# US 8,784,438 B2 · Perforation suturing method

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- Number: US 8,784,438 B2
- Document ID: US8784438B2
- Status: Granted
- Kind: B2
- Application number: 13/305,299
- Filed: 2011-11-28
- Published: 2012-03-22
- Granted: 2014-07-22
- Earliest claimed: 2005-11-14
- Assignees: Olympus Medical Sysems Corp.
- Applicants: Takayasu Mikkaichi; Masayuki Iwasaka; Kunihide Kaji
- Inventors: Takayasu Mikkaichi; Masayuki Iwasaka; Kunihide Kaji
- Web page: https://patentgrep.com/patent/US8784438B2

## CPC

- 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 17/0401: {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 17/29: Forceps for use in minimally invasive surgery
- A61B 2017/00637: {for sealing trocar wounds through abdominal wall}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0417: {T-fasteners}
- 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 2017/0464: {for soft tissue}
- A61B 2017/0496: {for tensioning sutures}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A perforation suturing method has the steps of: inserting a needle into a wall of a hollow organ at a periphery of the perforation formed in the hollow organ, and piercing the wall; withdrawing the needle from the wall after delivery of an anchor attaching suture thread from the needle, and having the suture thread transit the wall; and tightening the suture thread so that the mated insertion points at the time of insertion of the needle into the wall approximately coincide after having the needle pierce the wall at the periphery of the perforation a plurality of times, and making surfaces of the wall where the insertion points are formed coincide with each other.

## Claims

### Claim 1

A method for suturing a perforation formed in a wall of a luminal organ, the method comprising:
a step of inserting an endoscope into a lumen of the luminal organ via a natural orifice, and introducing the endoscope from the lumen into an abdominal cavity via the perforation;
a step of bending a tip of the endoscope toward the wall of the lumen organ in a state in which the endoscope is introduced via the perforation from the lumen into the abdominal cavity;
a step of protruding a needle, inside which a first anchor and a first suture thread attached to the first anchor are housed, from a channel of the endoscope toward the wall of the luminal organ, inserting the needle through the wall from the abdominal cavity toward the lumen at a first insertion point positioned in the vicinity of the perforation, and delivering the first anchor into the lumen to attach the first suture thread to the luminal organ;
a step of withdrawing the needle from the wall of the luminal organ after delivering the first anchor into the lumen to attach the first suture thread to the luminal organ such that a portion of the first suture thread extends into the abdominal cavity;
a step of protruding the needle, inside which a second anchor and a second suture thread attached to the second anchor are housed, from the channel of the endoscope toward the wall of the luminal organ, inserting the needle through the wall from the abdominal cavity toward the lumen at a second insertion point positioned in the vicinity of the perforation and opposite to the first insertion point with the perforation positioned between the first insertion point and the second insertion point, and delivering the second anchor into the lumen to attach the second suture thread to the luminal organ;
a step of withdrawing the needle from the wall of the luminal organ after delivering the second anchor into the lumen to attach the second suture thread to the luminal organ such that a portion of the second suture thread extends into the abdominal cavity; and
a step of sealing
a muscular layer of the wall of the luminal organ, which is located between the first insertion point and the perforation and faces the abdominal cavity, with
a muscular layer of the wall of the luminal organ, which is located between the second insertion point and the perforation and faces the abdominal cavity,
by pulling the portion of the first suture thread extending into the abdominal cavity and the portion of the second suture thread extending into the abdominal cavity into the lumen of the luminal organ through the perforation.

### Claim 2 (depends on 1)

The method according to claim 1, wherein the needle is inserted into the lumen of the luminal organ via a tool that is inserted via the channel of the endoscope from the natural orifice in a living body.

### Claim 3 (depends on 1)

The method according to claim 1, wherein in the steps of inserting the needle through the wall from the abdominal cavity toward the lumen to deliver the first anchor and the second anchor, the needle is pierced into an innermost surface of the wall of the luminal organ facing the lumen.

### Claim 4 (depends on 1)

The method according to claim 1, wherein in the step of sealing,
the muscular layer of the wall of the luminal organ, which is located between the first insertion point and the perforation and faces the abdominal cavity, and
the muscular layer of the wall of the luminal organ, which is located between the second insertion point and the perforation and faces the abdominal cavity,
are bent toward the lumen to be substantially parallel to each other and to contact each other.