 |
Claims  |
|
|
What is claimed is:
1. A suture anchor device, comprising:
a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath; and
a visceral anchor comprising:
a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;
a suture having a first secured region and a second secured region, the first secured region being attached to said anchor; and
an attachment member disposed within said lumen of said second sheath and configured to secure said suture.
2. The device of claim 1, wherein said suture has a proximal end and a distal end, said proximal end attached to a suture needle and said distal end being said first secured region.
3. The device of claim 1, wherein said device further comprises a suture securing means.
4. The device of claim 3, wherein said suture securing means comprises a cap disposed at said proximal end of said first sheath, said cap having a locking slot.
5. The device of claim 4, wherein said first secured region of said suture is positioned in said locking slot.
6. The device of claim 1 wherein said attachment member comprises an elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough.
7. The device of claim 6, wherein said attachment member comprises a first sleeve disposed about said elongated member.
8. The device of claim 7, wherein said first sleeve is disposed circumferentially about said elongated member.
9. The device of claim 7, wherein said attachment member comprises a second sleeve disposed about said elongated member in spaced relation to said first sleeve.
10. The device of claim 9, wherein said second sleeve is disposed circumferentially around said elongated member.
11. The device of claim 1, wherein said reinforcing member and said attachment member of said anchor are telescopingly engaged.
12. The device of claim 1, wherein said distal end of said second sheath is tapered.
13. The device of claim 12, wherein said distal end of said second sheath is conical.
14. A suture anchor device, comprising:
a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;
a cap mounted at said proximal end of said first sheath, said cap having a locking slot; and
a visceral anchor comprising:
a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath; and
a suture having a first secured region and a second secured region, the first secured region being a distal end of said suture attached to said anchor.
15. A suture anchor device, comprising:
a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
a cannula having a proximal end, a distal end and a lumen extending longitudinally therethrough, said cannula disposed in said lumen of said
first sheath; and
a visceral anchor comprising:
a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;
a suture having a first secured region and a second secured region, said first secured region being attached to said anchor; and
an attachment member disposed within said lumen of said second sheath and configured to secure said suture.
16. The device of claim 15, said device further comprising a suture securing means.
17. the device of claim 16, wherein said suture securing means comprises a cap mounted at said proximal end of said first sheath, said cap having a locking slot.
18. The device of claim 17, wherein said second secured region of said suture is positioned in said locking slot.
19. The device of claim 15, wherein translational movement of said cannula relative to said first sheath results in deployment of said anchor.
20. The device of claim 15, wherein said distal end of said second sheath is tapered.
21. The device of claim 20, wherein said distal end of said second sheath is conical.
22. A suture anchor device, comprising:
a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;
a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;
an elongated member disposed in said lumen of said second sheath, said elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough; and
a suture having a first secured region and a second secured region, said first secured region being attached to said elongated member.
23. A visceral anchor for anchoring a viscus to a body wall, comprising:
a sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
an attachment member including an elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said attachment member disposed in said lumen of said sheath; and
a suture having opposing ends, one of said opposing ends attached to said anchor.
24. The anchor of claim 23, said anchor further comprising at least one sleeve disposed about said elongated member.
25. The anchor of claim 23, wherein said attachment member comprises two sleeves disposed about said elongated member.
26. The anchor of claim 23, wherein the other of said opposite ends of said suture is attached to a suture needle.
27. The anchor of claim 23, wherein said distal end of said sheath is configured for entering a passageway in a body made by puncturing a region of said body.
28. The anchor of claim 23, wherein said distal end of said sheath is tapered.
29. The anchor of claim 23, wherein said one of said opposing ends is attached to said attachment member.
30. A visceral anchor, comprising:
a sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
an attachment member including an elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said attachment member disposed in said lumen of said sheath, said attachment member including at least one
sleeve circumferentially disposed about said elongated member; and
a suture having opposing ends, one of said opposing ends attached to said anchor.
31. The anchor of claim 30, wherein said anchor further comprises a second sleeve, said second sleeve disposed about said elongated member in spaced relation to said at least one sleeve.
32. The anchor of claim 30, wherein said one of said opposing ends is attached to said attachment member.
33. A kit for anchoring a viscus to a body wall, comprising:
a needle;
a suture anchor device, said device comprising:
a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;
a visceral anchor comprising:
a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;
a suture having a first secured region and a second secured region, said first secured region being attached to said anchor; and
an attachment member disposed within said lumen of said second sheath and configured to secure said suture.
