# US 12,108,939 B2 · Endoscopic tissue grasping systems and methods > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,108,939 B2 - Document ID: US12108939B2 - Status: Granted - Kind: B2 - Application number: 17/396,021 - Filed: 2021-08-06 - Published: 2022-03-03 - Granted: 2024-10-08 - Earliest claimed: 2008-06-17 - Assignees: Boston Scientific Scimed, Inc. - Applicants: Boston Scientific Scimed, Inc. - Inventors: Stephen West; David Miller; Vladimir Mitelberg; Donald K. Jones - Web page: https://patentgrep.com/patent/US12108939B2 ## CPC - A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery} - A61B 1/00087: {Tools (A61B17/00234 takes precedence)} - A61B 1/018: for receiving instruments - 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 17/0482: {Needle or suture guides (guides for drills, pins or wire A61B17/17; guides for puncturing needles A61B17/3403)} - 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 17/0491: {Sewing machines for surgery} - A61B 17/06066: {Needles, e.g. needle tip configurations} - A61B 17/06114: {Packages or dispensers for needles or sutures (packages for sharps A61B50/3001; for dental floss A61C15/043; packages for needles in general B65D85/24)} - 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 17/06123: {Flat cylinders, e.g. including an inner reel} - A61B 2017/00278: {Transorgan operations, e.g. transgastric} - A61B 2017/00296: {mounted on an endoscope} - A61B 2017/00336: {with a protective sleeve, e.g. retractable or slidable} - 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 2017/00367: {Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like} - A61B 2017/0042: {with special provisions for gripping} - A61B 2017/0409: {Instruments for applying suture anchors} - A61B 2017/0417: {T-fasteners} - A61B 2017/0464: {for soft tissue} - A61B 2017/0488: {Instruments for applying suture clamps, clips or locks} - A61B 2017/0496: {for tensioning sutures} - A61B 2017/06047: {located at the middle of the needle} - A61B 2017/0608: {J-shaped} - A61B 2017/06142: {having needle- or suture- retaining members, e.g. holding tabs or needle parks} - A61B 2017/0649: {Coils or spirals} - A61B 2017/2912: {transmission of forces to actuating rod or piston} - A61B 2090/08021: {of the patient or his organs} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract An endoscopic tissue grasper device includes a flexible tubular member, a flexible shaft extending through the tubular member, a proximal handle for moving the shaft and tubular member relative to each other, and a distal helical coil having a sharpened end for engaging tissue. The tissue grasper is advanced through a working channel of an endoscope, engaged relative to tissue, and retracted to pull tissue into a path of a movable needle coupled at a distal end of the endoscope so that the needle can be passed through the tissue. The needle is preferably provided with a suture so that as the needle is passed through the tissue a stitch is formed. ## Claims ### Claim 1 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, 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, wherein the needle holder rotates the straight needle into an orientation parallel with the longitudinal axis after the needle is advanced through the complete thickness of the wall of tissue. ### Claim 2 (depends on 1) The method of claim 1, wherein the tissue is formed into a tissue fold by at least one of retracting the tissue and advancing the needle through the complete thickness of the wall of the tissue. ### Claim 3 (depends on 1) The method of claim 1, wherein the needle is advanced through the complete thickness of the wall of the tissue by first passing the needle through the wall of tissue in a first direction and subsequently passing the needle through the tissue wall of tissue in a second direction. ### Claim 4 (depends on 3) The method of claim 3, wherein the first direction is a direction defined from an inner surface of the wall of tissue to an outer surface of the wall of tissue, and the second direction is a direction defined from the outer surface of the wall of tissue to the inner surface of the wall of tissue. ### Claim 5 (depends on 1) The method of claim 1, wherein the tissue grasper includes a helical coil adapted to engage the tissue. ### Claim 6 (depends on 1) The method of claim 1, wherein the tissue grasper extends through the instrument channel when the endoscope is flexed. ### Claim 7 (depends on 1) The method of claim 1, wherein the suture extends from the needle through the instrument channel of the endoscope. ### Claim 8 (depends on 1) The method of claim 1, further comprising: removing the needle from the needle holder arm, wherein the wall of tissue has a first side and a second side, the needle is first advanced through the first side of the wall of tissue, and the needle is removed from the needle holder arm when at the first side of the wall of tissue. ### Claim 9 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. ### Claim 10 (depends on 9) The method of claim 9, wherein the tissue is formed into a tissue fold by at least one of retracting the tissue and advancing the needle through the complete thickness of the wall of the tissue. ### Claim 11 (depends on 9) The method of claim 9, wherein the needle is advanced through the complete thickness of the wall of the tissue by first passing the needle through the wall of tissue in a first direction and subsequently passing the needle through the tissue wall of tissue in a second direction. ### Claim 12 (depends on 11) The method of claim 11, wherein the first direction is a direction defined from an inner surface of the wall of tissue to an outer surface of the wall of tissue, and the second direction is a direction defined from the outer surface of the wall of tissue to the inner surface of the wall of tissue. ### Claim 13 (depends on 9) The method of claim 9, wherein the tissue grasper includes a helical coil adapted to engage the tissue. ### Claim 14 (depends on 9) The method of claim 9, wherein the tissue grasper extends through the instrument channel when the endoscope is flexed. ### Claim 15 (depends on 9) The method of claim 9, further comprising: removing the needle from the needle holder arm, wherein the wall of tissue has a first side and a second side, the needle is first advanced through the first side of the wall of tissue, and the needle is removed from the needle holder arm when at the first side of the wall of tissue. ### Claim 16 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. ### Claim 17 (depends on 16) The method of claim 16, wherein the retracted tissue is pierced again by the needle through the second side and out of the first side by the needle moving along the path. ### Claim 18 (depends on 16) The method of claim 16, wherein the needle is straight. ### Claim 19 (depends on 18) The method of claim 18, wherein the suture extends through the instrument channel. ### Claim 20 (depends on 16) The method of claim 16, wherein the tissue grasper includes a helical coil adapted to engage the tissue.