Devices and methods for tissue invagination

Abstract

Surgical devices and methods used for invaginating tissue during, for example, an endoscopic fundoplication procedure, are disclosed. The device includes an elongated tube having a proximal end configured to extend outside of the body and a distal end configured to extend proximate the tissue to be invaginated, and a distal member coupled to the distal end of the tube. The distal member is configured to hold or grasp the tissue to be invaginated. The devices may include a protective distal sleeve.

1 - 91 . (canceled)  
   
   
       92 . A surgical device for invaginating esophageal tissue of a body, comprising: 
 an elongated tube having a proximal end configured to extend outside of the body and a distal end configured to extend proximate the esophageal tissue of the body; and    a distal member coupled to the distal end of the tube, the distal member including a radially expandable portion configured for selective expansion in the radial direction in order to engage esophageal tissue.    
   
   
       93 . The surgical device of  claim 92 , wherein: 
 the distal member comprises: 
 a proximal portion and a distal portion; and  
 an actuation member for axially moving the proximal portion and the distal portion relative to each other; and  
   wherein the radially expandable portion includes a plurality of flexible wires connecting the proximal portion and the distal portion, each of the wires configured to bend radially outwardly to engage the esophageal tissue when the proximal and distal portions are moved toward each other.    
   
   
       94 . The surgical device of  claim 92 , wherein the radially expandable portion includes at least one friction member for frictionally engaging the esophageal tissue.  
   
   
       95 . The surgical device of  claim 93 , wherein the radially expandable portion includes at least one friction member for frictionally engaging the esophageal tissue, wherein the at least one friction member is located along at least one of the plurality of flexible wires between the proximal and distal portions of the distal member.  
   
   
       96 . The surgical device of  claim 94 , wherein the at least one friction member comprises one of hooks or projections.  
   
   
       97 . The surgical device of  claim 93 , wherein the plurality of flexible wires are slidable within the proximal portion of the distal member.  
   
   
       98 . The surgical device of  claim 93 , wherein the proximal and distal portions of the distal member have profiles smaller than that of the elongated tube.  
   
   
       99 . The surgical device of  claim 92 , wherein the radially expandable portion includes a portion with an adhesive for adhering to tissue.  
   
   
       100 . The surgical device of  claim 92 , wherein the radially expandable portion comprises an expandable tube.  
   
   
       101 . The surgical device of  claim 100 , wherein the expandable tube is reinforced with a plurality of flexible wires.  
   
   
       102 . The surgical device of  claim 100 , wherein the radially expandable portion includes at least one friction member for frictionally engaging the esophageal tissue.  
   
   
       103 . The surgical device of  claim 92 , wherein: 
 the distal member comprises: 
 a central portion; and  
 an actuation member axially movable within the central portion; and  
   wherein the radially expandable portion comprises a plurality of wires linked to form an expandable anchor configured to engage the esophageal tissue when the actuation member is moved relative to the central portion.    
   
   
       104 . The surgical device of  claim 103 , wherein proximal ends of the wires are connected to the central portion, and the radially expandable portion includes struts connecting the actuation member to the plurality of wires such that axial movement of the actuation member causes the struts to radially expand or collapse the expandable anchor.  
   
   
       105 . The surgical device of  claim 103 , wherein the plurality of wires includes at least one friction member for frictionally engaging the esophageal tissue.  
   
   
       106 . The surgical device of  claim 105 , wherein the at least one friction member comprises one of hooks or projections.  
   
   
       107 . The surgical device of  claim 103 , wherein proximal ends of the wires are connected to the central portion, and the radially expandable portion includes a balloon inflatable to radially expand the expandable anchor.  
   
   
       108 . The surgical device of  claim 103 , wherein the expandable anchor comprises a self-expanding stent collapsable within the elongated tube and axially movable beyond the central portion to expand in order to engage the esophageal tissue.  
   
   
       109 . The surgical device of  claim 108 , wherein the stent is unconnected to the central portion.  
   
   
       110 . The surgical device of  claim 108 , wherein the stent includes at least one friction member for frictionally engaging the esophageal tissue.  
   
   
       111 . The surgical device of  claim 108 , wherein the stent includes tapered distal and proximal end portions.  
   
