SYSTEMS AND METHODS FOR PERFORMING ENDOSCOPIC PROCEDURES
According to exemplary embodiments of the present disclosure, devices, systems, and methods for endoscopic procedures may include an end effector of a grasping system having a first arm and a second arm. The first and second arms may extend from a common proximal joint. The first and second arms may be formed of a self-expanding material and may have a spring force to set the arms in an unconstrained open position. The first and second arms may have an arc shape such that a distal tip of each first and second arm are configured to close as the first and second arms are actuated to a constrained closed position. A catheter may include a locating element at a distal end of a flexible tube. The locating element may be configured for locating the grasping system.
This application is a non-provisional application of, and claims the benefit of priority to, U.S. Provisional Application Ser. No. 62/650,075, filed Mar. 29, 2018, entitled “Systems and Methods for Performing Endoscopic Procedures,” and to U.S. Provisional Application Ser. No. 62/650,080, filed Mar. 29, 2018, entitled “Devices, Systems, and Methods for Pyloric Occlusion,” the entirety of which both applications are expressly incorporated by reference herein.
FIELDThe present disclosure relates generally to systems and methods for performing endoscopic procedures, and, more particularly, to location and access devices, systems, and methods for gastrojejunostomy procedures.
BACKGROUNDObesity affects a growing population and may cause additional diseases such as type 2 diabetes, greatly increasing risk of a patient's health. Surgical procedures such as bariatric surgery, e.g., to restrict a portion of a stomach and/or bypass portions of the intestine, may be the only option for patients categorized as morbidly obese. Additionally, these types of procedures may have significant side effects such as enteric hormonal changes, and are relatively invasive surgical procedures with associated complications, tissue trauma, and/or infections, which in some instances may put the patient at risk.
It is with respect to these and other considerations that the present improvements may be useful.
SUMMARYThis Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not intended to necessarily identify key features or essential features of the claimed subject matter, nor is it intended as an aid in determining the scope of the claimed subject matter.
According to an exemplary embodiment of the present disclosure, an end effector of a grasping system for an endoscopic procedure may include a first arm and a second arm. The first and second arms may extend from a common proximal joint, and the first and second arms may be formed of a self-expanding material and may have a spring force to set the arms in an unconstrained open position. The first and second arms may have an arc shape such that a distal tip of each first and second arm may be configured to close as the first and second arms are actuated to a constrained closed position.
In various of the foregoing and other embodiments of the present disclosure, the first and second arms may include one or more projections on an inner surface. The one or more projections may be castellations. The castellations may be in the form of one or a combination of: a series of equally spaced projections and grooves forming atraumatic jaws of the first and second arms; a series of projections as rounded teeth sized and shaped differently from grooves forming alligator jaws of the first and second arms; a series of projections and grooves forming trapezoidal shapes; or a series of projections and grooves including a projection having a curvature forming a hook in the projections. The common proximal joint may be a single connection of the first and second arms from a unitary proximal end. The end effector may be actuatable relative to a sheath, such that the first and second arms may be actuated between an unconstrained open position in response to the end effector extending out of the sheath, and a constrained closed position in response to the end effector retracting within the sheath. In the constrained closed position, the arc shape of the first and second arms may form an oval shape. The projections on the inner surfaces of the first and second arms may provide atraumatic grasping of tissue, the tissue including a body lumen.
According to an exemplary embodiment of the present disclosure, a system for an endoscopic procedure may include a grasping device. The grasping device may include an end effector disposed at a distal end of the grasping system including a first arm and a second arm. The first and second arms may extend from a single connection at a proximal end, and the first and second arms may be formed of a self-expanding material and may have a spring force to set the arms in an unconstrained open position. The grasping device may further include an end effector disposed at a distal end of the grasping system. The end effector may include a first arm and a second arm. The first and second arms may extend from a single connection at a proximal end, and the first and second arms may be formed of a self-expanding material and may have a spring force to set the arms in an unconstrained open position. The grasping device may further include a handle disposed at a proximal end of the grasping system. The handle may include a movable portion for actuating the first and second arms of the end effector between an unconstrained open position and a constrained closed position. The system may further include a drive wire connecting the end effector and the handle, and a catheter may include a locating element at a distal end of a flexible tube.
