Devices and methods for securing tissue

Abstract

A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and one or more axially rigid elongated spikes extend from the body into the channel. The body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, with the spike being engaged only with the second axial segment. The first axial segment more tightly compresses the body structure than the second axial segment.

1 . A method for treating a diverticulum formed in an intestinal wall of a patient, comprising:
 advancing an applicator into the intestine through a natural orifice to the site of the diverticulum;   inverting the diverticulum at least in part using the applicator; and   clamping the diverticulum with a resilient ring having at least one spike that engages the diverticulum, a distal end of the applicator being formed with or engaged with a collar that bears the ring, the ring being materially biased to a relaxed state, in which the ring assumes a radially smaller configuration, the ring being stretchable to an enlarged state to fit onto the collar, the ring assuming the enlarged state when on the collar and assuming the relaxed state when urged off the collar and onto the diverticulum.   
     
     
         2 . The method of  claim 1 , wherein intestinal wall tissue adjacent the diverticulum is held by the ring serosa to serosa. 
     
     
         3 . The method of  claim 1 , wherein the ring comprises:
 a round resilient body defining an axial through-opening configured to receive the diverticulum;   the at least one spike extending from the body into the through-opening, wherein   the body is defined by at least first and second portions that are coaxial to each other and offset from each other in the axial dimension defined by the body, the first portion configured to compress the diverticulum a first magnitude and the second portion configured to compress the diverticulum a second magnitude, the first magnitude being greater than the second magnitude.   
     
     
         4 . The method of  claim 1 , wherein the spike is engaged with the second portion and no spike is engaged with the first portion, and the method further comprises:
 advancing the ring onto the diverticulum first portion first.   
     
     
         5 . The method of  claim 1 , wherein the first portion is defined by a first wall and the second portion is defined by a second wall, and the first wall is thicker than the second wall. 
     
     
         6 . The method of  claim 1 , wherein the first portion is made of a first material and the second portion is made of a second material different than the first material. 
     
     
         7 . The method of  claim 1 , comprising:
 preloading the ring onto the applicator; and   urging the ring off the applicator onto the diverticulum.   
     
     
         8 . The method of  claim 7 , comprising preloading plural rings onto the applicator. 
     
     
         9 . The method of  claim 1 , wherein the ring is preloaded onto the applicator with the spike extending distal of the body. 
     
     
         10 . The method of  claim 1 , wherein the ring is preloaded onto the applicator with the spike extending proximal to the body. 
     
     
         11 . The method of  claim 1 , wherein the ring is urged from a side opening in the applicator onto the diverticulum. 
     
     
         12 . The method of  claim 1 , wherein the ring comprises plural spikes. 
     
     
         13 . The method of  claim 1 , wherein the at least one spike extends substantially across a diameter of the through-hole. 
     
     
         14 . The method of  claim 12 , wherein each spike defines an end disposed substantially in the center of the ring when the ring is relaxed. 
     
     
         15 . The method of  claim 1 , wherein the ring includes plural tabs arranged on an outer periphery of the ring. 
     
     
         16 . The method of  claim 1 , wherein the spike is movable on the ring in the radial plane defined by the ring between a retracted position and an extended position, an actuating ring being engaged with the resilient ring to move the spike toward the extended position. 
     
     
         17 . A tissue compressing device, comprising:
 a round resilient body defining an axial central passage configured to receive tissue therein;   at least one spike extending from the body into the central passage, wherein   the body is defined by at least first and second portions that are coaxial to each other and offset from each other in the axial dimension defined by the body, the first portion configured to compress the diverticulum a first magnitude and the second portion configured to compress the diverticulum a second magnitude, the first magnitude being greater than the second magnitude.   
     
     
         18 . The tissue compressing device of  claim 17 , wherein the spike is engaged with the second portion and no spike is engaged with the first portion. 
     
     
         19 . The tissue compressing device of  claim 18 , wherein the first portion is defined by a first wall and the second portion is defined by a second wall, and the first wall is thicker than the second wall. 
     
     
         20 . The tissue compressing device of  claim 18 , wherein the first portion is made of a first material and the second portion is made of a second material different than the first material. 
     
     
         21 . The tissue compressing device of  claim 17 , comprising:
 an applicator onto which the ring is preloaded in a radially expanded configuration.   
     
     
         22 . The tissue compressing device of  claim 21 , wherein the ring is preloaded onto the applicator with the spike extending distal of the body. 
     
     
         23 . The tissue compressing device of  claim 21 , wherein the ring is preloaded onto the applicator with the spike extending proximal to the body. 
     
     
         24 . The tissue compressing device of  claim 17 , wherein the ring comprises plural spikes. 
     
     
         25 . The tissue compressing device of  claim 17 , wherein the at least one spike extends substantially across a diameter of the central passage. 
     
     
         26 . The tissue compressing device of  claim 24 , wherein each spike defines an end disposed substantially in the center of the ring when the ring is relaxed. 
     
     
         27 . The tissue compressing device of  claim 17 , wherein the ring includes plural tabs arranged on an outer periphery of the ring. 
     
     
         28 . The tissue compressing device of  claim 17 , wherein the spike is movable on the ring in the radial plane defined by the ring between a retracted position and an extended position. 
     
