2 (en) 2006-11-14 2010-11-17 オリンパスメディカルシステムズ株式会社 Clip device
WO2008088982A1 (en) 2007-01-16 2008-07-24 Board Of Regents, The University Of Texas System Needle-electrode and tissue anchor system
US8460314B2 (en) 2007-02-26 2013-06-11 Olympus Medical Systems Corp. Application of procedure through natural orifice
US20080208214A1 (en) 2007-02-26 2008-08-28 Olympus Medical Systems Corp. Applicator and tissue fastening method through natural orifice
US7780702B2 (en) 2007-02-27 2010-08-24 Olympus Medical Systems Corp. Suture tool
US8128657B2 (en) 2007-02-27 2012-03-06 Olympus Medical Systems Corp. Suture instrument
US8308766B2 (en) 2007-02-27 2012-11-13 Olympus Medical Systems Corp. Endoscopic treatment instrument
US7815662B2 (en) 2007-03-08 2010-10-19 Ethicon Endo-Surgery, Inc. Surgical suture anchors and deployment device
US8500777B2 (en) 2007-03-13 2013-08-06 Longevity Surgical, Inc. Methods for approximation and fastening of soft tissue
WO2008112850A2 (en) 2007-03-15 2008-09-18 Minos Medical System and method for translumenal closure in natural orifice surgery
US20080228202A1 (en) 2007-03-16 2008-09-18 Ethicon Endo-Surgery, Inc. Endoscopic tissue approximation system
US20080228199A1 (en) 2007-03-16 2008-09-18 Ethicon Endo-Surgery, Inc. Endoscopic tissue approximation method
US7815653B2 (en) 2007-04-04 2010-10-19 Ethicon Endo-Surgery, Inc. Method for plicating and fastening gastric tissue
US7803165B2 (en) 2007-04-04 2010-09-28 Ethicon Endo-Surgery, Inc. Device for plicating and fastening gastric tissue
US7722628B2 (en) 2007-04-04 2010-05-25 Ethicon Endo-Surgery, Inc. Device for plicating and fastening gastric tissue
US7799040B2 (en) 2007-04-04 2010-09-21 Ethicon Endo-Surgery, Inc. Device for plicating and fastening gastric tissue
US7803166B2 (en) 2007-04-04 2010-09-28 Ethicon Endo-Surgery, Inc. Method for plicating and fastening gastric tissue
US20080262525A1 (en) 2007-04-17 2008-10-23 Usgi Medical, Inc. Tissue penetration and grasping apparatus
US8500629B2 (en) 2007-04-30 2013-08-06 Ethicon Endo-Surgery, Inc. Endoscopic device
US7967741B2 (en) 2007-05-01 2011-06-28 Ethicon Endo-Surgery, Inc. Endoscopic guide device
US8814901B2 (en) 2007-05-08 2014-08-26 Ethicon Endo-Surgery, Inc. Surgical fastener
US8631991B2 (en) 2007-05-30 2014-01-21 Ethicon Endo-Surgery, Inc. Surgical instrument
US8052698B2 (en) 2007-05-30 2011-11-08 Ethicon Endo-Surgery, Inc. Surgical instrument
US7699871B2 (en) 2007-05-30 2010-04-20 Ethicon Endo-Surgery, Inc. Surgical instrument
US20080300624A1 (en) 2007-05-30 2008-12-04 Ethicon Endo-Surgery, Inc. Tissue Stabilizer and Fastener
US7967842B2 (en) 2007-06-01 2011-06-28 Ethicon Endo-Surgery, Inc. Integrated securement and closure apparatus
US8992569B2 (en) 2007-06-29 2015-03-31 Ethicon Endo-Surgery, Inc. Insertion device and method of use
US8858576B2 (en) 2007-09-10 2014-10-14 Olympus Medical Systems Corp. Tissue fastening tool, stent, applicator for placing the same, and tissue fastening method through natural orifice
US8771314B2 (en) 2007-09-28 2014-07-08 Ethicon, Inc. Surgical anchor device
US7998150B2 (en) 2007-09-28 2011-08-16 Olympus Medical Systems Corp. Suturing device
US8512362B2 (en) 2007-11-05 2013-08-20 Usgi Medical Inc. Endoscopic ligation
US9526487B2 (en) 2007-12-05 2016-12-27 Indiana University Research & Technology Corporation Methods and apparatuses for delivering anchoring devices into body passage walls
US20090287080A1 (en) 2008-05-15 2009-11-19 Olympus Medical Systems Corp. Treatment instrument for endoscope and lymph node removing method
US8652150B2 (en) 2008-05-30 2014-02-18 Ethicon Endo-Surgery, Inc. Multifunction surgical device
US8070759B2 (en) 2008-05-30 2011-12-06 Ethicon Endo-Surgery, Inc. Surgical fastening device
US20100010520A1 (en) 2008-07-11 2010-01-14 Olympus Medical Systems Corp. Tissue fastener
US8162958B2 (en) 2008-07-11 2012-04-24 Olympus Medical Systems Corp. Tissue fastening tool and applicator for indwelling the same within body, and tissue fastening method through natural orifice
US8828026B2 (en) 2008-07-11 2014-09-09 Olympus Medical Systems Corp. Tissue fastening apparatus
US8888792B2 (en) 2008-07-14 2014-11-18 Ethicon Endo-Surgery, Inc. Tissue apposition clip application devices and methods
US9943302B2 (en) 2008-08-12 2018-04-17 Covidien Lp Medical device for wound closure and method of use
US8551137B2 (en) 2008-08-20 2013-10-08 Covidien Lp Double threaded tissue tack
US8480686B2 (en) 2008-09-25 2013-07-09 Ethicon Endo-Surgery, Inc. Methods and devices for delivering and applying suture anchors
US9089320B2 (en) 2008-09-25 2015-07-28 Ethicon Endo-Surgery, Inc. Methods and devices for delivering and applying multiple suture anchors
US8262675B2 (en) 2008-10-29 2012-09-11 Ethicon Endo-Surgery, Inc. Methods and devices for applying multiple suture anchors
US20100113873A1 (en) 2008-11-06 2010-05-06 Takayuki Suzuki Suturing device and suturing system
WO2010085456A1 (en) 2009-01-20 2010-07-29 Guided Delivery Systems Inc. Anchor deployment devices and related methods
US20100249498A1 (en) 2009-03-24 2010-09-30 Tyco Healthcare Group Lp Endoscopic Apparatus for Manipulating Tissue
US8292154B2 (en) 2009-04-16 2012-10-23 Tyco Healthcare Group Lp Surgical apparatus for applying tissue fasteners
US9402605B2 (en) 2009-04-16 2016-08-02 Covidien Lp Magnetically retained incision closure devices and methods of incision closure using same
US8734484B2 (en) 2009-04-21 2014-05-27 Medtronic, Inc. System and method for closure of an internal opening in tissue, such as a trans-apical access opening

