Apparatus and methods for providing tactile feedback while delivering a closure device

An apparatus for delivering a closure element into a passage communicating with an opening into a body lumen, comprising:

• an elongate member comprising proximal and distal ends and defining a longitudinal axis;
• a housing slidably coupled to the elongate member, the housing configured for releasably holding a closure element, the closure element comprising a clip;
• and
• a locator member coupled to the elongate member, the locator member having a distal portion extending distally beyond the distal end of the elongate member, the distal portion comprising helically wound wire comprising a proximal end, a distal end, and an intermediate portion therebetween, and a control element fixedly connected to the distal end of the helically wound wire, the control element extending from the distal portion to the proximal end of the expandable locator member and between a first pair of adjacent uniform coils of the helical wound wire and along an outer surface of at least one coil of the helical wound wire and passing between a second pair of adjacent uniform coils of the helical wound wire in a pre-deployed configuration and being movable axially to buckle the intermediate portion of the helically wound wire substantially transversely with respect to the longitudinal axis.

An apparatus for positioning a closure device within a passage through tissue communicating with a body lumen, comprising:

• an elongate member comprising a proximal end, a distal end, and a lumen extending between the proximal and distal ends defining a longitudinal axis;
• a clip deliverable from the elongate member for sealing the passage;
• and
• a locator member extending through the lumen, the locator member comprising a distal portion extending distally beyond the distal end of the elongate member, the distal portion comprising an elongate deflectable element comprising a proximal end and a distal end, and a control element fixedly connected to a distal portion of the deflectable element, the control element extending from the distal portion to the proximal end of the locator member and being moveable axially to buckle an intermediate portion of the deflectable element substantially transversely with respect to the longitudinal axis wherein the deflectable element comprises a helically wound wire extending between the proximal and distal ends of the deflectable element and having an intermediate portion therebetween, and wherein the control element comprises a tether extending along an outer surface of at least the intermediate portion of the helically wound wire in a pre-deployed configuration.

A method for sealing a passage communicating with a body lumen using an elongate member comprising proximal and distal ends, and a closure element deployable from the distal end of the elongate member, the method comprising:

• providing a selectively expandable locator member coupled to the elongate member such that a distal portion of the locator member extends distally beyond the distal end of the elongate member;
• advancing the distal end of the elongate member through a patient's skin towards the body lumen via the passage until the distal portion of the locator member is located within the body lumen;
• moving a control element fixedly connected to a distal end of the deflectable element to buckle the deflectable element on the distal portion of the selectively expandable locator member from an axial collapsed configuration to a transverse expanded configuration, the deflectable element comprising a helically wound wire extending between a proximal end and a distal end and having an intermediate portion therebetween and the control element extending from the distal portion to the proximal end of the expandable locator member and extending along an outer surface of at least one coil of the helical wound wire and passing through at least one coil of the helical wound wire in a pre-deployed configuration;
• manipulating the elongate member until the deflectable element in the expanded configuration contacts a proximal wall of the body lumen, thereby providing a tactile indication of a location of the distal end of the elongate member relative to the body lumen;
• and
• deploying the closure element from the distal end of the elongate member within the passage, the closure element comprising a clip.

A method for sealing a passage communicating with a body lumen using a tubular member comprising proximal and distal ends and a lumen extending therebetween, and a closure element deployable from the distal end of the tubular member, the method comprising:

• advancing the distal end of the tubular member through a patient's skin into the passage towards the body lumen;
• introducing a selectively expandable locator member into the lumen of the tubular member until a distal portion of the locator member extends beyond the distal end of the tubular member;
• moving a control element fixedly connected to a distal portion of a deflectable element to buckle the deflectable element of the distal portion of the selectively expandable locator member from a collapsed configuration to a transversely expanded configuration within the body lumen, the deflectable element comprising a helically wound wire extending between a proximal end and a distal end and having an intermediate portion therebetween and the control element extending from the distal portion to the proximal end of the expandable locator member and extending along an outer surface of at least one coil of the helical wound wire and passing through at least one coil of the helical wound wire in a pre-deployed configuration;
• manipulating the tubular member until the deflectable element in the expanded condition contacts a proximal wall of the body lumen, thereby providing a tactile indication of a location of the distal end of the tubular member relative to the body lumen;
• and
• deploying the closure element from the distal end of the tubular member within the passage, the closure element comprising a clip.

A method for sealing a passage communicating with a body lumen, the method comprising:

• introducing a selectively expandable locator member into the passage until a distal portion of the selectively expandable locator member extends into the body lumen;
• moving a control element fixedly connected to a distal portion of a deflectable element to buckle the deflectable element on the distal portion of the selectively expandable locator member from a collapsed configuration to a transversely expanded configuration within the body lumen, the deflectable element comprising a helically wound wire extending between a proximal end and a distal end and having an intermediate portion therebetween and the control element extending from the distal portion to the proximal end of the expandable locator member and extending along an outer surface of at least one coil of the helical wound wire and passing through at least one coil of the helical wound wire in a pre-deployed configuration;
• manipulating the selectively expandable locator member until the deflectable element in the expanded condition contacts a proximal wall of the body lumen;
• advancing a clip having tines which extend substantially axially and distally along the selectively expandable locator member until the clip is disposed at a predetermined location relative to the distal portion of the locator member;
• returning the distal portion of the selectively expandable locator member from the expanded condition to the collapsed configuration;
• and
• withdrawing the locator member from the passage, leaving the clip in the passage.

A method for sealing a passage communicating with a body lumen using an elongate member comprising proximal and distal ends, and a closure element deployable from the distal end of the elongate member, the method comprising:

• coupling a locator member to the elongate member such that a distal portion of the locator member extend distally beyond the distal end of the elongate member;
• advancing the distal end of the elongate member through a patient's skin towards the body lumen via the passage until the distal portion of the locator member is located within the body lumen;
• moving a control element fixedly connected to a distal portion of a deflectable element to buckle the deflectable element comprising a helically wound wire on the distal portion of the locator member from an axial collapsed configuration to a transverse expanded configuration, the helically wound wire extending between a proximal end and a distal end and having an intermediate portion therebetween and the control element extending from the distal portion to the proximal end of the locator member and extending along an outer surface of at least one coil of the helical wound wire and passing through at least one coil of the helical wound wire in a pre-deployed configuration;
• manipulating the elongate member until the deflectable element in the expanded configuration contacts a proximal wall of the body lumen, thereby providing a tactile indication of a location of the distal end of the elongate member relative to the body lumen;
• and
• deploying the closure element from the distal end of the elongate member within the passage, the closure element comprising a clip.