   
       112 . The surgical device of  claim 108 , wherein, in a deployed state, the stent includes a distal portion having an increased diameter relative to a proximal portion of the stent.  
   
   
       113 . The surgical device of  claim 103 , wherein upon deployment of the radially expandable portion, the distal ends of the wires bend backwards to form a flange configured to engage the esophageal tissue.  
   
   
       114 . The surgical device of  claim 92 , wherein the radially expandable portion includes a bellows.  
   
   
       115 . The surgical device of  claim 114 , wherein the bellows is configured for axial contraction and extension, and wherein during deployment the radially expandable portion forms a substantially smooth outer profile.  
   
   
       116 . The surgical device of  claim 114 , wherein the bellows is configured for axial contraction and includes a plurality of projections configured to engage the esophageal tissue.  
   
   
       117 . The surgical device of  claim 92 , wherein radial expansion of the radially expandable portion occurs upon axial contraction of the radially expandable portion.  
   
   
       118 . A method of invaginating tissue toward an organ having an opening, comprising: 
 providing an elongated tube having proximal and distal ends and a distal member coupled to the distal end of the tube, the distal member including a radially expandable portion;    inserting the elongated tube into a body passage so that a distal end of the tube is proximate the tissue;    radially expanding the radial expandable portion to engage the tissue; and    displacing the tissue toward the opening of the organ by displacing the distal member.    
   
   
       119 . The method of  claim 118 , wherein: 
 the distal member comprises: 
 a proximal portion and a distal portion; and  
 an actuation member for axially moving the proximal portion and the distal portion relative to each other;  
   wherein the radially expandable portion includes a plurality of flexible wires connecting the proximal portion and the distal portion, each of the wires configured to bend radially outwardly; and    wherein radially expanding the radially expandable portion comprises moving the proximal and distal portions toward each other.    
   
   
       120 . The method of  claim 118 , further comprising radially expanding a plurality of wires.  
   
   
       121 . The method of  claim 118 , wherein radially expanding the radially expandable portion comprises frictionally engaging the tissue with at least one friction member provided on the radially expandable portion.  
   
   
       122 . The method of  claim 121 , wherein the at least one friction member comprises one of hooks or projections.  
   
   
       123 . The method of  claim 118 , wherein: 
 the distal member comprises: 
 a central portion; and  
 an actuation member axially movable within the central portion;  
   wherein the radially expandable portion comprises a plurality of wires linked to form an expandable anchor; and    wherein radially expanding the radially expandable portion comprises moving the actuation member relative to the central portion.    
   
   
       124 . The method of  claim 123 , wherein proximal ends of the wires are connected to the central portion and the radially expandable portion includes struts connecting the actuation member to the plurality of wires; and wherein radially expanding the radially expandable portion comprises axially moving the actuation member, thereby causing the struts to radially expand or collapse the expandable anchor to engage the tissue.  
   
   
       125 . The method of  claim 118 , wherein the radially expandable portion comprises a self-expanding stent collapsed within the elongated tube; and wherein radially expanding the radially expandable portion comprises moving the stent beyond the elongated tube to expand the stent and engage the tissue.  
   
   
       126 . The method of  claim 118 , wherein the radially expandable portion includes an adhesive, and wherein radially expanding the radially expandable portion comprises engaging the tissue with the adhesive.  
   
   
       127 . The method of  claim 118 , further comprising providing a balloon, and wherein radially expanding the radially expandable portion comprises inflating the balloon.  
   
   
       128 . The method of  claim 118 , wherein the radially expandable portion includes a bellows configured for axial contraction and axial extension, and wherein radially expanding the radially expandable portion comprises moving the bellows from an axially extended state to an axially contracted state.  
   
   
       129 . The method of  claim 118 , wherein radially expanding the radially expandable portion comprises axially contracting the radially expandable portion.  
   
   
       130 . The method of  claim 118 , wherein the radially expandable portion comprises an expandable tube.  
   
   
       131 . The method of  claim 130 , wherein the expandable tube is reinforced with a plurality of flexible wires.  
   
   
       132 . The method of  claim 130 , wherein the radially expandable portion includes at least one friction member for frictionally engaging the esophageal tissue.