# US 12,004,735 B2 · Endoscopic suturing system > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,004,735 B2 - Document ID: US12004735B2 - Status: Granted - Kind: B2 - Application number: 16/778,060 - Filed: 2020-01-31 - Published: 2020-05-28 - Granted: 2024-06-11 - Earliest claimed: 2008-06-17 - Assignees: Boston Scientific Scimed, Inc. - Applicants: Boston Scientific Scimed, Inc. - Inventors: J. Landon Gilkey; Brett E. Naglreiter; Peter K. Kratsch; Donald K. Jones; Vladimir Mitelberg - Web page: https://patentgrep.com/patent/US12004735B2 ## CPC - A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery} - A61B 1/018: for receiving instruments - 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 17/06123: {Flat cylinders, e.g. including an inner reel} - A61B 17/0625: {the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator (A61B17/06109 takes precedence)} - A61B 17/068: Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00}) - A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 2017/00296: {mounted on an endoscope} - 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 2017/0417: {T-fasteners} - A61B 2017/0464: {for soft tissue} - A61B 2017/0496: {for tensioning sutures} - A61B 2017/06047: {located at the middle of the needle} - A61B 2017/0608: {J-shaped} - A61B 2017/0649: {Coils or spirals} - A61B 2017/2912: {transmission of forces to actuating rod or piston} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue. ## Claims ### Claim 1 A method for suturing tissue adjacent a distal end of an endoscope having an instrument channel with a distal opening, the method comprising: grasping tissue with a tissue grasping instrument and retracting the tissue grasping instrument to bring the tissue closer to the endoscope; providing a needle having a tissue-piercing end and a length of suture; and rotating the needle from a first protected position in which the tissue-piercing end is protected from piercing tissue, and through the tissue which has been brought closer to the endoscope by the tissue grasping instrument, to a second protected position in which the tissue-piercing end is protected from piercing tissue and is closer to the distal end of the endoscope than when in the first protected position. ### Claim 2 (depends on 1) The method of claim 1, wherein during movement of the tissue-piercing end from the first protected position to the second protected position, the orientation of the tissue-piercing end with respect to the end of the endoscope changes. ### Claim 3 (depends on 1) The method of claim 1, wherein the needle is rotated within a plane oriented orthogonal to the distal end of the endoscope. ### Claim 4 (depends on 3) The method of claim 3, wherein the endoscope includes an instrument channel with a distal opening, and the plane extends through the distal opening of the instrument channel of the endoscope. ### Claim 5 (depends on 1) The method of claim 1, wherein the needle is held by a needle holder arm which rotates to move the tissue piercing end closer to the endoscope. ### Claim 6 (depends on 1) The method of claim 1, wherein the first protected position and the second protected position are at least 90° apart. ### Claim 7 (depends on 1) The method of claim 1, wherein the grasping instrument is inserted through the instrument channel and to the location between the first protected position and the second protected position before the needle is rotated. ### Claim 8 A method for suturing tissue adjacent a distal end of an endoscope, the distal end of the endoscope having an end face that defines a footprint, the method comprising: providing a needle adjacent the end face, the needle having a tissue-piercing end and a length of suture; and rotating the needle through a path from a first position that shields the tissue-piercing end to a second position in which the tissue-piercing end is unshielded and the tissue-piercing end is closer to the distal end face than in the first position, to a third position that shields the tissue-piercing end and in which in the third position the tissue-piercing end is closer to the distal end face than in the first position, and the path of the tissue-piercing end of the needle crosses at least a portion of the footprint of the distal end face of the endoscope, wherein the tissue-piercing end of the needle is further from the distal end of the endoscope when in the first position than when in the second position or the third position. ### Claim 9 (depends on 8) The method of claim 8, wherein during movement of the tissue-piercing end from the first to third positions, the tissue-piercing end traverses a diameter of the footprint. ### Claim 10 (depends on 8) The method of claim 8, wherein the needle is rotated within a plane oriented orthogonal to the end face of the endoscope. ### Claim 11 (depends on 10) The method of claim 10, wherein the endoscope includes an instrument channel with a distal opening, and the plane extends through the distal opening of the instrument channel of the endoscope. ### Claim 12 (depends on 8) The method of claim 8, wherein the first and third positions are at least 90° apart. ### Claim 13 (depends on 8) The method of claim 8, wherein the endoscope has an instrument channel, and an axis of the instrument channel intersects the path of the tissue-piercing end. ### Claim 14 A method for suturing tissue adjacent a distal end of an endoscope, the method comprising: providing a needle adjacent the distal end of the endoscope, the needle having a tissue-piercing end and a length of suture; and rotating the needle through a needle path from a first position in which the tissue-piercing end is shielded by a needle guard, to a second position in which the tissue-piercing end is closer to the endoscope than when in the first position and is unshielded, to a third position in which the tissue-piercing end is closer to the distal end of the endoscope than when in the first position and is shielded. ### Claim 15 (depends on 14) The method of claim 14, wherein during movement of the needle through the needle path, the tissue-piercing end traverses a diameter of a footprint defined by an end face of the distal end of the endoscope. ### Claim 16 (depends on 14) The method of claim 14, wherein the needle path extends within a plane oriented orthogonal to the end face of the distal end of the endoscope. ### Claim 17 (depends on 16) The method of claim 16, wherein a channel axis of an instrument channel extends within the plane. ### Claim 18 (depends on 14) The method of claim 14, wherein the tissue piercing end is closer to being parallel to a longitudinal axis of the endoscope in the third position than in the first position. ### Claim 19 (depends on 14) The method of claim 14, wherein the first and third positions are at least 90° apart. ### Claim 20 (depends on 14) The method of claim 14, further comprising inserting a grasping instrument through an instrument channel extending through the endoscope and to a location between the first and third positions of the needle before the needle is rotated from the first position to the third position.