Multi-position tissue manipulation assembly

Abstract

Multi-position tissue manipulation assemblies are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. One or all the articulation controls and functions can be integrated into a singular handle enclosure connectable to the tissue manipulation assembly via a rigid or flexible tubular body. A needle deployment mechanism may be positioned within the enclosure. Such a mechanism can have multiple positions adapted to lock and/or advance a needle assembly within the enclosure in a controlled manner as well as for deploying the anchor assembly.

1 . A handle for use in forming a tissue fold, comprising: 
 an enclosure having a proximal end and a distal end; and    a needle deployment mechanism having a first position adapted to lock a needle assembly within the enclosure and allow longitudinal translation of the needle deployment mechanism to pivot a distal portion of a needle tubular member, and a second position adapted to allow longitudinal translation of the needle assembly through the needle tubular member.    
   
   
       2 . The handle of  claim 1  further comprising a pivotable member mounted on the enclosure and adapted to articulate a tissue engagement assembly relative to the enclosure.  
   
   
       3 . The handle of  claim 2  wherein the pivotable member is connected via one or more wires to the tissue engagement assembly.  
   
   
       4 . The handle of  claim 1  further comprising a rotatable tissue engagement control adapted to be translated longitudinally through the enclosure.  
   
   
       5 . The handle of  claim 4  wherein the enclosure defines an engagement control lumen extending through the enclosure through which the rotatable tissue engagement control is translatable.  
   
   
       6 . The handle of  claim 1  wherein the enclosure further defines at least one opening therethrough.  
   
   
       7 . The handle of  claim 1  wherein the enclosure is adapted to be reusable.  
   
   
       8 . The handle of  claim 1  wherein the enclosure is symmetrically-shaped about a longitudinal axis extending from the proximal end to the distal end.  
   
   
       9 . The handle of  claim 1  wherein the needle deployment mechanism comprises an outer sleeve rotatably disposed about an inner sleeve such that the outer sleeve and the inner sleeve are configured to interlock in a corresponding manner.  
   
   
       10 . The handle of  claim 9  wherein the outer sleeve is adapted to interlock with the inner sleeve when rotated about its longitudinal axis relative to the inner sleeve.  
   
   
       11 . The handle of  claim 1  wherein the needle deployment mechanism when in the first position is adapted to retain the needle assembly when the needle deployment mechanism is partially rotated relative to the enclosure.  
   
   
       12 . The handle of  claim 11  wherein the needle deployment mechanism is further adapted to longitudinally advance the needle tubular member relative to the enclosure.  
   
   
       13 . The handle of  claim 1  wherein the needle deployment mechanism when in the second position is adapted to allow for the longitudinal translation of the needle assembly via a slot defined in the needle deployment mechanism.  
   
   
       14 . The handle of  claim 1  further comprising an elongate tubular member extending from the distal end of the enclosure through which the needle assembly is translatable.  
   
   
       15 . The handle of  claim 14  wherein the elongate tubular member is detachable from the enclosure.  
   
   
       16 . The handle of  claim 14  wherein the elongate tubular member comprises a rigid shaft.  
   
   
       17 . The handle of  claim 14  wherein the elongate tubular member comprises a flexible endoscopic device.  
   
   
       18 . The handle of  claim 17  wherein the flexible endoscopic device is shape-lockable.  
   
   
       19 . A needle deployment system adapted to be retained in an enclosure, comprising: 
 an outer sleeve disposed about an inner sleeve such that the outer sleeve and the inner sleeve are configured to interlock in a corresponding manner;    wherein the outer sleeve is adapted to partially rotate relative to the inner sleeve such that the deployment mechanism defines:    a first position adapted to lock a needle assembly within the needle deployment mechanism and allow longitudinal translation of the needle deployment mechanism to pivot a distal portion of a needle tubular member, and    a second position adapted to allow longitudinal translation of the needle assembly through the needle tubular member.    
   
   
       20 . The system of  claim 19  further comprising an enclosure which is adapted to retain the needle deployment mechanism therewithin.  
   
   
       21 . The system of  claim 20  wherein the enclosure defines an engagement control lumen therethrough.  
   
   
       22 . The system of  claim 20  wherein the enclosure is symmetrically-shaped about a longitudinal axis extending therealong.  
   
   
       23 . The system of  claim 20  further comprising an elongate tubular member extending from a distal end of the enclosure.  
   
   
       24 . The system of  claim 23  wherein the elongate tubular member is detachable from the enclosure.  
   
   
       25 . The system of  claim 23  wherein the elongate tubular member comprises a rigid shaft.  
   
   
       26 . The system of  claim 23  wherein the elongate tubular member comprises a flexible endoscopic device.  
   
   
       27 . The system of  claim 19  wherein the outer sleeve defines a slot thereon.  
   
   
       28 . The system of  claim 19  further comprising a pivotable member adapted to articulate a tissue engagement assembly relative to the needle deployment system.  
   
   
       29 . The system of  claim 19  further comprising a rotatable tissue engagement control adapted to be translated longitudinally relative to the needle deployment system.  
   
   
       30 . The system of  claim 19  further comprising a needle assembly having a hollow needle body disposed at a distal end of an elongate flexible shaft.  
   
   
       31 . A method of deploying a needle assembly, comprising: 
 loading a needle assembly within an enclosure;    articulating a needle deployment mechanism within the enclosure to a first position such that the needle assembly is locked within the needle deployment mechanism;    translationally advancing the needle deployment mechanism relative to the enclosure such that a distal portion of a needle tubular member is pivoted;    articulating the needle deployment mechanism to a second position such that the needle assembly is longitudinally translatable through the needle tubular member.    
   
   
       32 . The method of  claim 31  wherein loading a needle assembly comprises advancing the needle tubular member through the enclosure.  
   
   
       33 . The method of  claim 31  wherein articulating a needle deployment mechanism within the enclosure comprises partially rotating the needle deployment mechanism relative to the enclosure such that the needle assembly is locked.  
   
   
       34 . The method of  claim 31  wherein translationally advancing the needle deployment mechanism comprises urging the deployment mechanism distally relative to the enclosure.  
   
   
       35 . The method of  claim 31  wherein articulating the needle deployment mechanism to a second position comprises partially rotating the needle deployment mechanism relative to the enclosure such that the needle assembly is translatable distally relative to the enclosure.  
   
   
       36 . The method of  claim 31  further comprising deploying at least one anchor from the needle assembly.  
   
   
       37 . The method of  claim 36  further comprising withdrawing the needle assembly from the needle deployment mechanism.  
   
   
       38 . The method of  claim 37  further comprising re-loading a second needle assembly within the enclosure.