Methods for closing a gastrotomy

A surgical method for forming a gastrotomy through a gastric wall having an inner layer of tissue and at least one outer layer of tissue adjacent to said inner layer of tissue, wherein the inner layer of tissue is stretchable from a first relaxed condition to a stretched condition, wherein the inner layer comprises a first inner tissue portion, wherein the outer layer comprises a first outer tissue portion, and wherein said method comprises:

• providing a surgical instrument having a hollow tip thereon, the hollow tip having a tip axis and a distal end that extends at an acute angle relative to the tip axis;
• positioning the hollow tip relative to the first inner tissue portion of the inner layer, wherein the first inner tissue portion of the inner layer is in alignment with the first outer tissue portion of the outer layer;
• pushing the angled distal end of the hollow tip into contact with the first inner tissue portion of the inner layer;
• shifting the first inner tissue portion of the inner layer out of alignment with the first outer tissue portion of the outer layer and into alignment with a second outer tissue portion of the outer layer, wherein the first outer tissue portion is different from the second outer tissue portion;
• forming a first hole through the first inner tissue portion of the inner layer of tissue;
• forming a second hole through the second outer tissue portion of the outer layer of adjacent tissue such that said first and second holes are aligned with each other to permit passage of a surgical tool therethrough;
• passing the surgical tool through the first hole of the first inner tissue portion;
• passing the surgical tool through the second hole of the second outer tissue portion;
• performing a surgical procedure through the aligned first and second holes;
• removing the surgical tool from the first and second holes;
• and
• permitting the inner layer to return to the first relaxed condition to shift the first inner tissue portion of the inner layer out of alignment with the second outer tissue portion of the outer layer such that the first and second holes are no longer aligned with each other.