In various of the foregoing and other embodiments of the present disclosure, the first and second arms may have an arc shape such that a distal tip of each first and second arm may be configured to close as the first and second arms are actuated to a constrained closed position. The first and second arms may include one or more projections on an inner surface. The one or more projections may be castellations. The castellations may be in the form of one or a combination of: a series of equally spaced projections and grooves forming atraumatic jaws of the first and second arms; a series of projections as rounded teeth sized and shaped differently from grooves forming alligator jaws of the first and second arms; a series of projections and grooves forming trapezoidal shapes; or a series of projections and grooves including a projection having a curvature forming a hook in the projections. The end effector may be actuatable relative to a sheath, such that the first and second arms may be actuated between the unconstrained open position in response to the end effector extending out of the sheath, and the constrained closed position in response to the end effector retracting within the sheath. The catheter may include one or more projections for engaging with gastrointestinal tissue during peristaltic contractions. The one or more projections of the catheter may include any of the following: a frustoconical section extending radially from a surface of the catheter, the frustoconical section having a planar section and connecting a larger diameter of the frustoconical section to the catheter; a plurality of protrusions extending radially from the surface of the catheter, the plurality of protrusions being equidistantly spaced from each other; or a helical feature having a thread extending radially from the surface of the catheter. The locating element of the catheter may include a light emitting element, a sensor, a transmitter, or a receiver, or combinations thereof. The locating element may be configured for locating the grasping device. The drive wire may be connected to the movable portion of the handle, for actuating the end effector between the unconstrained open position in response to the end effector extending out of the sheath, and the constrained closed position in response to the end effector retracting within the sheath. In various embodiments, a catheter may be a nasocatheter
According to an exemplary embodiment of the present disclosure, a method for performing an endoscopic procedure on a patient may include inserting a catheter in the patient. A distal end of a catheter may be selectively positioned in a small bowel of the patient. The method may further include inserting an endoscope in the patient. A distal end of the endoscope may be selectively positioned in a stomach of the patient based on the selected position of the catheter in the small bowel. The method may further include actuating a grasping system to extend an end effector for grasping selected tissue of the small bowel at the selected position of the catheter. The end effector may include a first arm and a second arm extending from a single connection at a proximal end of the arms, and may have an arc shape such that a distal tip of each first and second arm may be configured for atraumatically closing around the small bowel as the first and second arms are actuated to a closed position.
In various of the foregoing and other embodiments of the present disclosure, the catheter may be selectively positioned at a first location in the small bowel and the endoscope may be selectively positioned at a second location apposing the first location. The method may further include creating an opening in the stomach, and grasping the tissue of the small bowel with the grasping system through the stomach opening. The method may further include creating an opening in the small bowel and delivering an anastomotic device across the openings. The device may appose the stomach and small bowel at the respective selected positions and creates a conduit for stomach content to flow therethrough. The catheter may include projections that may be acted upon by peristaltic motion to propel the catheter to the selected position in the small bowel. The end effector may be actuatable relative to a sheath, such that the first and second arms may be actuated between an unconstrained open position in response to the end effector extending out of the sheath, and a constrained closed position in response to the end effector retracting within the sheath.
Non-limiting embodiments of the present disclosure are described by way of example with reference to the accompanying figures, which are schematic and not intended to be drawn to scale. In the figures, each identical or nearly identical component illustrated is typically represented by a single numeral. For purposes of clarity, not every component is labeled in every figure, nor is every component of each embodiment shown where illustration is not necessary to allow those of ordinary skill in the art to understand the disclosure. In the figures:
The present disclosure is not limited to the particular embodiments described herein. The terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting beyond the scope of the appended claims. Unless otherwise defined, all technical terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the disclosure belongs.
As used herein, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” or “includes” and/or “including” when used herein, specify the presence of stated features, regions, steps elements and/or components, but do not preclude the presence or addition of one or more other features, regions, integers, steps, operations, elements, components and/or groups thereof.
The present disclosure relates to devices, systems, and methods for performing a procedure, e.g., an endoscopic, laparoscopic, and/or open surgical procedure, to create a gastrojejunal anastomosis. For example, devices and systems described herein may aide gastrojejunal anastomosis placement by reliably and repeatably locating a desired position in a patient's gastrointestinal system, e.g., distinguishing a position in the jejunum 120 proximal and/or distal to the Ligament of Treitz 130. Additionally, devices and systems may allow for a physician to better grasp and/or hold a portion of the small bowel 125 during a gastrojejunal anastomosis procedure. Although the systems and devices are described herein with respect to a gastrointestinal system, it may be understood that exemplary embodiments of devices and systems in accordance with the present disclosure may be advantageous for use in any other procedures and/or anatomy, where selective location is blind and atraumatic grasping of tissue (e.g., a body lumen and/or other sensitive tissue structures) is indicated.
