Independent gripper

Abstract

The invention provides devices, systems and methods for tissue approximation and repair at treatment sites. The devices, systems and methods of the invention will find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions, including the abdomen, thorax, cardiovascular system, heart, intestinal tract, stomach, urinary tract, bladder, lung, and other organs, vessels, and tissues. The invention is particularly useful in those procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site. In addition, many of the devices and systems of the invention are adapted to be reversible and removable from the patient at any point without interference with or trauma to internal tissues.

What is claimed is: 
     
         1 . A fixation system for engaging tissue comprising:
 an implantable fixation device comprising a pair of fixation elements each having a first end, a free end opposite the first end, and an engagement surface therebetween for engaging the tissue, the first ends being movably coupled together such that the fixation elements are moveable between a closed position wherein the engagement surfaces face each other to a first open position wherein the engagement surfaces are positioned away from each other; an actuation mechanism coupled to the fixation elements adapted to move the fixation elements between the closed position and the first open position; and a pair of gripping elements comprising a first gripping element and a second gripping element, each of the gripping elements moveable with respect to one of the fixation elements and configured to be moved in opposition to one of the engagement surfaces so as to capture tissue therebetween; and   a first gripper actuator releasably coupled to the implantable fixation device and configured to individually actuate the gripping elements.   
     
     
         2 . The fixation system according to  claim 1 , wherein the free ends are moveably coupled to move between a closed position where the engagement surfaces face each other and a closed position where the engagement surfaces face away from one another. 
     
     
         3 . The fixation system according to  claim 1 , wherein the fixation elements each have a concave portion for receiving a corresponding one of the pair of gripping elements when the gripping elements are moved into opposition to one of the engagement surfaces. 
     
     
         4 . The fixation system according to  claim 1 , wherein the first gripping actuator is releasably coupled to the implantation fixation device and being actuatable between a first configuration and a second configuration that moves the first gripping element toward a first fixation element of the pair of fixation elements. 
     
     
         5 . The fixation system according to  claim 4 , wherein the first gripper actuator is actuatable between the second configuration and a third configuration that moves the second gripping element toward a second fixation element of the pair of fixation elements independently of the movement of the first gripping element. 
     
     
         6 . The fixation system according to  claim 1 , further comprising an elongate delivery shaft having a proximal portion and a distal portion, wherein the distal portion is releasably coupled to the proximal portion of the implantable fixation device. 
     
     
         7 . The fixation system according to  claim 6 , wherein the gripper actuator comprises a proximal end and a distal end, the distal end being releasably coupled to at least one of the proximal end of the implantable fixation device or the distal end of the elongate delivery shaft. 
     
     
         8 . The fixation system according to  claim 6 , wherein the gripper actuator comprises a gripper line that extends from the proximal end of the delivery shaft and is coupled to each of the first gripping element and the second gripping element at portions of the gripper line between the proximal end of the delivery shaft and releasably coupled to at least one of the proximal end of the implantable fixation device or the distal end of the elongate delivery shaft. 
     
     
         9 . The fixation system according to  claim 6 , wherein the gripper line is actuated by tension on the gripper line and is configured to apply a different resultant force the each of the first gripping element and the second gripping element to induce the individual activation of the gripping elements at different levels of tension. 
     
     
         10 . The fixation system according to  claim 6 , wherein the gripper actuator is released from the implantable fixation device when the elongate delivery shaft is decoupled from the implantable fixation device. 
     
     
         11 . The fixation system according to  claim 8 , wherein the gripper line is releasably fixed to the implantation fixation device. 
     
     
         12 . The fixation system according to  claim 8 , wherein the gripper actuator is released from the implantable fixation device when the elongate delivery shaft is decoupled from the implantable fixation device. 
     
     
         13 . The fixation system according to  claim 1 , further comprising a gripper pusher releasably coupled to the implantable fixation device adjacent the pair of gripping elements, the gripper pusher having an expanded configuration and a collapsed configuration, wherein in the expanded configuration the gripper pusher engages the pair of gripping elements and advances the pair of gripping elements toward the engagement surfaces of the fixation elements. 
     
     
         14 . The fixation system according to  claim 13 , wherein in the collapsed configuration the gripper pusher has a reduced radial profile relative to the gripper pusher radial profile in the expanded configuration thereby allowing the pair of gripping elements to move away from the engagement surfaces of the fixation elements. 
     
     
         15 . The fixation system according to  claim 13 , wherein the first gripping actuator is releasably coupled to the implantation fixation device and being actuatable between a first configuration and a second configuration that moves the first gripping element toward a first fixation element of the pair of fixation elements. 
     
     
         16 . The fixation system according to  claim 15 , wherein the first gripper actuator is actuatable between the second configuration and a third configuration that moves the second gripping element toward a second fixation element of the pair of fixation elements independently of the movement of the first gripping element. 
     
     
         17 . The fixation system according to  claim 13 , further comprising an elongate delivery shaft having a proximal portion and a distal portion, wherein the distal portion is releasably coupled to the proximal portion of the implantable fixation device. 
     
     
         18 . The fixation system according to  claim 17 , wherein the gripper actuator comprises a proximal end and a distal end, the distal end being releasably coupled to at least one of the proximal end of the implantable fixation device or the distal end of the elongate delivery shaft. 
     
     
         19 . The fixation system according to  claim 17 , wherein a distal portion of the gripper pusher is releasably attached to the implantable fixation device. 
     
     
         20 . The fixation system according to  claim 19 , wherein the gripper pusher comprises a pair of elongate flexible arms and a shaft of the implantable fixation device includes apertures for releasably engaging a distal end of each of the pair of elongate flexible arms. 
     