     
         29 . The tissue compressing device of  claim 17 , wherein the spike includes at least one barb. 
     
     
         30 . The tissue compressing device of  claim 17 , wherein at least one of the spike or the body is coated for eluting a drug. 
     
     
         31 . A method for holding tissue together, comprising:
 advancing into a patient through a natural orifice a closure ring including a resilient ring-shaped body defining a compression channel and at least one axially rigid elongated gripping element extending from the body into the channel;   engaging the closure ring with body structure such that the gripping element penetrates the body structure and the body surrounds and compresses in the compression channel at least a part of the body structure.   
     
     
         32 . The method of  claim 31 , wherein the body structure is a diverticulum. 
     
     
         33 . The method of  claim 31 , wherein the body structure is a hemorrhoid. 
     
     
         34 . The method of  claim 31 , wherein the body structure includes tissue defining a tissue hole. 
     
     
         35 . The method of  claim 31 , wherein the body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, the first axial segment not being engaged with the gripping element, the second axial segment being engaged with the gripping element, the first axial segment more tightly compressing the body structure than the second axial segment. 
     
     
         36 . The method of  claim 35 , wherein the first axial segment is defined by a first wall and the second axial segment is defined by a second wall, and the first wall is thicker than the second wall. 
     
     
         37 . The method of  claim 35 , wherein the first axial segment is made of a first material and the second axial segment is made of a second material different than the first material. 
     
     
         38 . The method of  claim 31 , comprising:
 preloading the ring onto an applicator; and   urging the ring off the applicator onto the body structure.   
     
     
         39 . The method of  claim 38 , comprising preloading plural rings onto the applicator. 
     
     
         40 . The method of  claim 31 , wherein the ring is preloaded onto an applicator with the gripping element extending distal of the body. 
     
     
         41 . The method of  claim 31 , wherein the ring is preloaded onto an applicator with the gripping element extending proximal to the body. 
     
     
         42 . The method of  claim 31 , wherein the ring is urged from a side opening in an applicator onto the body structure. 
     
     
         43 . The method of  claim 31 , wherein the ring comprises plural gripping elements. 
     
     
         44 . The method of  claim 31 , wherein the at least one gripping element extends substantially across a diameter of the compression channel. 
     
     
         45 . The method of  claim 31 , wherein each gripping element defines an end disposed substantially in the center of the ring when the ring is relaxed. 
     
     
         46 . The method of  claim 31 , wherein the ring includes plural tabs arranged on an outer periphery of the body. 
     
     
         47 . The method of  claim 31 , wherein the gripping element is movable on the body in the radial plane defined by the ring between a retracted position and an extended position, an actuating ring being engaged with the closure ring to move the gripping element toward the extended position. 
     
     
         48 . The method of  claim 31 , wherein the gripping element includes at least one barb. 
     
     
         49 . The method of  claim 31 , wherein at least one of the gripping element or the ring is coated for eluting a drug. 
     
     
         50 . Apparatus comprising:
 a resilient ring-shaped body defining a compression channel; and   at least one axially rigid elongated gripping element extending from the body into the channel, wherein the body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, the first axial segment not being engaged with the gripping element, the second axial segment being engaged with the gripping element, the first axial segment more tightly compressing the body structure than the second axial segment.   
     
     
         51 . The apparatus of  claim 50 , wherein the first axial segment is defined by a first wall and the second axial segment is defined by a second wall, and the first wall is thicker than the second wall. 
     
     
         52 . The apparatus of  claim 50 , wherein the first axial segment is made of a first material and the second axial segment is made of a second material different than the first material. 
     
     
         53 . The apparatus of  claim 50 , comprising an applicator onto which the ring is preloaded. 
     
     
         54 . The apparatus of  claim 53 , wherein the ring is preloaded onto the applicator with the gripping element extending distal of the body. 
     
     
         55 . The apparatus of  claim 53 , wherein the ring is preloaded onto the applicator with the gripping element extending proximal to the body. 
     
     
         56 . The apparatus of  claim 50 , wherein the ring comprises plural gripping elements. 
     
     
         57 . The apparatus of  claim 50 , wherein the at least one gripping element extends substantially across a diameter of the compression channel. 
     
     
         58 . The apparatus of  claim 56 , wherein each gripping element defines an end disposed substantially in the center of the ring when the ring is relaxed. 
     
     
         59 . The apparatus of  claim 50 , wherein the ring includes plural tabs arranged on an outer periphery of the body. 
     
     
         60 . The apparatus of  claim 50 , wherein the gripping element is movable on the body in the radial plane defined by the ring between a retracted position and an extended position, an actuating ring being engaged with the closure ring to move the gripping element toward the extended position. 
     
     
         61 . The apparatus of  claim 50 , wherein the gripping element includes at least one barb. 
     
     
         62 . The apparatus of  claim 50 , wherein at least one of the gripping element or the body is coated for eluting a drug. 
     
     
         63 . A method for treating a diverticulum formed in an intestinal wall of a patient, comprising:
 advancing an applicator into the intestine through a natural orifice to the site of the diverticulum;   inverting the diverticulum at least in part using the applicator; and   clamping the diverticulum with a resilient ring having at least one spike that engages the diverticulum.