Also Published As

Publication number Publication date
JP5565881B2 (en) 2014-08-06
WO2010080386A3 (en) 2010-08-26
US20100160935A1 (en) 2010-06-24
US8491610B2 (en) 2013-07-23
EP2389122B1 (en) 2015-03-04
AU2009335901B2 (en) 2013-09-19
CA2747233A1 (en) 2010-07-15
EP2389122A2 (en) 2011-11-30
JP2012512714A (en) 2012-06-07
WO2010080386A2 (en) 2010-07-15
AU2009335901A1 (en) 2011-07-07

Similar Documents

Publication Publication Date Title
CA2747233C (en) Clip devices and methods of delivery and deployment
CA2807385C (en) Clip devices and methods of delivery and deployment
JP4028175B2 (en) Gastrointestinal compression clip
US6387114B2 (en) Gastrointestinal compression clips
JP4776881B2 (en) Device for endoscopic suturing
AU2006223494B2 (en) Multi-clip device
JP5606563B2 (en) Release mechanism for clip device
US20100130965A1 (en) Redundant Tissue Closure Methods and Apparatuses
EP2637577A1 (en) Clip system having tether segments for closure
WO2011081837A1 (en) Clip devices and systems and methods for deployment
CA2478469A1 (en) Blood vessel occlusion device
US11622773B2 (en) Apparatus for fastening tissue and occluding tubular body structures

Legal Events

Date Code Title Description
EEER Examination request