34. The kit of claim 33, further including a wire guide.
35. A kit for anchoring a viscus to a body wall, comprising:
a needle;
a suture anchor device, said device comprising:
a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;
a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;
an elongated member disposed in said lumen of said second sheath, said elongated member having a proximal end, a distal end, a lumen extending longitudinally therethrough; and
a suture having a first secured region and a second secured region, said first secured region being attached to said elongated member.
36. The kit of claim 35, further including a wire guide.
37. A method for anchoring a viscus to a body wall of a patient, said viscus having an interior viscus wall and a viscus lumen, said method comprising:
providing a tract from outside of the body through the skin and said interior viscus wall to said viscus lumen, the tract having a longitudinal axis extending from outside the body to said viscus lumen;
positioning a suture anchor device through said tract and in said viscus lumen, said device comprising:
a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath; and
a visceral anchor including:
a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;
a suture having a first secured region and a second secured region, the first secured region being attached to said anchor; and
an attachment member disposed within said lumen of said second sheath and configured to secure said suture;
deploying said anchor into said viscus lumen; and
moving said proximal end of said suture to draw said anchor against the interior wall of said viscus so that said viscus is pulled against the body wall.
38. The method of claim 37, wherein said proximal end of said suture is attached to a suture needle.
39. The method of claim 37, said method further comprising anchoring said suture outside of the body to retain said viscus against the body wall.
40. The method of claim 37, wherein said anchoring comprises inserting said suture needle into the skin of said body.
41. The method of claim 37, wherein said device further comprises a suture securing means.
42. The method of claim 41, wherein said suture securing means comprises a cap mounted at said proximal end of said first sheath, said cap having a locking slot.
43. The method of claim 42, wherein said deploying said anchor comprises removing said suture from said locking slot of said cap.
44. The method of claim 37, wherein said deploying said anchor comprises moving said reinforcing member relative to said first sheath so that said anchor is deployed in said viscus lumen.
45. The method of claim 37, wherein said providing a tract from outside of the body through the skin and said interior viscus wall to said viscus lumen comprises making a puncture by inserting a needle through the skin and into said viscus
lumen.
46. The method of claim 45, wherein said needle has a lumen.
47. The method of claim 46, further comprising inserting a wire guide through said lumen of said needle and into said viscus lumen and removing said needle.
48. A method for anchoring a viscus to a body wall of a patient, said viscus having an interior viscus wall and a viscus lumen, said method comprising:
puncturing the skin with a needle having a lumen to provide a tract from outside of the body through the skin and said interior viscus wall to said viscus lumen, the tract having a longitudinal axis extending from outside the body to said viscus
lumen;
inserting a wire guide through the lumen of said needle and into said viscus lumen;
removing said needle;
positioning a suture anchor device through said tract and in said viscus lumen, said device comprising:
a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath; and
a visceral anchor comprising:
a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;
a suture having a first secured region and a second secured region, the first secured region being attached to said anchor; and
an attachment member disposed within said lumen of said second sheath and configured to secure said suture;
deploying said anchor into said viscus lumen; and
moving said proximal end of said suture to draw said anchor against the interior wall of said viscus so that said viscus is pulled against the body wall.
49. A method for anchoring a viscus to a body wall of a patient, said viscus having an interior viscus wall and a viscus lumen, said method comprising:
providing a tract from outside of the body through the skin and said interior viscus wall to said viscus lumen, the tract having a longitudinal axis extending from outside the body to said viscus lumen;
positioning a suture anchor device through said tract and in said viscus lumen, said device comprising:
a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;
a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;
a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;
an attachment member including an elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said attachment member disposed in said lumen of said second sheath, said attachment member including at
least one sleeve circumferentially disposed about said elongated member; and
a suture having a first secured region and a second secured region, said first secured region being attached to said device;
deploying said anchor into said viscus lumen; and
moving said proximal end of said suture to draw said anchor against the interior wall of said viscus so that said viscus is pulled against the body wall.