     
         21 . The fixation system according to  claim 20 , wherein a proximal portion of the implantable fixation device comprises a pair of apertures, wherein the distal portion of the elongate delivery shaft comprises a pair of L-shaped ends resiliently biased to fit into the pair of apertures, wherein the distal ends of the pair of elongate flexible arms are releasably coupled to the implantable fixation device by being fitted into the apertures and with the pair of L-shaped ends. 
     
     
         22 . The fixation system according to  claim 21 , further comprising an actuation rod configured to extend through the elongate delivery shaft and into the implantable fixation device to actuate the pair of fixation elements, wherein the fixation system is configured such that withdrawal of the actuation rod from the implantable fixation device releases the L-shaped ends and the distal ends of the pair of elongate flexible arms from the implantable fixation device. 
     
     
         23 . The fixation system according to  claim 6 , wherein the first gripper actuator comprises a distal end, and wherein placing the distal end of the first gripper actuator adjacent a distal end of the elongate delivery shaft and coupling the distal portion of the elongate delivery shaft to the proximal portion of the fixation device locks the distal end of the first gripper actuator in position. 
     
     
         24 . The fixation system according to  claim 23 , wherein the distal end of the first gripper actuator comprises a narrow portion and a wide portion, and wherein the elongate delivery shaft and the fixation device are shaped to form a hollow portion that when coupled together that holds the wide portion of the first gripper actuator in position. 
     
     
         25 . The fixation system according to  claim 23 , wherein the distal end of the first gripper actuator comprises a narrow portion and a wide portion, wherein the elongate delivery shaft includes an open slot having a width narrower than the wide portion of the first gripper actuator and the fixation device closes the open slot when coupled to the elongate delivery shaft to hold the first gripper actuator in position. 
     
     
         26 . The fixation system according to  claim 23 , further comprising a covering assembly coupled to and disposed over the distal portion of the elongate delivery shaft, the covering assembly comprising an outer slideable section and an inner section having a T-shaped opening,
 wherein the first gripper actuator is releasably coupled to the fixation device by sliding a T-shaped distal end of the first gripper actuator into the T-shaped opening of the inner section of the covering assembly and sliding the outer slideable section to cover the T-shaped openings.   
     
     
         27 . The fixation system according to  claim 6 , further comprising an actuator rod that extends through the delivery shaft and into the implantable fixation device to actuate the pair of fixation elements, wherein the delivery shaft comprises an opening portion and a liner disposed inside of the delivery shaft configured to occlude the opening portion, and wherein the first gripper actuator is disposed in the opening portion and fixed by the liner when the actuator rod is extended into the implantable fixation device and released by the liner when the actuator rod is withdraw from the implantable fixation device. 
     
     
         28 . The fixation system according to  claim 27 , wherein the liner is hingedly attached to the delivery shaft. 
     
     
         29 . The fixation system according to  claim 6 , further comprising an actuator rod that extends through the delivery shaft and into the implantable fixation device to actuate the pair of fixation elements, wherein the delivery shaft comprises opening portions and spring members disposed on the exterior of the delivery shaft having bent portions that extend into the opening portions, each spring member having a notched end, wherein the notched ends of the spring members abut to form an opening sized to releasably engage the first gripper actuator. 
     
     
         30 . The fixation system according to  claim 29 , wherein the actuator rod has a taper shape configured to press the bent portions when the actuator rod is withdrawn from the implantable fixation device to release the first gripper actuator by causing the notched ends to separate. 
     
     
         31 . The fixation system according to  claim 29 , wherein the actuator rod has a taper shape configured to press the bent portions when the actuator rod is withdrawn from the implantable fixation device to release the first gripper actuator and the second gripper actuator by causing the notched ends to separate. 
     
     
         32 . A method for fixing tissue, said method comprising;
 providing an implantable fixation device comprising a pair of fixation elements each having a first end, a free end opposite the first end, and an engagement surface therebetween for engaging the tissue, the first ends being movably coupled together such that the fixation elements are moveable between a closed position wherein the engagement surfaces face each other to a first open position wherein the engagement surfaces are positioned away from each other; an actuation mechanism coupled to the fixation elements adapted to move the fixation elements between the closed position and the first open position; and a pair of gripping elements comprising a first gripping element and a second gripping element, each of the gripping elements moveable with respect to one of the fixation elements and configured to be moved in opposition to one of the engagement surfaces so as to capture tissue therebetween;   positioning the fixation elements so that tissue is disposed between the pair of gripping elements and the engagement surfaces of the pair of fixation element; and   activating a first gripper actuator to individually actuate the first gripping elements to grasp tissue between the first gripping element and one of the fixation elements.   
     
     
         33 . The method according to  claim 32 , further comprising activating the first gripper actuator to actuate the second gripping element to grasp tissue between the second gripping element and the other of the fixation elements while the first gripping element is engaged with tissue. 
     
     
         34 . The method according to  claim 32 , providing a gripper pusher releasably coupled to the implantable fixation device adjacent the pair of gripping elements; and
 wherein individually actuating the first gripper element comprises engaging the pair of gripping elements with the gripper pusher.   
     
     
         35 . The method according to  claim 32 , wherein the first gripper actuator comprises a proximal end and a distal end, the distal end being releasable coupled to the implantable fixation device. 
     
     
         36 . The method according to  claim 32 , further comprising removing an actuator rod for actuating the actuation mechanism that causes an elongated delivery shaft to decouple from the implantable fixation device and causes the first gripper actuator to be released from the implantable fixation device.