Devices and methods for endoluminal plication

Abstract

Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof In one aspect, a method of gastric volume reduction is disclosed that includes advancing a tissue acquisition and fixation device endoscopically into a stomach, manipulating the device to form a first fold of tissue on an interior surface of an anterior wall of the stomach, and manipulating the device to form a second fold of tissue on an anterior surface of a posterior wall of the stomach, where the second fold is not attached to the first fold.

1 - 20 . (canceled) 
     
     
         21 . A surgical device, comprising:
 an elongate shaft;   first and second jaws at a distal end of the elongate shaft, the first and second jaws being configured to move between a closed position and an open position; and   a vacuum port configured to operably couple to a vacuum source, the vacuum source being configured to provide a vacuum through the vacuum port, the vacuum port being configured to be advanced with the first and second jaws into a patient, the vacuum port being configured to move away from the first and second jaws with the first and second jaws in the open position in the patient and with the vacuum being provided through the vacuum port such that tissue drawn toward the vacuum port by the vacuum is moved into a space between the first and second jaws and forms a first fold of tissue.   
     
     
         22 . The device of  claim 21 , wherein the first and second jaws in the closed position are configured to be advanced into a stomach of a patient through an esophagus of the patient, and the vacuum port is configured to be advanced with the first and second jaws into the stomach of the patient. 
     
     
         23 . The device of  claim 21 , wherein the vacuum port is in a surface of a tissue acquisition member of the surgical device. 
     
     
         24 . The device of  claim 23 , wherein the first and second jaws are connected to one another at a pivot point, and the tissue acquisition member is hingedly connected to the first and second jaws. 
     
     
         25 . The device of  claim 23 , wherein the first and second jaws are configured to positioned within the patient to extend substantially parallel to a tissue surface of the patient, and the surface of the tissue acquisition member is configured to be positioned within the patient to extend parallel to the tissue surface and on an opposite side of the jaws from the tissue surface. 
     
     
         26 . The device of  claim 25 , wherein the tissue acquisition member is configured to move away from the first and second jaws while maintaining the parallel orientation of the surface of the tissue acquisition member and the tissue surface, thereby causing the vacuum port to move away from the first and second jaws. 
     
     
         27 . The device of  claim 21 , wherein a first plane extends through the first and second jaws in the open position, and the vacuum port is configured to move away from the first and second jaws in a second plane that is perpendicular to the first plane. 
     
     
         28 . The device of  claim 21 , further comprising a fastener configured to be inserted through the first fold of tissue. 
     
     
         29 . The device of  claim 28 , wherein the fastener includes a staple. 
     
     
         30 . The device of  claim 29 , wherein the staple is retained in the second jaw and is configured to be ejected from the second jaw and through the first fold of tissue toward a staple-forming receptacle formed in the first jaw. 
     
     
         31 . The device of  claim 28 , wherein the fastener includes a collapsible T-tag. 
     
     
         32 . The device of  claim 21 , wherein, after the formation of the first form of tissue, the first and second jaws are configured to be articulated to a second position within the patient to allow formation of a second fold of tissue using the vacuum port. 
     
     
         33 . A surgical method, comprising:
 providing the vacuum through the vacuum port of  claim 21  such that tissue is drawn against the vacuum port; and   with the tissue drawn against the vacuum port, moving the vacuum port away from the first and second jaws of  claim 21  with the first and second jaws in the open position and thereby moving the acquired tissue through the space.   
     
     
         34 . A surgical device, comprising:
 an elongate shaft;   an end effector at a distal end of the elongate shaft, the end effector having a closed position and an open position, the end effector in the closed position being configured to clamp tissue; and   a tissue acquisition member configured to move horizontally relative to the first and second jaws along a longitudinal axis of the tissue acquisition member, and configured to move vertically relative to the first and second jaws.   
     
     
         35 . The device of  claim 34 , wherein movement of the tissue acquisition member relative to the first and second jaws can only be the vertical movement and the horizontal movement. 
     
     
         36 . The device of  claim 34 , wherein a longitudinal axis of the end effector and a longitudinal axis of the tissue acquisition member are configured to be substantially parallel to one another during the horizontal movement of the tissue acquisition member and during the vertical movement of the tissue acquisition member. 
     
     
         37 . The device of  claim 34 , wherein the end effector includes first and second jaws configured to have a gap of space therebetween with the end effector in the open position;
 the tissue acquisition member is configured to acquire tissue; and   the vertical movement of the tissue acquisition member is configured to move the acquired tissue through the gap of space.   
     
     
         38 . The device of  claim 37 , further comprising a fastener configured to be delivered from one of the first and second jaws and through the acquired tissue. 
     
     
         39 . The device of  claim 34 , wherein the end effector includes first and second jaws, at least one of the first and second jaws being configured to move relative to the elongate shaft to move the end effector between the open and closed positions. 
     
     
         40 . The device of  claim 34 , further comprising a linkage coupling the tissue acquisition member to the first and second jaws. 
     
     
         41 . The device of  claim 34 , further comprising a hinge coupling the tissue acquisition member to the first and second jaws. 
     
     
         42 . A surgical method, comprising:
 acquiring tissue with the tissue acquisition member of  claim 34 ; and   with the tissue acquired by the tissue acquisition member and with the end effector in the open position, moving the tissue acquisition member vertically relative to the end effector of  claim 34  and thereby moving the acquired tissue through a gap of space defined by the end effector.