Method and device for use in endoscopic organ procedures

Abstract

Methods and devices for use in tissue approximation and fixation are described herein. The present invention provides, in part, methods and devices for acquiring tissue folds in a circumferential configuration within a hollow body organ, e.g., a stomach, positioning the tissue folds for affixing within a fixation zone of the stomach, preferably to create a pouch or partition below the esophagus, and fastening the tissue folds such that a tissue ring, or stomas, forms excluding the pouch from the greater stomach cavity. The present invention further provides devices for performing a transoral, endoscopic hollow organ division, including a tissue acquisition device capable of acquiring the desired tissue circumferentially, and a fixation mechanism to secure the muscular layers of the acquired tissue such that the desired healing response is achieved.

1 - 29 . (canceled)  
     
     
         30 . A tissue approximation and fixation apparatus, comprising: 
 an elongate outer tubular member defining at least a first lumen therethrough;    an elongate inner tubular member defining at least a second lumen therethrough and slidingly disposed throughout the first lumen such that a distal portion of the inner tubular member extends partially beyond a distal end of the outer tubular member;    a fastening device attached to the distal end of the inner tubular member, wherein the fastening device defines a circumferential receiving surface about the inner tubular member, and wherein the fastening device further defines at least one port in fluid communication with the second lumen of the inner tubular member,    wherein an enclosable channel is defined about the distal portion of the inner tubular member when the receiving surface of the fastening device is positioned adjacently to the distal end of the outer tubular member.    
     
     
         31 . The apparatus of  claim 30  further comprising a vacuum pump in fluid communication with the fastening device through the second lumen.  
     
     
         32 . The apparatus of  claim 30  wherein the inner tubular member is positioned concentrically within the outer tubular member.  
     
     
         33 . The apparatus of  claim 30  wherein the inner tubular member has a translational travel distance limited by pins defined along the inner tubular member.  
     
     
         34 . The apparatus of  claim 30  wherein the distal portion defines the at least one port in fluid communication with the second lumen.  
     
     
         35 . The apparatus of  claim 34  wherein the distal portion defines a plurality of additional ports.  
     
     
         36 . The apparatus of  claim 30  wherein the distal portion is rotatable about a pivot relative to a longitudinal axis of the inner tubular member.  
     
     
         37 . The apparatus of  claim 36  wherein the distal portion is rotatable up to 90°,  
     
     
         38 . The apparatus of  claim 30  wherein the distal portion is adapted to collapse about a longitudinal axis of the inner tubular member such that a diameter of the distal portion is reduced.  
     
     
         39 . The apparatus of  claim 30  wherein the circumferential receiving surface is angled relative to a longitudinal axis of the inner tubular member.  
     
     
         40 . The apparatus of  claim 30  further comprising a tubular drive element slidably disposed within the outer tubular member, the tubular driver element comprising a proximal end in communication with a driver actuator and a distal end.  
     
     
         41 . The apparatus of  claim 40  further comprising at least one fastener disposed within the outer tubular member, wherein the fastener is adapted to be urged distally by the distal end of the driver element.  
     
     
         42 . The apparatus of  claim 41  further comprising a plurality of additional fasteners circumferentially disposed within the outer tubular member.  
     
     
         43 - 49 . (canceled)