Tissue-acquisition and fastening devices and methods

Abstract

Devices and methods for acquiring and fastening tissues folds within an internal organ, such as the stomach, and for applying the methods and devices to producing reductions in organ volume or repair of bariatric procedures, are disclosed. An exemplary method for forming a continuous laterally extending tissue fold involves forming a succession of laterally extending folds having adjacent overlapping fold portions. One exemplary tissue-acquisition device has an open-end roller-and-arm structure that allows individual tissue folds to be formed and fastened, then advanced to an adjacent region within the stomach, for capture of a new fold that will form an extension of the existing fold(s).

1 - 30 . (canceled) 
     
     
         31 . A method for delivering a fastener to tissue of a patient, comprising:
 positioning a distal end of an elongate arm adjacent to the tissue, wherein the elongate arm includes an internal channel and a fastener positioned within the internal channel, and wherein an outer surface of the elongate arm tapers radially inward in a proximal-to-distal direction, and wherein positioning includes positioning the outer surface against the tissue so that the internal channel of the elongate arm forms an acute angle with the tissue; and   deploying the fastener from the internal channel to cause the fastener to secure two tissue layers together.   
     
     
         32 . The method of  claim 31 , wherein the fastener includes at least one leg that is preformed to adopt a loop shape after deployment. 
     
     
         33 . The method of  claim 31 , wherein the elongate arm includes a plurality of fasteners positioned within the internal channel. 
     
     
         34 . The method of  claim 33 , wherein the method includes deploying each of the plurality of fasteners from the internal channel. 
     
     
         35 . The method of  claim 31 , wherein the fastener includes a base and a pair of elongate legs extending from the base, and when positioned in the internal channel, the base is positioned proximally to the legs. 
     
     
         36 . The method of  claim 31 , wherein the tissue is stomach tissue of the patient. 
     
     
         37 . The method of  claim 31 , wherein the internal channel includes a trapezoidal cross-sectional shape. 
     
     
         38 . The method of  claim 31 , wherein the fastener includes nitinol. 
     
     
         39 . A method for delivering a fastener to tissue of a patient, comprising:
 positioning a distal end of an elongate arm adjacent to the tissue so that an internal channel of the elongate arm forms an acute angle with the tissue, wherein the elongate arm includes a plurality of fasteners positioned within the internal channel; and   deploying each of the plurality of fasteners to cause each fastener to secure two tissue layers together, forming a continuous tissue fold.   
     
     
         40 . The method of  claim 39 , wherein an outer surface of the elongate arm tapers radially inward in a proximal-to-distal direction, and wherein positioning includes positioning the outer surface against the tissue. 
     
     
         41 . The method of  claim 39 , wherein each fastener includes a base and a pair of elongate legs extending from the base. 
     
     
         42 . The method of  claim 41 , wherein each elongate leg of each fastener is preformed to adopt a loop shape after deployment, and after deployment, each loop extends fully through a first layer of the two tissue layers and at least partially through a second layer of the two tissue layers. 
     
     
         43 . The method of  claim 39 , wherein each of the plurality of fasteners is deployed using a pusher against a proximal end of a proximal-most fastener of the plurality of fasteners. 
     
     
         44 . The method of  claim 39 , wherein the plurality of fasteners are arranged inline while in the internal channel of the elongate arm. 
     
     
         45 . The method of  claim 39 , wherein at least one fastener of the plurality of fasteners includes only a single elongate leg, and the single elongate leg is preformed to adopt a loop shape. 
     
     
         46 . A method for delivering a fastener to tissue of a patient, comprising:
 positioning a distal end of an elongate arm adjacent to tissue, wherein the elongate arm includes an internal channel and a plurality of fasteners positioned within the internal channel, and wherein an outer surface of the elongate arm tapers radially inward in a proximal-to-distal direction, and wherein positioning includes positioning the outer surface against the tissue so that the internal channel of the elongate arm forms an acute angle with the tissue; and   deploying each of the plurality of fasteners to cause each fastener to secure two tissue layers together, forming a continuous tissue fold;   wherein each fastener includes at least one leg that is preformed to adopt a loop shape after deployment.   
     
     
         47 . The method of  claim 46 , wherein each fastener includes a pair of legs that are preformed to adopt a loop shape after deployment. 
     
     
         48 . The method of  claim 46 , wherein the tissue fold is comprised of stomach tissue of the patient. 
     
     
         49 . The method of  claim 46 , wherein the at least one leg of each fastener includes nitinol. 
     
     
         50 . The method of  claim 46 , wherein the loop shape has a diameter between 60-120 mils.