US-12622685-B2 - Large tissue defect recruiting device

Abstract

A tissue recruiting device for treating and closing a defect and methods of using the same. The tissue recruiting device includes a tissue recruiting assembly with two grasping devices and a shroud. An actuation assembly couples control actuators to the grasping devices via actuation elements. The grasping devices may be maneuvered to grasp tissue from different locations by actuation of the control actuators. The grasping devices may be retracted into a shroud to substantially close the defect. The grasping devices and the shroud may be decoupled from the remainder of the tissue recruiting assembly to maintain closure of the defect.

Inventors

• Reza Mohammadpour
• Alex Uspenski
• Keith Randall John
• Seth Byers
• Brittany Ochs
• Michael C. Hauser
• Meha Elango
• Brett DuFour

Assignees

• UNITED STATES ENDOSCOPY GROUP, INC.

Dates

Publication Date

20260512

Application Date

20230519

Claims (20)

1. 1 . A tissue recruiting device comprising: a catheter; a tissue recruiting assembly comprising: first and second grasping devices; and a shroud operably coupled with the catheter and configured to at least partially surround the grasping devices in a retracted position; and an actuation assembly comprising: a first control actuator coupled with a first actuation element, the first actuation element being operably coupled with the first grasping device; and a second control actuator coupled with a second actuation element, the second actuation element being operably coupled with the second grasping device; wherein the first control actuator is operable to maneuver the first grasping device to grasp tissue at a first location and the second control actuator is operable to maneuver the second grasping device to grasp tissue at a second location; and wherein the grasping devices may be decoupled from the actuation elements and the shroud may be decoupled from the catheter when the grasping devices grasp tissue.
2. 2 . The tissue recruiting device of claim 1 , wherein each grasping device is operably coupled to the respective actuation element by a coupler.
3. 3 . The tissue recruiting device of claim 2 , wherein the coupler is fixed to a distal end of the actuation element and includes outwardly biased prongs configured to be received in a receiving portion of the grasping device.
4. 4 . The tissue recruiting device of claim 3 , wherein prongs of the coupler include projections configured to be received in detents of the coupling portion of the grasping device to operably couple the coupler to the grasping device.
5. 5 . The tissue recruiting device of claim 1 , wherein the shroud is operably coupled to the catheter by a connector.
6. 6 . The tissue recruiting device of claim 1 , wherein the actuation elements are operable to recruit the grasping devices into the shroud before the grasping devices are decoupled from the actuation elements and the shroud is decoupled from the catheter when the grasping devices grasp tissue.
7. 7 . The tissue recruiting device of claim 1 , further comprising a release member operable to decouple the grasping devices from the actuation elements via proximal retraction of the actuation elements.
8. 8 . A tissue recruiting assembly of a tissue recruiting device operable to extend through a catheter and grasp tissue, the tissue recruiting assembly comprising: a first grasping device operably coupled to a first actuation element by a first coupler; a second grasping device operably coupled to a second actuation element by a second coupler; a shroud configured to surround the first and second grasping devices; and a connector configured to operably couple the shroud to the catheter; wherein the first grasping device may be controlled by the first actuation element to grasp tissue at a first location and the second grasping device may be controlled by the second actuation element to grasp tissue at a second location; wherein the grasping devices may be retracted into the shroud and locked in place when grasping tissue; and wherein the grasping devices are operably decoupled from the actuation elements and the shroud is operably decoupled from the catheter after the grasping devices are retracted into the shroud.
9. 9 . The tissue recruiting assembly of claim 8 , wherein the connector includes a proximal connector portion fixed to the catheter and a distal connector portion fixed to the shroud.
10. 10 . The tissue recruiting assembly of claim 8 , wherein each coupler comprises a coupling link which operably couples the actuation element to the grasping device.
11. 11 . The tissue recruiting assembly of claim 8 , further comprising a release slider disposed operable to decouple the grasping devices from the couplers when the actuation elements are proximally retracted.
12. 12 . The tissue recruiting assembly of claim 8 , wherein the grasping devices each have a plurality of helical coils for grasping tissue.
13. 13 . The tissue recruiting assembly of claim 8 , wherein the grasping devices and shroud are configured to maintain closure of a defect after the grasping devices are decoupled from the actuation elements and the shroud is decoupled from the catheter.
14. 14 . The tissue recruiting assembly of claim 8 , wherein the shroud is configured to decrease in length when the grasping devices grasp tissue and are retracted into the shroud.
15. 15 . A method for treating a defect with a tissue recruiting device, the method comprising the steps of: grasping a first side of the defect with a first grasping device via a first actuation element; grasping a second side of the defect with a second grasping device via a second actuation element; retracting the first and second grasping devices into a shroud coupled to a catheter; decoupling the first grasping device from the first actuation element and the second grasping device from the second actuation element; and decoupling the shroud from the catheter.
