# US 8,540,740 B2 · Apparatus and methods for forming and securing gastrointestinal tissue folds

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- Number: US 8,540,740 B2
- Document ID: US8540740B2
- Status: Granted
- Kind: B2
- Application number: 13/545,524
- Filed: 2012-07-10
- Published: 2012-11-01
- Granted: 2013-09-24
- Earliest claimed: 2002-12-11
- Assignees: USGI Medical, Inc.
- Applicants: Cang Lam; Rich Ewers; Alexander Khairkhahan; Vahid C. Saadat
- Inventors: Cang Lam; Rich Ewers; Alexander Khairkhahan; Vahid C. Saadat
- Web page: https://patentgrep.com/patent/US8540740B2

## CPC

- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- 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 17/0487: {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 17/062: Needle manipulators
- A61B 17/3421: {Cannulas}
- A61B 17/3478: {Endoscopic needles, e.g. for infusion (biopsy needles A61B10/0233; catheters with injection needles A61M25/0067)}
- A61B 17/0644: {penetrating the tissue, deformable to closed position}
- A61B 17/29: Forceps for use in minimally invasive surgery
- A61B 17/3468: {for implanting or removing devices, e.g. prostheses, implants, seeds, wires (devices for implanting seeds A61M37/0069)}
- A61B 2017/0404: {Buttons}
- A61B 2017/0417: {T-fasteners}
- A61B 2017/0419: {H-fasteners}
- A61B 2017/0443: {the shaft being resilient and having a coiled or helical shape in the released state}
- A61B 2017/0451: {Cams or wedges holding the suture by friction}
- A61B 2017/0454: {the anchor being crimped or clamped on the suture}
- A61B 2017/0458: {Longitudinal through hole, e.g. suture blocked by a distal suture knot}
- A61B 2017/0461: {with features cooperating with special features on the suture, e.g. protrusions on the suture}
- A61B 2017/0462: {One way system, i.e. also tensioning the suture}
- A61B 2017/0464: {for soft tissue}
- A61B 2017/0496: {for tensioning sutures}
- A61B 2017/061: {hollow or tubular}
- A61B 2017/0649: {Coils or spirals}
- A61B 2017/3445: {used as instrument channel for multiple instruments}
- A61B 2017/3488: {Fixation to inner organ or inner body tissue}
- A61F 5/0086: {using clamps, folding means or the like}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)

## Abstract

Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point, moving the first tissue contact point from a position initially distal to a second tissue contact point to a position proximal of the second contact point to form a tissue fold, and extending an anchor assembly through the tissue fold near the second tissue contact point. Adjustable anchor assemblies, as well as anchor delivery systems, are also provided.

## Claims

### Claim 1

Apparatus for intraluminally forming and securing gastrointestinal tissue folds, comprising:
a flexible tube;
a treadmill assembly attached onto a distal end of the flexible tube, with the treadmill assembly including a conveyor belt rotatable about first and second hubs;
a driver linked to the treadmill assembly for driving the conveyor belt continuously around the first and second hubs;
a hollow needle within the flexible tube, with a distal end of the needle extendible out of the flexible tube at a position proximal of the distal end of the flexible tube; and
one or more tissue anchor assemblies within the hollow needle.

### Claim 2 (depends on 1)

The apparatus of claim 1 with the driver comprising a drive shaft extending through the flexible tube and driving the first hub via gears.

### Claim 3 (depends on 1)

The apparatus of claim 1 with the flexible tube having a plurality of through wall slots to enhance flexibility of the tube while maintaining torqueability.

### Claim 4 (depends on 1)

The apparatus of claim 1 with a tip of the needle substantially perpendicular to the treadmill assembly when in a piercing position.

### Claim 5 (depends on 1)

The apparatus of claim 1 with the treadmill assembly including a bracket rigidly attached onto the distal end of the flexible tube, and with the first and second hubs rotatably supported on the bracket.

### Claim 6 (depends on 5)

The apparatus of claim 5 with the bracket and the hubs holding the conveyor belt in an oval shape.

### Claim 7 (depends on 1)

The apparatus of claim 1 further comprising barbs or needles on the conveyor belt.

### Claim 8 (depends on 1)

The apparatus of claim 1 with the driver including a drive shaft in the flexible tube, with the drive shaft linked to the first hub for driving the conveyor belt.

### Claim 9 (depends on 1)

The apparatus of claim 1 with the drive shaft linked to a motor or knob at a proximal end of the flexible tube.

### Claim 10 (depends on 1)

The apparatus of claim 1 further comprising a control wire in or on the flexible tube, for bending the distal end of the flexible tube.

### Claim 11 (depends on 10)

The apparatus of claim 10 with the distal end of the flexible tube bendable substantially into a U-shape.

### Claim 12 (depends on 1)

The apparatus of claim 1 with the treadmill assembly entirely outside of the flexible tube.