TECHNICAL FIELD

The disclosure is directed to devices for use with endoscopes and more particularly to devices that work with an endoscope or similar device for endoscopically suturing tissue.

BACKGROUND

A variety of endoscopic treatments may result in defects (or wounds) that are too large for hemostasis clips to easily bridge and thus help to close the defect. Examples of such endoscopic treatments include removal of large lesions, tunneling under the mucosal layer, full thickness removal of tissue, treating other organs by passing outside of the gastrointestinal tract, and repair of post-surgical issues such as post-surgical leaks, failing surgical staple lines and anastomotic leaks. Endoscopic treatments also include bariatric revision procedures. Of the known devices and methods for endoscopically closing large defects, each has certain advantages and disadvantages.

SUMMARY

The disclosure is directed to several alternative designs, materials and methods of devices for endoscopically closing large defects. An example of the disclosure is an endoscopic handle attachment that is adapted to be secured to an endoscope having a working channel and used in combination with a suture device adapted to extend through the working channel, the suture device including a translation assembly axially translatable within the working channel and adapted to releasably engage and disengage a needle and a distal endcap securable to the distal end of the endoscope and adapted to releasable engage the needle when the translation assembly disengages the needle and to disengage the needle when the translation assembly engages the needle, the suture device including a proximal handle and a translation handle slidingly coupled to the proximal handle and operably coupled to the translation assembly such that movement of the translation handle relative to the proximal handle causes movement of the translation assembly. The endoscopic handle attachment includes a backbone that is adapted to conform to an outer surface of the endoscope and that includes one or more attachment features that are adapted to enable the endoscopic handle attachment to be releasably secured to the endoscope proximate a handle region of the endoscope. A primary arm extends radially outwardly from the backbone and one or attachment members are coupled to the primary arm, at least one of the one or more attachment members adapted to releasably secure the proximal handle of the suture device such that the translation handle may be moved relative to the proximal handle without an operator needing to separately hold the proximal handle.

Alternatively or additionally, the one or more attachment features may include hook structures that are formed into the backbone and are adapted to secure one or more elastic members that engage the hook structures and extend around the endoscope.

Alternatively or additionally, the hook structures may include a first hook on a first side of the backbone and an opposing second hook on a second side of the backbone.

Alternatively or additionally, the primary arm may include a first attachment member adapted to releasably secure the proximal handle of the suture device and a second attachment member adapted to releasably secure a handle for a secondary device used in combination with the suture device.

Alternatively or additionally, the first attachment member may include a C-shaped attachment member into which the proximal handle of the suture device is releasably engageable via a snap fit.

Alternatively or additionally, the endoscopic handle attachment may further include a secondary arm having an attachment member adapted to releasably secure an external lumen used with the suture device.

Alternatively or additionally, the attachment member of the secondary arm may include an aperture extending through the attachment member such that a fitting of the external lumen may be extended upwardly through the aperture and a valve may be extended down into the aperture to engage the fitting and thus releasably secure the external lumen to the attachment member of the secondary arm.

Alternatively or additionally, the secondary device may be adapted to extend from the handle releasably secured to the second attachment member of the primary arm and into the external lumen releasably secured to the attachment member of the secondary arm.

Alternatively or additionally, the endoscope may include an instrument channel port that is fluidly coupled with the working channel, and the backbone may include an upper portion adapted to fit about an instrument channel port bump out accommodating the instrument channel port.

Alternatively or additionally, the upper portion adapted to fit about the instrument channel port bump out may include one or more tabs adapted to contact the instrument channel port bump out and thus vertically position the endoscopic handle attachment relative to the instrument channel port.

Another example of the disclosure is an endoscopic handle attachment that is adapted to be secured to an endoscope having a working channel and used in combination with a suture device adapted to extend through the working channel, the suture device including a translation assembly axially translatable within the working channel and a distal assembly and adapted to pass a needle back and forth between the translation assembly and the distal assembly, the suture device including a proximal handle and a translation handle slidingly coupled to the proximal handle and operably coupled to the translation assembly. The endoscopic handle attachment includes a backbone that is adapted to conform to an outer surface of the endoscope and that includes one or more attachment features that are adapted to enable the endoscopic handle attachment to be releasably secured to the endoscope proximate a handle region of the endoscope. A primary arm extends radially outwardly from the backbone and a suture device attachment member is coupled to the primary arm and adapted to releasably secure the proximal handle of the suture device such that the translation handle may be moved relative to the proximal handle without an operator needing to separately hold the proximal handle. A secondary device attachment member is coupled to the primary arm and adapted to releasably engage a handle of a secondary device adapted to be used in combination with the suture device.

Alternatively or additionally, the endoscopic handle attachment further includes a secondary arm extending radially outwardly from the backbone and including an external lumen attachment member, the external lumen attachment member including an aperture extending through the external lumen attachment member such that a fitting of the external lumen may be extended upwardly through the aperture and a valve may be extended down into the aperture to engage the fitting and thus releasably secure the external lumen to the external lumen attachment member.

Alternatively or additionally, the one or more attachment features may include hook structures that are formed into the backbone and are adapted to secure one or more elastic members that engage the hook structures and extend around the endoscope.

Alternatively or additionally, the hook structures may include a first hook on a first side of the backbone and an opposing second hook on a second side of the backbone.

Alternatively or additionally, the suture device attachment member may be adapted to releasably engage the proximal handle of the suture device via a snap fit.

Alternatively or additionally, the secondary device attachment member may be adapted to releasably engage the handle of the secondary device via a snap fit.

Alternatively or additionally, the endoscope includes an instrument channel port that is fluidly coupled with the working channel, and the backbone may include an upper portion adapted to fit about an instrument channel port bump out accommodating the instrument channel port, the upper portion including one or more tabs adapted to contact the instrument channel port bump out and thus vertically position the endoscopic handle attachment relative to the instrument channel port.

Another example of the disclosure is a suture assembly for use in combination with an endoscope having a working channel and a distal end. The suture assembly includes a translation assembly that is axially translatable within the working channel and includes a needle configured to carry a suture, a distal shuttle configured to releasably secure the needle and a sleeve disposable over the distal shuttle, the sleeve movable between a locked position in which the needle is secured to the distal shuttle and an unlocked position in which the needle is releasable from the distal shuttle. The suture assembly includes a distal endcap that is securable to the distal end of the endoscope and is configured to engage the needle when the needle is advanced distally into the endcap and to release the needle when the needle is locked to the distal shuttle and the distal shuttle is withdrawn proximally. The suture assembly includes a proximal handle and a translating handle that is slidingly disposed relative to the proximal handle and is operably coupled to the translation assembly. A backbone is adapted to conform to an outer surface of the endoscope and to be releasably secured to the endoscope proximate an instrument channel port of the endoscope. An arm extends radially outwardly from the backbone and a suture assembly attachment member is coupled to the arm and is adapted to releasably secure the proximal handle such that the translation handle may be moved relative to the proximal handle without an operator needing to separately hold the proximal handle.

Alternatively or additionally, the suture assembly may further include a secondary device attachment member coupled to the arm for securing a handle of a secondary device used in combination with the suture assembly.

Alternatively or additionally, the suture assembly may further include a second arm bearing an external lumen attachment member.

The above summary of some embodiments is not intended to describe each disclosed embodiment or every implementation of the present disclosure. The Figures, and Detailed Description, which follow, more particularly exemplify these embodiments.

