# US 12,178,463 B2 · Endoluminal treatment method and associated surgical assembly including tissue occlusion device

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- Number: US 12,178,463 B2
- Document ID: US12178463B2
- Status: Granted
- Kind: B2
- Application number: 17/393,719
- Filed: 2021-08-04
- Published: 2021-11-25
- Granted: 2024-12-31
- Earliest claimed: 2005-08-05
- Assignees: Boston Scientific Scimed, Inc.
- Applicants: Boston Scientific Scimed, Inc.
- Inventors: Gregory Piskun
- Web page: https://patentgrep.com/patent/US12178463B2

## CPC

- A61B 17/320016: {Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes (A61B10/0233, A61B17/29, A61B17/3207 take precedence)}
- A61B 1/00078: {with stiffening means}
- A61B 1/00082: {Balloons}
- A61B 1/018: for receiving instruments
- A61B 1/045: Control thereof
- A61B 1/051: {Details of CCD assembly}
- A61B 1/0676: {at distal tip of an endoscope}
- A61B 1/31: for the rectum, e.g. proctoscopes or sigmoidoscopes
- A61B 17/072: for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B 17/22: Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B 17/3205: Excision instruments
- A61B 18/1442: {Probes having pivoting end effectors, e.g. forceps}
- A61B 18/1445: {at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod}
- A61B 18/22: the beam being directed along or through a flexible conduit, e.g. an optical fibre; {Couplings or} hand-pieces therefor
- A61B 2017/00269: {endoscopic mucosal resection EMR}
- A61B 2017/0034: {adapted to be inserted through a working channel of an endoscope}
- A61B 2017/00893: {pharmaceutically effective}
- A61B 2017/07214: {Stapler heads}
- A61B 2017/07221: {curved}
- A61B 2017/2944: {Translation of jaw members}
- A61B 2017/32004: {having a laterally movable cutting member at its most distal end which remains within the contours of said end}
- A61B 2017/3452: {for the rectum, e.g. for hemorrhoid surgery}
- A61B 2018/00428: {Severing}
- A61B 2018/005: {Rectum}
- A61B 2018/00589: {Coagulation}
- A61B 2018/0063: {Sealing}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A surgical instrument includes a hollow member having a sidewall provided with a window and a closure member movably connected to the hollow member for alternately covering and uncovering the window. The hollow member has a first clamping surface along an edge of the window, while the closure member has a second clamping surface opposing the first clamping surface and disposable substantially adjacent thereto in a clamping or closure configuration of the instrument. The instrument additionally comprises a tissue occlusion component mounted to at least one of the hollow member and the closure member for acting on tissues gripped between the first clamping surface and the second clamping surface, to couple the tissues to each other.

## Claims

### Claim 1

A method of treating tissue comprising:
inserting into a body of a patient an endoscopic instrument having first and second tissue engaging surfaces, one or more of the first and second tissue engaging surfaces being slidably adjustable relative to one another to form a chamber;
moving the chamber from a collapsed insertion configuration to a laterally expanded use configuration to form a laterally expanded chamber with respect to a longitudinal axis of the endoscopic instrument within a body lumen, wherein the chamber, in the expanded use configuration, provides a working space within the body lumen;
inserting a distal portion of a working instrument into the chamber, and extending the working instrument laterally with respect to the longitudinal axis of the endoscopic instrument; and
visualizing the distal portion of the working instrument by a visualization device positioned distal of the second tissue engaging surface;
wherein visualizing the distal portion of the working instrument includes angling the visualization device so it extends laterally with respect to the longitudinal axis of the endoscopic instrument.

### Claim 2 (depends on 1)

The method of claim 1, wherein moving the chamber expands the chamber to only one side of the longitudinal axis of the endoscopic instrument.

### Claim 3 (depends on 1)

The method of claim 1, further comprising visualizing a portion of the body lumen using the visualization device.

### Claim 4 (depends on 1)

The method of claim 1, further comprising severing a tissue mass positioned within the chamber.

