Endoscopic tissue grasping systems and methods

A method of passing a needle through a wall of tissue having a thickness, comprising:

• a) providing:
• an endoscope having a proximal end, a distal end with a distal end face, an instrument channel extending within the endoscope between the proximal and distal ends, and a longitudinal axis extending between the proximal and distal ends,
• a distal end cap removably mounted on the distal end of the endoscope,
• a needle holder movably mounted on the end cap,
• a handle operable from the proximal end of the endoscope to move the needle holder relative to the end cap,
• a straight needle removably coupled to the needle holder, the needle having a sharp tissue piercing end and a length of suture coupled thereto, the length of suture extending through the instrument channel of the endoscope and out of the proximal end of the endoscope, and
• the needle holder operable to move the needle along a path from a first location to a second location;
• b) providing a tissue grasper;
• c) engaging the tissue grasper with the tissue;
• d) retracting the tissue with the grasper tissue toward the distal end face of the endoscope and into the path;
• and
• e) operating the handle to rotate the needle holder and thereby advance the needle along the path and through a complete thickness of the wall of tissue.

A method of passing a needle through a wall of tissue, the wall of tissue having a first side and a second side, the method comprising:

• a) providing:
• an endoscope having a proximal end, a distal end with a distal end face, an instrument channel extending within the endoscope between the proximal and distal ends, and a longitudinal axis extending between the proximal and distal ends,
• a distal end cap removably mounted on the distal end of the endoscope,
• a needle holder movably mounted on the end cap,
• a handle operable from the proximal end of the endoscope to move the needle holder relative to the end cap,
• a needle removably coupled to the needle holder, the needle having a sharp tissue piercing end and a length of suture coupled thereto, and
• the needle holder operable to move the needle along a path from a first location in which the needle is angled relative to the longitudinal axis to a second location in which the needle is oriented parallel to the longitudinal axis;
• b) providing a tissue grasper;
• c) retracting the tissue with the grasper tissue toward the distal end face of the endoscope and into the path;
• d) operating the handle to rotate the needle holder to move the needle along the path from the first location to the second location to cause the needle to pierce through the first side of the tissue out of the second side of the tissue;
• and
• e) removing the needle from the needle holder arm.