Adapter for Attaching Devices to Endoscopes

Abstract

An improved system for attaching devices to the distal end of endoscopic instruments is described. An attachment adapter comprises a distal stop, such as a complete or partial loop or cylinder, which limits the penetration of an endoscope into the adapter. The adapter has at least one flange protruding proximally along the endoscope. The adapter is secured on the endoscope by a securing means, which compresses the flange or flanges sufficiently to provide a friction fit. The flexibility of the inventive adapter system allows the adapter to work reliably with endoscopes that are used, damaged or repaired. The adapter may further provide a slit or window allowing viewing of the vessel wall by a lens on an endoscope, thereby improving the operator's ability to understand the location of the endoscope during operation. The adapter may carry any of a variety of devices, including devices for closing a surgical incision, or treating or manipulating tissue. Improvements are described in a number of areas to allow more flexible pairing of particular endoscopes or endoscopic instruments with devices to be carried on their exteriors, while maintaining a tightly locked position of the external device on the carrier.

1 .- 42 . (canceled) 
     
     
         43 . An adapter for attaching devices for dispensing tissue fasteners to a distal end of an endoscopic instrument, the adapter comprising:
 a distal stop to limit the penetration of the endoscopic instrument into the adapter;   a flange projecting axially from the distal stop, the flange having a longitudinal opening; and   a securing element releasable attachable to the flange to compress the flange against the endoscopic instrument for locking the adapter to the endoscopic instrument;   wherein the adapter carries a deployment assembly activated by an actuating mechanism operated by an outer sheath connected to a pusher, and the pusher is configured so that it can be pushed into the deployment assembly and push a tissue fastener out of the deployment assembly.   
     
     
         44 . The adapter of  claim 43 , wherein the securing element, when attached to the flange, spans the opening in the flange and contacts the instrument. 
     
     
         45 . The adapter of  claim 44 , wherein at least a portion of the flange is conical. 
     
     
         46 . A system for deploying a tissue fastener from a distal end of an endoscopic instrument, the system comprising:
 an adapter including a flange and a securing element,   the flange having a longitudinal opening and being configured for insertion of the endoscopic instrument therein,   the securing element releasably attachable to the flange to compress the flange against the endoscopic instrument for locking the adapter to the endoscopic instrument, the securing element, when attached to the flange, spanning the opening in the flange and contacting the instrument;   a deployment assembly carried by the adapter, the deployment assembly including the tissue fastener; and   a pusher configured so that it can be pushed into the deployment assembly and push the tissue fastener out of the deployment assembly.   
     
     
         47 . The system of  claim 46 , wherein the deployment assembly defines an annular space to receive the tissue fastener. 
     
     
         48 . The system of  claim 47 , wherein the deployment assembly includes an inner shell, an outer shell, and a connecting wall, the inner and outer shells and the connecting wall defining the annular space. 
     
     
         49 . The system of  claim 46 , wherein the deployment assembly is carried by the adapter in a manner that does not obstruct the opening in the flange. 
     
     
         50 . The system of  claim 49 , wherein the pusher includes a longitudinal opening. 
     
     
         51 . The system of  claim 46 , wherein the deployment assembly is activated by an actuating mechanism operable at a distance from the deployment assembly. 
     
     
         52 . The system of  claim 51 , wherein the actuating mechanism includes an outer sheath connected to the pusher. 
     
     
         53 . The system of  claim 52 , wherein the actuating mechanism further includes a wire extending through the outer sheath, the wire being connected to the deployment assembly. 
     
     
         54 . The system of  claim 46 , further including a distal stop to limit penetration of the endoscopic instrument into the adapter. 
     
     
         55 . The system of  claim 54 , wherein the distal stop comprises a closed circumference. 
     
     
         56 . The system of  claim 54 , wherein the flange projects axially from the distal stop. 
     
     
         57 . The system of  claim 46 , wherein at least a portion of the flange is conical. 
     
     
         58 . The system of  claim 46 , wherein at least a portion of the flange is expandable. 
     
     
         59 . A method for deploying a tissue fastener from a distal end of an endoscopic instrument, the method comprising:
 inserting the endoscopic instrument into a flange of an adapter, the flange having a longitudinal opening, the adapter carrying a deployment assembly that includes the tissue fastener;   releasably attaching a securing element to the flange to compress the flange against the endoscopic instrument for locking the adapter to the endoscopic instrument, the securing element, when attached to the flange, spanning the opening in the flange and contacting the instrument; and   pushing a pusher into the deployment assembly to push the tissue fastener out of the deployment assembly.   
     
     
         60 . The method of  claim 59 , further comprising activating the deployment assembly by an actuating mechanism operable at a distance from the deployment assembly. 
     
     
         61 . The method of  claim 59 , further comprising limiting penetration of the endoscopic instrument into the adapter with a distal stop. 
     
     
         62 . The method of  claim 59 , further comprising expanding a portion of the flange when inserting the endoscopic instrument.