It may be understood that references to “proximal” may be defined as an end of the systems and devices closest to the entry point of the patient (e.g., a nasal and/or oral cavity) and “distal” may be defined as an end of the systems and devices closest to the desired location of the system and devices in the patient (e.g., a patient's gastrointestinal system such as the jejunum).
Referring now to
As shown in
In embodiments, e.g., illustrated in
In some embodiments and as shown in
As further shown in
The locating element as a light source 335 and/or the LED 350 may allow a medical professional to visualize the distal end 330b of the nasocatheter 300 from outside the wall of the jejunum 120 by an endoscopic and/or laparoscopic visualization. As described below with respect to
In another embodiment, as shown in
A sensor configuration as described may be advantageous in that a medical professional may be able to manipulate the end effector and/or grasper to get closer to the targeted tissue, or loop of interest, before light emitted from the outside wall of jejunum is visible. The sensor 375 may be any type of sensor and/or micro-sensor, including but not limited to ultrasonic sensors, laser sensors, infrared (IR) sensors, electromagnetic sensors, hall-effect sensors, and/or magnetic reed switches. A weight of the sensor 375 on the nasocatheter may also aide in the advancement of nasocatheter 300 by peristalsis, e.g., supplementing and/or replacing the material 360.
Referring now to
As shown in
Each section may include a frustoconical portion 420, in which the frustoconical 420 includes a smaller diameter 425 distal of a larger diameter 430. The frustoconical portion 420 may be integrally formed with the nasocatheter 400, although in some embodiments, the frustoconical portion 420 may be attached to the nasocatheter, e.g., by a mechanical fastener, adhesive, and/or geometrical configuration such as a press fit, tongue and groove, and/or slot configuration. The smaller diameter 425 may be approximately the diameter of the nasocatheter 400 and flush with the surface 410 of the nasocatheter 400, and the larger diameter 430 may extend radially from the surface 410 of the nasocatheter 400. The frustoconical portion 420 may include a planar surface 435 extending substantially perpendicular to the longitudinal axis 415 connecting the larger diameter 430 to the surface 410 of the nasocatheter 400 (see reference numeral 440 and
Referring now to
The sets of protrusions 505a, 505b, . . . 505n may include a plurality of protrusions 520, which may each be a circular section and/or ridge. Each protrusion 520 may extend radially from the surface 510 and substantially perpendicular from the longitudinal axis 515, although in other embodiments the protrusions 520 may extend at any angle relative to the surface 510 of the nasocatheter 500. In some embodiments, the protrusions 520 may be spaced equidistantly from each other along the longitudinal axis 515, in each set of protrusions 505a, 505b, . . . 505n, although in other embodiments, the projections may be variably spaced apart from each other. The protrusions 520 may be integrally formed with the nasocatheter 500, although in some embodiments, the protrusions 520 may be attached to the nasocatheter 500, e.g., by a mechanical fastener, adhesive, and/or geometrical configuration such as a press fit, tongue and groove, and/or slot configuration. Each protrusion 520 may have a proximal surface side 525, so that the intestinal wall may contact the surface sides 525 during contractions (see reference numeral 540 and
Referring now to
The helical features 605a, 605b, . . . 605n may include a helical protrusion 620, extending radially from the surface 610, e.g., a screw thread. In embodiments having a helical feature such as a screw thread, a higher pitch of the helical features may correlate to more forward movement (e.g., in direction of arrow 645) as long as peristalsis allows for continuous engagement of the screw thread. It may be understood that if a pitch is too high there may not be continuous engagement with the screw thread (e.g., the intestinal walls may have intermittent engagement and disengagement with the screw thread, which may result in less forward movement or less efficient forward movement.
The helical protrusion 620 may be integrally formed with the nasocatheter 600, although in some embodiments, the helical protrusion 620 may be attached to the nasocatheter 600, e.g., by a mechanical fastener, adhesive, and/or geometrical configuration such as a press fit, tongue and groove, and/or slot configuration. The helical protrusion 620 may have a proximal surface side 625, so that the intestinal wall may contact the surface side 625 during contractions (see reference numeral 640 and
Referring now to
The helix 720 may have a proximal surface side 725, so that the intestinal wall may contact the surface side 725 during contractions (see reference numeral 740 and
Referring now to
For example, during peristalsis the intestinal walls contract and may contact the spiral 825 to provide a force in a forward direction as indicated by arrow 845 and substantially parallel to the nasocatheter 800, thereby maximizing the force to advance the nasocatheter 800. As the intestinal walls contract and advance the nasocatheter 800 in a direction indicated by arrow 845, the spiral 825 may also result in the nasocatheter 800 rotating about the longitudinal axis 815 as shown by arrow 850, e.g., as a corkscrew.