50. The method of claim 49, wherein said first secured region is attached to said attachment member.
51. The method of claim 47, wherein said wire guide is a micro wire guide.
52. A surgical apparatus adapted to be inserted through a body wall to form an anchor relative to the body wall comprising:
a two piece dilator having a first piece and a releasable second piece, said first piece being an outer cannula having a near end and a far end, the outer cannula having an outer surface and an inner surface extending between the near end and the
far end, the inner surface defining a first passageway extending generally along a first axis between the near end and far end, said releasable second piece having a first end and a second end, said second piece having an outward facing surface and an
inward facing surface extending between the first end and the second end, the inward facing surface defining a second passageway extending generally along a second axis between the first end and second end;
a pull string having a first end and a second end, the second end of said pull string being attached to said second piece;
an elongated member having a proximal end and a distal end, said member having an outer surface and an inner surface extending between the proximal end and the distal end, the inner surface of said member defining a third passageway extending
between the proximal end and distal end, said member adapted to fit within the first passageway of said first piece; and,
said apparatus having a first mode wherein said member is generally disposed within the first passageway and the distal end of said member acts as a telescoping joint such that said first piece and said second piece are associated with one
another and the first axis is substantially parallel to the second axis, the distal end of said member extending beyond the far end of said first piece and into the first end of the second passageway in the first mode, and said apparatus having a second
mode wherein said second piece is released when the distal end of said member is substantially withdrawn from the second passageway.
53. The apparatus of claim 52, wherein the second end of said second piece is tapered.
54. The apparatus of claim 52, wherein the first axis is substantially coaxial with the second axis in the first mode. |
|
 |
|
 |
Claims |
|
|
|
Description |
|
|
FIELD OF THE INVENTION
The present invention relates generally to the field of surgical methods and devices for establishing drains in intra-abdominal viscera.
BACKGROUND OF THE INVENTION
The insertion of a drain tube into the stomach, gall bladder and other intra-abdominal viscera carries an inherent risk of spillage of gastric juices, bile or infected fluids into the peritoneal cavity if the viscus becomes invaginated during
tract dilation, or the wire guide becomes coiled within the peritoneal cavity and the drain can not be reinserted. Various devices and methods have been proposed for the purpose of facilitating the insertion of drains in intra-abdominal viscera. Many
of these methods utilize an anchor attached to a suture wherein the anchor is inserted into a viscus lumen and the viscus is pulled against a body wall. However, most of these methods require the anchor to be delivered by a relatively large gauge
introducer needle as the inside diameter of the needle must be large enough to accommodate the anchor. A potential of injuring the interior of a viscus by the needle point during placement of the anchor exists when such large gauge needles are utilized. A device and method for anchoring a viscus to a body wall of a patient that eliminates the use of large gauge needles and thus reduces the potential of injuring the interior of a viscus by the needle point is needed. The present invention addresses this
need.
SUMMARY OF THE INVENTION
The present invention relates to a suture anchor device, a visceral anchor for anchoring a viscus to a body wall, a kit for anchoring a viscus to a body wall and a method for anchoring a viscus to a body wall of a patient.
In one aspect of the invention, a suture anchor device is described that includes a first sheath, a reinforcing member, and a visceral anchor. The first sheath, reinforcing member and anchor all have a proximal end, a distal end and a lumen
extending longitudinally therethrough. The reinforcing member is disposed in the lumen of the first sheath and, in one embodiment of the invention, is a cannula. The visceral anchor includes a second sheath wherein the proximal end of the second sheath
abuts the distal end of the first sheath. The anchor further includes a suture having a first secured region and a second secured region wherein the first secured region is attached to the anchor. The anchor also includes an attachment member disposed
within the lumen of the second sheath. The attachment member is further configured to secure the suture.
In another embodiment of the invention, the visceral anchor may include a second suture. The second suture is advantageous in retrieving the anchor after the anchor is deployed in a viscus lumen.
In a further embodiment, the device includes a first sheath, a reinforcing member and a second sheath all having a proximal end, a distal end and a lumen extending longitudinally therethrough. The device further includes an elongated member
disposed in the lumen of the second sheath wherein the elongated member has a proximal end, a distal end and a lumen extending longitudinally therethrough. The device further has a suture having a first secured region and a second secured region. The
first secured region is attached to the elongated member. A sleeve may be disposed about, preferably circumferentially about, the elongated member.
In yet another embodiment of the invention, the suture anchor device includes a suture securing means. In one embodiment, the suture securing means is a cap mounted at the proximal end of the first sheath. The cap has a locking slot wherein the
second secured region of the suture is positioned in the locking slot.
In a further embodiment of the invention, a visceral anchor for anchoring a viscus to a body wall is provided. The visceral anchor includes a sheath, an attachment member and a suture having opposing ends. The sheath and attachment member are
elongated members having a proximal end, a distal end and a lumen extending longitudinally therethrough. In another aspect of the invention, the visceral anchor may include at least one sleeve disposed about the attachment member. One of the opposing
ends of the suture is advantageously attached to the anchor, preferably in a central region of the attachment member.
