Tissue fastening devices and processes that promote tissue adhesion

Abstract

The invention in certain aspects relates to a surgical fastener for fastening tissue segments having tissue surfaces. The fastener includes a first fastener member having a base and a piercing element connected to the base for piercing the tissue segments to be fastened, a second fastener member having an opening for receiving and retaining the piercing element of the first fastener member such that the tissue segments to be fastened are retained between the first and second fastening members, and means for promoting adhesion between the tissue surfaces. The invention also relates to related methods and devices for promoting adhesion of tissue segments and preventing fastener migration, especially in an endoscopic procedure for the treatment of GERD.

1 - 69 . (canceled) 
     
     
         70 . A method of fastening tissue segments of a gastrointestinal tract, comprising:
 piercing a first tissue segment and a second tissue segment with a piercing structure of a tissue fastener;   causing trauma to the first and second tissue segments with a puncturing structure of the tissue fastener; and   retaining the first and second tissue segments between a first part and a second part of the tissue fastener such that an outer surface of the first tissue segment contacts an outer surface of the second tissue segment.   
     
     
         71 . The method of  claim 70 , wherein the first part includes the piercing structure, and wherein retaining the first and second tissue segments includes receiving the first part in the second part. 
     
     
         72 . The method of  claim 70 , wherein the puncturing structure includes at least one spike or blade. 
     
     
         73 . The method of  claim 70 , wherein the puncturing structure includes a plurality of spikes or blades. 
     
     
         74 . The method of  claim 70 , wherein the piercing is performed prior to causing the trauma. 
     
     
         75 . The method of  claim 70 , wherein one of the first or second tissue segments is part of a stomach. 
     
     
         76 . The method of  claim 70 , wherein one of the first or second tissue segments is part of a fundus of a stomach. 
     
     
         77 . The method of claim of  claim 76 , wherein the other one of the first or second tissue segments is part of a lower esophageal sphincter. 
     
     
         78 . The method of  claim 70 , further comprising;
 piercing a third tissue segment and a fourth tissue segment with an additional tissue fastener; and   retaining the third and fourth tissue segments between a first part and a second part of the additional tissue fastener such that an outer surface of the third tissue segment contacts an outer surface of the fourth tissue segment.   
     
     
         79 . The method of  claim 78 , further comprising:
 causing trauma to the third and fourth tissue segments with a puncturing structure of the additional tissue fastener.   
     
     
         80 . The method of  claim 79 , wherein one of the third or fourth tissue segments is part of a stomach. 
     
     
         81 . The method of  claim 70 . further comprising, adhering the first and second tissue segments together. 
     
     
         82 . The method of  claim 70 , wherein the puncturing structure is disposed on a base of the first part of the tissue fastener. 
     
     
         83 . The method of  claim 70 , wherein the puncturing structure is a spike or a blade having a height greater than a thickness of one of the first and second tissue segments. 
     
     
         84 . The method of  claim 81 , wherein the adhering is due to bleeding from at least one of the first and second tissue segments. 
     
     
         85 . The method of  claim 70 , wherein the puncturing structure is a plurality of spikes or blades disposed on a base of the first part of the tissue fastener, wherein the piercing structure is a shaft of the first part of the tissue fastener disposed between at least two of the spikes or blades. 
     
     
         86 . The method of  claim 70 , wherein the puncturing structure pierces completely through the first tissue segment and only partially through the second tissue segment. 
     
     
         87 . A method of fastening tissue segments of a gastrointestinal tract, comprising:
 inserting a tissue fastening device within the gastrointestinal tract;   placing a first tissue segment and a second tissue segment within a tissue fastener of the tissue fastening device;   piercing the first tissue segment and the second tissue segment with a piercing structure of the tissue fastener;   causing trauma to the first and second tissue segments with a puncturing structure: and   retaining the First and second tissue segments between a first part and a second part of the tissue fastener such that an outer surface of the first tissue segment contacts an outer surface of the second tissue segment.   
     
     
         88 . The method of  claim 87 , wherein the puncturing structure is disposed on the tissue fastener. 
     
     
         89 . The method of  claim 87 , wherein the puncturing structure is disposed on the tissue fastening device.