When the nasocatheter 205, 300, 400, 500, 600, 700, 800, is in the desired position, e.g., at a selected distance from the pylorus 110, an endoscope may be inserted into a patient's stomach 105 for deploying additional accessories. For example, an endoscope may include a channel for deploying an end effector for locating and grasping a proximal area of the jejunum (see
Referring now to
An end effector 905 may include arms 905a, 905b, . . . 905n disposed at a distal end of the end effector 905 and extending longitudinally along a longitudinal axis 902. In some embodiments, the end effector 905 may include two arms 905a, 905b, and in other embodiments three or more arms 905a, 905b, . . . 905n (see also
In some embodiments, the drive wire 915 may be a single wire, double wire, or three wires, e.g., a triple-wire drive system, and the joint 910 may be a crimp connection for joining the wires and connecting to the common proximal joint 930 of the end effector 905. In some embodiments, the common proximal joint 930 may be joined to the drive wire 915 by laser welding, adhesive, and/or mechanical fastener. For example, the joint 910 may be joined to the end effector 905 through a hole (not shown) of the common proximal joint 930 of the arms 905a, 905b.
The end effector 905 and drive wire 915 may be disposed within a sheath 925 extending along and disposed coaxial to the longitudinal axis 902 (see
The arms 905a, 905b may have an outer surface 950, e.g., a surface on an outer circumferential portion of the arc shape 940, and an inner surface 945, e.g., a surface on an inner circumferential portion of the arc shape 940. The inner surface 945 may include one or more projections 955, e.g., teeth. It is understood that all arms 905a, 905b, . . . 905n on an end effector 905, may include projections 955, although in other embodiments one arm (e.g., either 905a or 905b) may include projections 955 on the inner surface 945 while the other of the arm 905a or 905b does not include any projections 955. Projections on the inner surface 945 of the arms 905a, 905b may increase surface area for gripping tissue to spread out forces applied to tissue, thereby minimizing a risk of perforating tissue during grasping. The projections 955 may be any shape and size for distributing gripping forces in an atraumatic manner (see
In embodiments, the arms 905a, 905b may be hingeless, e.g., the end effector 905 may be formed of a self-expanding or shape memory material such as nitinol. For example, the end effector may have arms that are manipulatable without including a mechanical hinge fastener for movement relative to each other such as scissors. In systems having a scissor-like hinge, when the arms are manipulated to a closed position, forces applied to tissue at the distal end are dependent on the angle between the arms 905a, 905b at the hinge, so that a greater force maybe applied at the distal end of the arms as opposed to the proximal end at the handle. Additionally, as the hinge manipulates the arms to a closed position, tissue may be pushed out from between the arms, resulting in a smaller volume of tissue gripped by the end effector. A smaller volume of tissue gripped between the arms of the end effector, combined with potential higher forces being exerted by a medical professional with reduced tactile feedback may increase a risk of perforation or other tissue damage. In accordance with the present disclosure, and as shown in
A self-expanding or shape memory material such as nitinol may have higher elasticity and may therefore allow for a greater opening span as opposed to other known graspers. Additionally, a self-expanding or shape memory material such as nitinol may allow for the arms 905a, 905b to more easily be constrained within a catheter.
In a constrained position 1005, the arms 905a, 905b may be closed (e.g.,
In some embodiments, the medical professional may close the arms 905b, 905b by extending the sheath 925 in a distal direction along the longitudinal axis 902 as indicated at arrow 1115, leaving the end effector 905 in the desired position as the sheath closes the arms 905a, 905b around tissue, as shown in
Although some embodiments illustrate arms 905a, 905b having an arc shape 940, other arms shapes are envisioned. Referring now to
As described above, the inner surface 945 of the arm 905a, 905b may include one or more projections 955, which may allow for sufficient gripping force on the selected tissue by increasing surface area. Referring now to
As shown in
The castellations 1325 may differ from the castellations 1310 of
As shown in
As shown in
As shown in
Referring now to
Referring now to
The actuator 1425, 1426, 1430, 1435 may be any configuration that allows a medical professional to adjust the movable portion with one hand along the zipper 1440. As shown in
Referring now to
The compression component 1429 may be included in the actuator 1426 to adjust a force applied to the locking component 1428 against the teeth of the zipper 1400. The compression component 1429 may be disposed between the locking component 1428 and a cap 1431, and may compress and/or expand in response to a user applying a force to the cap 1431. In embodiments, the compression component 1429 may be formed as a helical spring, disposed along axis 1403. The compression component 1429 may be disposed vertically above the locking component 1428 along the axis 1403, and the cap 1431 may be disposed vertically above the compression component 1429.