16. 16 . The method of claim 15 , wherein each grasping device is coupled to the respective actuation element by a coupler.
17. 17 . The method of claim 15 , wherein each grasping device includes helical coils and the actuation elements are operable to translate and rotate the grasping devices to grasp tissue.
18. 18 . The method of claim 15 , wherein the grasping devices are decoupled from the actuation elements by proximal retraction of the actuation elements.
19. 19 . The method of claim 15 , further comprising the step of retracting the catheter and the actuation elements from the grasping devices and the shroud.
20. 20 . The method of claim 15 , further comprising the step of locking the grasping devices in the shroud.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS The present application claims priority to U.S. Provisional Patent Application No. 63/344,063, filed on May 20, 2022, the entire disclosure of which is incorporated herein by reference as though recited herein its entirety. TECHNICAL FIELD The present disclosure relates generally to surgical devices and, more specifically, to a tissue recruiting device that allows for improved tissue recruitment tissue. BACKGROUND Tissue grasping and recruiting devices are used in various parts of the body, including the gastrointestinal, urinary, and vascular systems, to treat internal bleeding or defects. These devices may be deployed using an endoscope, such as a flexible endoscope, and may be provided in a variety of forms and may be used with hemostatic devices, including clamps, clips, staples, sutures, and the like. One or more hemostatic devices may be deployed around tissue in the body to apply constrictive forces to blood vessels and surrounding tissue, such as to control and prevent bleeding. In some cases, a hemostatic device may be deployed around a growth of tissue, such as a polyp. The hemostatic device may be used to close the defect after the growth has been removed, such as to prevent or otherwise reduce bleeding. In other cases, target tissue may be recruited, such as into a pseudo-polyp, and the hemostatic device may be used to close the defect after the recruited tissue has been cut or severed, such as to remove the defect. The target tissue could be dysplasia, a defect, or the like. However, in some cases, particularly those involving larger defects and fibrotic tissue, it can be difficult to utilize conventional hemostatic devices to successfully close the defect. Most hemostatic devices rely on variations of conventional tissue recruiting techniques to recruit tissue before the hemostatic device is deployed. Conventional tissue recruiting techniques often involve extending a tissue recruiting device through an endoscope to the desired location to recruit tissue. However, conventional tissue recruitment techniques can sometimes fail to adequately recruit tissue before the hemostatic device is deployed. For example, conventional tissue recruitment techniques may fail to adequately grasp and recruit multiple sides of a defect. Additionally, needing to deploy a hemostatic clip to close the defect may be difficult, cumbersome, and expensive. Accordingly, there is an unmet need for an improved recruiting device that utilizes separate, independently controlled graspers to improve tissue recruitment. SUMMARY This summary is meant to provide some examples and is not intended to be limiting of the scope of the invention in any way. For example, any feature included in an example of this summary is not required by the claims, unless the claims explicitly recite the features. Also, the features, components, steps, concepts, etc. described in examples in this summary and elsewhere in this disclosure can be combined in a variety of ways. The description herein relates to systems, assemblies, methods, devices, apparatuses, combinations, etc. that may be utilized for recruiting tissue, such as a tissue defect. Various features and steps as described elsewhere in this disclosure may be included in the examples summarized here. Further, the treatment techniques, methods, operations, steps, etc. described or suggested herein can be performed on a living animal or on a non-living simulation, such as on a cadaver, simulator (e.g., with the body parts, tissue, etc. being simulated), etc. In one example embodiment, a tissue recruiting device is provided. The tissue recruiting device includes a catheter and a tissue recruiting device with first and second grasping devices and a shroud a shroud operably coupled with the catheter and configured to at least partially surround the grasping devices in a retracted position. The tissue recruiting device also includes an actuation assembly with a first control actuator coupled with a first actuation element, the first actuation element being operably coupled with the first grasping device, and a second control actuator coupled with a second actuation element, the second actuation element being operably coupled with the second grasping device. The first control actuator is operable to maneuver the first grasping device to grasp tissue at a first location and the second control actuator is operable to maneuver the second grasping device to grasp tissue at a second location. The grasping devices may be decoupled from the actuation elements and the shroud may be decoupled from the catheter when the grasping devices grasp tissue. In one example embodiment, a tissue recruiting assembly of a tissue recruiting device operable to extend through a catheter and grasp tissue is provided. The tissue recruiting assembly includes a first grasping device operably coupled to a first actuation element by a first coupler and a second grasping device operably co