# US 11,026,690 B2 · Tissue ligation devices and tensioning devices therefor > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,026,690 B2 - Document ID: US11026690B2 - Status: Granted - Kind: B2 - Application number: 15/356,521 - Filed: 2016-11-18 - Published: 2017-07-27 - Granted: 2021-06-08 - Earliest claimed: 2011-06-08 - Assignees: SentreHEART, Inc. - Applicants: SentreHEART, Inc. - Inventors: Gregory W. Fung; Ryan Douglas Helmuth; Arnold M. Escano; Russell A. Seiber; Robert L. Clark, III - Web page: https://patentgrep.com/patent/US11026690B2 ## CPC - A61B 17/12013: {for use in minimally invasive surgery, e.g. endoscopic surgery} - A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery} - A61B 2017/00115: {with audible or visual output} - A61B 2017/00243: {cardiac} - A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)} - A61B 2017/00867: {shape memory effect} - A61B 2017/0225: {flexible, e.g. fabrics, meshes, or membranes} - A61B 2090/037: {with a frangible part, e.g. by reduced diameter} - A61B 2090/064: {for measuring force, pressure or mechanical tension} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Described here are closure devices and methods for ligating tissue, such as the left atrial appendage, and tensioning devices and mechanism for actuating these devices. The tensioning mechanisms and devices may allow a user to apply one or more predetermined forces to a suture or other portion of the closure devices. The closure devices may comprise a suture loop releasably attached to a snare loop assembly, and a tensioning mechanism or device may be configured to tighten the suture loop and/or release the suture loop from the snare loop assembly. ## Claims ### Claim 1 A method of closing a target tissue comprising: advancing a closure device to a target tissue, wherein the closure device comprises a snare loop, and a suture loop releasably coupled to the snare loop, and wherein a tail of the suture loop is coupled directly to a distal end of a tensioning device, wherein the tensioning device comprises a spring and a handle; advancing the snare loop and suture loop around the target tissue; pulling the tensioning device proximally relative to the closure device until a first predetermined force is applied to the suture loop, wherein the distal end of the tensioning device moves distally relative to the tensioning device handle during pulling; and pulling the tensioning device proximally relative to the closure device until a second predetermined force is applied to the suture loop. ### Claim 2 (depends on 1) The method of claim 1, wherein the target tissue is a left atrial appendage. ### Claim 3 (depends on 1) The method of claim 1, wherein the first predetermined force is about 7 pounds. ### Claim 4 (depends on 3) The method of claim 3, wherein the second predetermined force is approximately equal to the first predetermined force. ### Claim 5 (depends on 1) The method of claim 1, wherein the second predetermined force is approximately equal to the first predetermined force. ### Claim 6 (depends on 1) The method of claim 1, wherein the second predetermined force is greater than the first predetermined force. ### Claim 7 (depends on 1) The method of claim 1 further comprising applying a tension to the suture loop to release the suture loop from the snare loop assembly. ### Claim 8 (depends on 1) The method of claim 1 further comprising waiting a time period between pulling the tensioning device to apply the first predetermined force and pulling the tensioning device to apply the second predetermined force. ### Claim 9 (depends on 8) The method of claim 8, wherein the time period is at least thirty seconds. ### Claim 10 (depends on 8) The method of claim 8, wherein the time period is at least two minutes. ### Claim 11 (depends on 1) The method of claim 1, wherein the tensioning device indicates when the first and second predetermined tensions are applied. ### Claim 12 (depends on 1) The method of claim 1, wherein the spring is coupled between the handle and the distal end of the tensioning device. ### Claim 13 (depends on 1) The method of claim 1, wherein the tensioning device further comprises an elongate member, and wherein the tail of the suture loop is coupled to the elongate member. ### Claim 14 (depends on 13) The method of claim 13, wherein a first end of the spring is attached to the elongate member. ### Claim 15 (depends on 14) The method of claim 14, wherein a second end of the spring is attached to the tensioning device handle. ### Claim 16 (depends on 1) The method of claim 1 further comprising closing the snare loop around the target tissue, applying a tension to the suture loop to release the suture loop from the snare loop assembly, and opening the snare loop after releasing the suture loop from the snare loop. ### Claim 17 A method of closing a target tissue comprising: advancing a closure device to a target tissue, the closure device comprising a snare loop, and a suture loop releasably coupled to the snare loop; advancing the closure device around the target tissue; applying a tension to the suture loop to release the suture loop from the snare loop; coupling a tail of the suture loop directly to a distal end of a tensioning device, wherein the tensioning device comprises a spring and a handle; pulling the tensioning device proximally relative to the closure device until a first predetermined force is applied to the suture loop, wherein the distal end of the tensioning device moves distally relative to the tensioning device handle during pulling; and pulling the tensioning device proximally relative to the closure device until a second predetermined force is applied to the suture loop. ### Claim 18 (depends on 17) The method of claim 17 further comprising waiting a time period between pulling the tensioning device to apply the first predetermined force and pulling the tensioning device to apply the second predetermined force, wherein the time period is at least four minutes.