The cap 1431 may be attachable to the housing 1427 to enclose the locking component 1428 and/or the compression component 1429. In embodiments, a user may apply a force in a direction of arrow 1432 on a cover 1431a of the cap 1431, to compress and/or expand the compression component 1429 so that the locking component 1428 engages and/or disengages with the teeth of the zipper 1440. The compression component 1429 may provide additional force against the locking component 1428, to increase contact and/or frictional forces needed to move the movable element 1420 along the axis 1402. The cap 1431 may additionally and/or alternatively be rotatable about axis 1403 in a direction indicated by arrow 1433, which may lock and/or unlock the locking component 1428 in a desired position. For example, the user may twist the cap 1431 about the axis 1403, which may engage with the housing 1427 to hold the actuator 1426 in a desired vertical position and thus maintaining a position of the movable element 1420.
As shown in
Referring now to
Referring now to
As shown in
It is understood that the exemplary embodiments of handles illustrated in
Referring now to
When the distal end 1645 of the endoscope 1640 is in the desired position,
Referring now to
Numerous specific details have been set forth herein to provide a thorough understanding of the embodiments. It will be understood by those skilled in the art, however, that the embodiments may be practiced without these specific details. In other instances, well-known operations, components, and circuits have not been described in detail so as not to obscure the embodiments. It can be appreciated that the specific structural and functional details disclosed herein may be representative and do not necessarily limit the scope of the embodiments.
Some embodiments may be described using the expression “coupled” and “connected” along with their derivatives. These terms are not intended as synonyms for each other. For example, some embodiments may be described using the terms “connected” and/or “coupled” to indicate that two or more elements are in direct physical or electrical contact with each other. The term “coupled,” however, may also mean that two or more elements are not in direct contact with each other, but yet still co-operate or interact with each other.
It should be noted that the methods described herein do not have to be executed in the order described, or in any particular order. Moreover, various activities described with respect to the methods identified herein can be executed in serial or parallel fashion.
Although specific embodiments have been illustrated and described herein, it should be appreciated that any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of various embodiments. It is to be understood that the above description has been made in an illustrative fashion, and not a restrictive one. Combinations of the above embodiments, and other embodiments not specifically described herein will be apparent to those of skill in the art upon reviewing the above description. Thus, the scope of various embodiments includes any other applications in which the above compositions, structures, and methods are used.
Although the subject matter has been described in language specific to structural features and/or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described above. Rather, the specific features and acts described above are disclosed as example forms of implementing the subject matter of the claims.
Claims
1. An end effector of a grasping system for an endoscopic procedure, the end effector comprising:
- a first arm and a second arm, the first and second arms extending from a common proximal joint, and the first and second arms being formed of a self-expanding material and having a spring force to set the first and second arms in an unconstrained open position;
- wherein the first and second arms have an arc shape such that a distal tip of each first and second arm are configured to close as the first and second arms are actuated to a constrained closed position.
2. The end effector according to claim 1, wherein the first and second arms include one or more projections on an inner surface.
3. The end effector according to claim 2, wherein the one or more projections are castellations, the castellations being in the form of one or a combination of:
- a series of equally spaced projections and grooves forming atraumatic jaws of the first and second arms;
- a series of projections as rounded teeth sized and shaped differently from grooves forming alligator jaws of the first and second arms;
- a series of projections and grooves forming trapezoidal shapes; or
- a series of projections and grooves including a projection having a curvature forming a hook in the projections.
4. The end effector according to claim 1, wherein the common proximal joint is a single connection of the first and second arms from a unitary proximal end.
5. The end effector according to claim 1, wherein the end effector is actuatable relative to a sheath, such that the first and second arms are actuated between an unconstrained open position in response to the end effector extending out of the sheath, and a constrained closed position in response to the end effector retracting within the sheath.
6. The end effector according to claim 1, wherein in the constrained closed position, the arc shape of the first and second arms forms an oval shape, and wherein projections on inner surfaces of the first and second arms provide atraumatic grasping of tissue, the tissue including a body lumen.
