# US 10,441,284 B2 · Devices for approximating tissue and related methods of use

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- Number: US 10,441,284 B2
- Document ID: US10441284B2
- Status: Granted
- Kind: B2
- Application number: 15/439,524
- Filed: 2017-02-22
- Published: 2017-06-08
- Granted: 2019-10-15
- Earliest claimed: 2009-09-25
- Assignees: Boston Scientific Scimed, Inc.
- Applicants: Boston Scientific Scimed, Inc.
- Inventors: Lindsay Gordon; Sylvie Stacy; Johannah Van Der Plas; Anita R. Kalra; Eamon Doyle; David Wurtz
- Web page: https://patentgrep.com/patent/US10441284B2

## CPC

- A61B 17/08: Wound clamps {or clips, i.e. not or only partly penetrating the tissue (suture bridges A61B17/0466); Devices for bringing together the edges of a wound}
- A61B 17/0057: {Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect (sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009)}
- A61B 17/083: {Clips, e.g. resilient}
- A61B 17/10: for applying or removing wound clamps {, e.g. containing only one clamp or staple (A61B17/076 takes precedence; containing multiple wound clamps A61B17/068)}; Wound clamp magazines
- A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 2017/00278: {Transorgan operations, e.g. transgastric}
- A61B 2017/00349: {Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue (A61B17/06066 takes precedence)}
- A61B 2017/00579: {Barbed implements}
- A61B 2017/00584: {Clips}
- A61B 2017/00588: {Rigid or stiff implements, e.g. made of several rigid parts linked by hinges}
- A61B 2017/00637: {for sealing trocar wounds through abdominal wall}
- A61B 2017/00659: {located only on one side of the opening}
- A61B 2017/00668: {the implement being a tack or a staple}
- A61B 2017/00818: {Treatment of the gastro-intestinal system}
- A61B 2017/081: {Tissue approximator (A61B2017/1103, A61B17/8866 take precedence)}
- A61B 2017/2906: {Multiple forceps}
- A61B 2017/2931: {with releasable head}
- A61B 2090/037: {with a frangible part, e.g. by reduced diameter}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Devices for approximating multiple tissue edges internal to a body are disclosed.

## Claims

### Claim 1

A method of approximating tissue in a patient, comprising:
positioning a delivery member into a cavity of the patient, the delivery member including a first arm and a second arm at a distal end of the delivery member, each of the first arm and the second arm being movable toward and away from a longitudinal axis of the delivery member;
grasping a first tissue edge using the first arm by moving the first arm in a first direction relative to the longitudinal axis;
moving the first tissue edge, via the first arm, toward a second tissue edge;
grasping the second tissue edge using the second arm by moving the second arm in a second direction, relative to the longitudinal axis, that is opposite of the first direction;
when a unitary clip is at the distal end of the delivery member, pulling the delivery member proximally to release the unitary clip from the delivery member into the patient, the unitary clip being in an open configuration when at the distal end of the delivery member, the unitary clip including a first jaw having teeth and a second jaw having teeth, wherein the first jaw and the second jaw of the unitary clip are disposed radially outward of the first arm and the second arm when the unitary clip is at the distal end of the delivery member, wherein, while in the patient, the unitary clip is in a closed configuration where the teeth of the first jaw and the teeth of the second jaw are closer to a central axis of the unitary clip than when in the open configuration, and the first tissue edge and the second tissue edge are secured to one another between the first jaw and the second jaw of the unitary clip while the unitary clip is in the closed configuration, separated from the delivery member, and deployed in the patient; and
removing the delivery member from the patient.

### Claim 2 (depends on 1)

The method of claim 1, wherein the first direction is away from the longitudinal axis of the delivery member.

### Claim 3 (depends on 2)

The method of claim 2, wherein grasping the first tissue edge includes grasping the first tissue edge between the first arm of the delivery member and the first jaw of the unitary clip.

### Claim 4 (depends on 1)

The method of claim 1, wherein the second direction is away from the longitudinal axis of the delivery member.

### Claim 5 (depends on 4)

The method of claim 4, wherein grasping the second tissue edge includes grasping the second tissue edge between the second arm of the delivery member and the second jaw of the unitary clip.

### Claim 6 (depends on 1)

The method of claim 1, wherein a plurality of unitary clips are positioned on the delivery member.

### Claim 7 (depends on 1)

The method of claim 1, wherein the delivery member is a rod.

### Claim 8 (depends on 1)

The method of claim 1, wherein the unitary clip includes a through hole through which a portion of the delivery member is located during the positioning step.

### Claim 9 (depends on 1)

The method of claim 1, wherein at least one of the first tissue edge and the second tissue edge includes stomach tissue.

### Claim 10 (depends on 1)

The method of claim 1, wherein at least one of the first tissue edge and the second tissue edge includes gastrointestinal tissue.

### Claim 11

A method of approximating tissue in a patient, comprising:
abutting a first portion of tissue against a first arm of a grasper;
moving the first portion of tissue, while abutted against the first arm, toward a second portion of tissue;
abutting the second portion of tissue against a second arm of the grasper;
while the first portion of tissue is abutted against the first arm and while the second portion of tissue is abutted against the second arm, moving the first arm and the second arm proximally relative to a clip coupled to the first arm and the second arm, wherein the clip is coupled to the first arm and the second arm before being released into the patient, and at least a portion of the clip radially surrounds the first arm and the second arm when the clip is coupled to the first arm and the second arm; and
releasing the clip into the patient with the first portion of tissue coupled to the second portion of tissue via the clip.

### Claim 12 (depends on 11)

The method of claim 11, wherein the clip is a unitary clip.

### Claim 13 (depends on 11)

The method of claim 11, wherein abutting the first portion of tissue against the first arm of the grasper includes moving the first arm in a first direction, and abutting the second portion of tissue against the second arm of the grasper includes moving the second arm in a second direction that is opposite of the first direction.

### Claim 14 (depends on 11)

The method of claim 11, further including removing the grasper from the patient.