### Claim 5 (depends on 4)

The method of claim 4, further removing the severed tissue mass from the patient via a first channel in the endoscopic instrument.

### Claim 6 (depends on 5)

The method of claim 5, further comprising receiving a polyp within the chamber and severing the polyp from the body lumen utilizing the working instrument inserted through the first channel of the endoscopic instrument.

### Claim 7 (depends on 4)

The method of claim 4, further comprising removing the severed tissue mass from the patient by retaining the severed tissue mass in the chamber and withdrawing the endoscopic instrument from the patient.

### Claim 8 (depends on 1)

The method of claim 1, further comprising illuminating at least a portion of the chamber to enable a visual inspection of tissue adjacent to, or protruding into, the chamber.

### Claim 9

A method of treating tissue comprising:
inserting into a body of a patient an endoscopic instrument having a sheath and a channel for receiving an endoscope, the endoscopic instrument further including first and second tissue engaging surfaces, one or more of the first and second tissue engaging surfaces being slidably adjustable relative to one another to form a chamber;
moving the chamber from a collapsed insertion configuration to a laterally expanded use configuration to form a laterally expanded chamber with respect to a longitudinal axis of the endoscopic instrument within a body lumen, wherein the chamber, in the expanded use configuration, provides a working space within the body lumen;
inserting a distal portion of a working instrument into the chamber, and extending the working instrument laterally with respect to the longitudinal axis of the endoscopic instrument; and
visualizing the distal portion of the working instrument using the endoscope when the endoscope is positioned distal of the second tissue engaging surface,
wherein visualizing the distal portion of the working instrument includes angling the endoscope so it extends laterally with respect to the longitudinal axis of the endoscopic instrument.

### Claim 10 (depends on 9)

The method of claim 9, wherein moving the chamber expands the chamber to only one side of the longitudinal axis of the endoscopic instrument.

### Claim 11 (depends on 9)

The method of claim 9, further comprising visualizing a portion of the body lumen using the endoscope.

### Claim 12 (depends on 9)

The method of claim 9, further comprising severing a tissue mass positioned within the chamber.

### Claim 13 (depends on 12)

The method of claim 12, further removing the severed tissue mass from the patient via a first channel in the endoscopic instrument.

### Claim 14 (depends on 13)

The method of claim 13, further comprising receiving a polyp within the chamber and severing the polyp from the body lumen utilizing the working instrument inserted through the first channel of the endoscopic instrument.

### Claim 15 (depends on 12)

The method of claim 12, further comprising removing the severed tissue mass from the patient by retaining the severed tissue mass in the chamber and withdrawing the endoscopic instrument from the patient.

### Claim 16 (depends on 9)

The method of claim 9, further comprising illuminating at least a portion of the chamber to enable a visual inspection of tissue adjacent to, or protruding into, the chamber.

### Claim 17

A method of treating tissue comprising:
inserting into a body of a patient an endoscopic instrument having first and second tissue engaging surfaces, one or more of the first and second tissue engaging surfaces being slidably adjustable relative to one another to form a chamber therebetween;
moving the chamber from a collapsed insertion configuration to a laterally expanded use configuration to form a laterally expanded chamber with respect to a longitudinal, axis of the endoscopic instrument within a body lumen, the laterally expanded chamber forming a working space within the body lumen;
inserting a distal portion of a working instrument into the chamber;
visualizing the distal portion of the working instrument using a visualization device positioned distal of the second tissue engaging surface; and
severing a tissue mass disposed within the chamber using the working instrument; and removing the severed tissue mass from the patient,
wherein visualizing the distal portion of the working instrument includes angling the endoscope so it extends laterally with respect to the longitudinal axis of the endoscopic instrument.

### Claim 18 (depends on 17)

The method of claim 17, wherein removing the severed tissue mass from the patient comprises at least one of removing the severed tissue mass from the patient via a first channel in the endoscopic instrument and retaining the severed tissue mass in the chamber and withdrawing the endoscopic instrument from the patient.