# US 10,765,433 B2 · Endoluminal anastomosis and tissue closure devices

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- Number: US 10,765,433 B2
- Document ID: US10765433B2
- Status: Granted
- Kind: B2
- Application number: 15/750,909
- Filed: 2016-07-11
- Published: 2018-08-09
- Granted: 2020-09-08
- Earliest claimed: 2015-08-07
- Assignees: Mayo Foundation for Medical Education and Research
- Applicants: Mayo Foundation for Medical Education and Research
- Inventors: Shanda Blackmon
- Web page: https://patentgrep.com/patent/US10765433B2

## CPC

- A61B 17/1114: {of the digestive tract, e.g. bowels or oesophagus}
- 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 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/0487: {Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks (suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122)}
- A61B 17/3468: {for implanting or removing devices, e.g. prostheses, implants, seeds, wires (devices for implanting seeds A61M37/0069)}
- A61B 2017/0034: {adapted to be inserted through a working channel of an endoscope}
- A61B 2017/00575: {for closure at remote site, e.g. closing atrial septum defects}
- A61B 2017/00672: {Locating means therefor, e.g. bleed back lumen}
- A61B 2017/00818: {Treatment of the gastro-intestinal system}
- A61B 2017/00827: {Treatment of gastro-esophageal reflux}
- A61B 2017/00907: {for light}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0417: {T-fasteners}
- A61B 2017/0464: {for soft tissue}
- A61B 2017/0474: {Knot pushers}
- A61B 2017/0475: {using sutures having a slip knot}
- A61B 2017/0488: {Instruments for applying suture clamps, clips or locks}
- A61B 2017/1132: {End-to-end connections}
- A61B 2017/345: {for introduction into a natural body opening}
- A61B 2090/0807: {Indication means}
- A61B 2090/309: {using white LEDs}
- A61F 5/0076: {preventing normal digestion, e.g. Bariatric or gastric sleeves}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)

## Abstract

Multiple endoscopic devices and methods for closing perforations and/or creating anastomoses in tissue are described. For example, this document provides devices and methods for performing esophagogastric anastomoses and for closing esophageal perforations in a minimally invasive fashion. The devices and methods provided herein can also be used for, without limitation, colorectal anastomoses, any bowel anastomosis, gastric bypass anastomoses, and broader vessel anastomoses.

## Claims

### Claim 1

A system for creating an anastomosis, the system comprising:
a bougie;
an obturator extending from a distal end of the bougie, wherein the obturator includes a portion having an outer diameter relief area;
a stent releasably disposable about at least a portion of the obturator;
a sheath that is slidably engageable with the bougie, the sheath including a distal end portion configured for covering at least a portion of the stent while the stent is disposed about the obturator; and
a plurality of T-fasteners, wherein each of the plurality of T-fasteners are configured to pass through a wall of the stent, and wherein a portion of each of the plurality of T-fasteners are sized to fit within the portion having an outer diameter relief area.

### Claim 2 (depends on 1)

The system of claim 1, wherein the stent is bioresorbable, biodegradable, or bioabsorbable.

### Claim 3 (depends on 1)

The system of claim 1, wherein the obturator includes one or more indicator lights positioned to indicate a location of the portion having an outer diameter relief area.

### Claim 4 (depends on 1)

The system of claim 1, wherein each T-fastener of the plurality of T-fasteners has a beveled tip configured for puncturing tissue.

### Claim 5 (depends on 1)

The system of claim 1, wherein the obturator comprises a waist portion disposed between a proximal portion and a distal tip portion, and wherein an outer diameter of the waist portion is smaller than adjacent portions of the proximal and distal tip portions.

### Claim 6 (depends on 5)

The system of claim 5, wherein the distal tip portion is conical.

### Claim 7 (depends on 5)

The system of claim 5, wherein the stent is releasably disposable about the waist portion and the adjacent portions of the proximal and distal tip portions.

### Claim 8 (depends on 1)

The system of claim 1, wherein the obturator is releasably coupled to the bougie.

### Claim 9 (depends on 1)

The system of claim 1, wherein the obturator includes a reversibly deployable mechanism configured to capture tissue.

### Claim 10 (depends on 1)

The system of claim 1, wherein the stent includes a one-way valve.

### Claim 11 (depends on 1)

The system of claim 1, wherein the stent includes one or more devices configured to penetrate tissue.

### Claim 12 (depends on 1)

The system of claim 1, wherein the stent is self-expanding.

### Claim 13 (depends on 1)

The system of claim 1, wherein the stent includes a graft material such that the stent is a stent graft device.