7. A system for an endoscopic procedure, comprising:
- a grasping device including: an end effector disposed at a distal end of the system including a first arm and a second arm, the first and second arms extending from a single connection at a proximal end, and the first and second arms being formed of a self-expanding material and having a spring force to set the arms in an unconstrained open position; and a handle disposed at a proximal end of the grasping system, the handle including a movable portion for actuating the first and second arms of the end effector between an unconstrained open position and a constrained closed position; and a drive wire connecting the end effector and the handle; and
- a catheter including a locating element at a distal end of a flexible tube.
8. The system according to claim 7, wherein the first and second arms have an arc shape such that a distal tip of each first and second arm is configured to close as the first and second arms are actuated to a constrained closed position.
9. The system according to claim 7, wherein the first and second arms include one or more projections on an inner surface.
10. The system according to claim 9, wherein the one or more projections are castellations, the castellations being in the form of one or a combination of:
- a series of equally spaced projections and grooves forming atraumatic jaws of the first and second arms;
- a series of projections as rounded teeth sized and shaped differently from grooves forming alligator jaws of the first and second arms;
- a series of projections and grooves forming trapezoidal shapes; or
- a series of projections and grooves including a projection having a curvature forming a hook in the projections.
11. The system according to claim 7, wherein the end effector is actuatable relative to a sheath, such that the first and second arms are actuated between the unconstrained open position in response to the end effector extending out of the sheath, and the constrained closed position in response to the end effector retracting within the sheath.
12. The system according to claim 7, wherein the catheter includes one or more projections for engaging with gastrointestinal tissue during peristaltic contractions.
13. The system according to claim 12, wherein the one or more projections of the catheter include any of the following:
- a frustoconical section extending radially from a surface of the catheter, the frustoconical section having a planar section and connecting a larger diameter of the frustoconical section to the catheter;
- a plurality of protrusions extending radially from the surface of the catheter, the plurality of protrusions being equidistantly spaced from each other; or
- a helical feature having a thread extending radially from the surface of the catheter.
14. The system according to claim 7, wherein the locating element of the catheter includes a light emitting element, a sensor, a transmitter, or a receiver, or combinations thereof, and wherein the locating element is configured for locating the grasping device.
15. The system according to claim 7, wherein the drive wire is connected to the movable portion of the handle, for actuating the end effector between the unconstrained open position in response to the end effector extending out of a sheath, and the constrained closed position in response to the end effector retracting within the sheath.
16. A method for performing an endoscopic procedure on a patient, comprising:
- inserting a catheter in the patient, a distal end of a catheter being selectively positioned in a small bowel of the patient;
- inserting an endoscope in the patient, a distal end of the endoscope being selectively positioned in a stomach of the patient based on the selected position of the catheter in the small bowel; and
- actuating a grasping system to extend an end effector for grasping selected tissue of the small bowel at the selected position of the catheter;
- wherein the end effector includes a first arm and a second arm extending from a single connection at a proximal end of the first and second arms, and having an arc shape such that a distal tip of each first and second arm are configured for atraumatically closing around the small bowel as the first and second arms are actuated to a closed position.
17. The method according to claim 16, wherein the catheter is selectively positioned at a first location in the small bowel and the endoscope is selectively positioned at a second location apposing the first location.
18. The method according to claim 16, further comprising:
- creating an opening in the stomach;
- grasping the tissue of the small bowel with the grasping system through the stomach opening;
- creating an opening in the small bowel; and
- delivering an anastomotic device across the openings;
- wherein the device apposes the stomach and small bowel at the respective selected positions and creates a conduit for stomach content to flow therethrough.
19. The method according to claim 16, wherein the catheter includes projections that are acted upon by peristaltic motion to propel the catheter to the selected position in the small bowel.
20. The method according to claim 16, wherein the end effector is actuatable relative to a sheath, such that the first and second arms are actuated between an unconstrained open position in response to the end effector extending out of the sheath, and a constrained closed position in response to the end effector retracting within the sheath.
Type: Application
Filed: Mar 22, 2019
Publication Date: Oct 3, 2019
Inventors: Saurav V. Gupta (Medway, MA), Camron Hagemeyer (Bloomington, IN), Marc A. Barthet (Marseille), Jean-Michel Gonzalez (Marseille), Barry Weitzner (Acton, MA), Dan Bacon (Fitchburg, MA), Kenneth R. Keene (Winchester, MA), John B. Golden (Norton, MA), Jeffrey V. Bean (Fitchburg, MA)
Application Number: 16/361,733