In yet a further aspect of the invention, a kit for anchoring a viscus to a body wall is provided. The kit includes a needle and the suture anchor device described above. The kit may also include a guide preferably a wire guide.
In a further embodiment of the invention, a method for anchoring a viscus to a body wall of a patient is provided. The method includes providing a tract from outside of the body through the skin and the interior viscus wall to a viscus lumen
wherein the tract has a longitudinal axis extending from outside the body to the viscus lumen, positioning a suture anchor device described above through the tract and in the viscus lumen, deploying the visceral anchor into the viscus lumen and moving
the proximal end of the suture to draw the anchor against the interior wall of the viscus so that the viscus is pulled against a body wall, such as an abdominal wall. In one aspect of the invention, the method includes puncturing the skin with a needle
having a lumen to provide a tract from outside of the body through the skin and interior viscus to the viscus lumen. A wire preferably a micro guide may then be inserted through the lumen of the needle and into the viscus lumen. The needle may then be
removed prior to positioning the suture anchor device.
It is an object of the invention to provide a suture anchor device that may deploy a visceral anchor without loading the anchor into a lumen of a large gauge needle, thus reducing the probability of injuring the interior of a viscus.
It is a further object of the invention to provide a suture anchor that does not need to be loaded into a needle for delivery into a viscus lumen and thus reduces the probability of injuring the interior of a viscus.
It is yet another object of the invention to provide a kit for anchoring a viscus to a body wall that includes a suture anchor device that may deploy a visceral anchor wherein the probability of injuring the interior of a viscus is reduced.
It is a further object of the invention to provide a method for anchoring a viscus to a body wall that reduces the probability of injuring the interior of a viscus.
These and other objects and advantages of the present invention will become apparent after reading the following description of the preferred embodiment.
BRIEF DESCRIPTION OF THE FIGURES
FIG. 1 is a side view of a suture anchor device of the present invention with a portion of a sheath component broken away to show a reinforcing member component.
FIG. 2 is a side perspective view of the sheath component of a suture anchor device of the present invention
FIG. 3 is a side perspective view of the reinforcing member.
FIG. 4 is a side perspective view of a visceral anchor component of the suture anchor device.
FIG. 5 is a side perspective view of a visceral anchor component of the suture anchor device having a curved distal end.
FIG. 6 is a cut-away side view of the anchor shown in FIG. 4.
FIG. 7 is a side view of the anchor shown in FIG. 5 with a second suture.
FIG. 8 is a side perspective view showing a reinforcing member component of the present invention disposed in the lumen of the sheath component and showing how a visceral anchor component is attached to form a suture anchor device of the present
invention.
FIG. 9 shows a longitudinal cross-section view of the suture anchor device shown in FIG. 8 viewed along line 8--8.
FIG. 10 depicts region 9 of the suture anchor device shown in FIG. 9, showing the telescopic engagement of attachment member 50 and reinforcing member 20.
FIG. 11 is a schematic representation of a step in one embodiment of the method of visceral wall mobilization of the present invention.
FIG. 12 is a schematic representation of a further step of the method of FIG. 11, particularly showing a visceral anchor component of a suture anchor device after insertion into a hollow viscus.
FIG. 13 is a schematic representation of a further step of the method of FIG. 12, showing deployment of a visceral anchor component of a suture anchor device into the lumen of a hollow viscus.
FIG. 14 is a schematic representation of a further step according to the method of FIG. 13, particularly showing a visceral anchor positioned in perpendicular relation to the longitudinal axis of the tract and engaged with the viscus wall.
FIG. 15 is a schematic representation of another step according to the method of FIG. 14, particularly showing the viscus wall retracted against a body wall, such as an abdominal wall, and a drain tube inserted into the viscus lumen.
FIG. 16 is a schematic representation according to one embodiment of a visceral anchor removal step of the method of the present invention, particularly showing the visceral anchor released from engagement with the viscus wall and suture 70
extending through a cannula.
FIG. 17 is a schematic representation according to the anchor removal step of FIG. 16, particularly showing the visceral anchor aligned along the longitudinal axis of a cannula prior to being removed with the cannula.
FIG. 18 is a side perspective view of an alternate embodiment of a visceral anchor and reinforcing member component of a suture anchor device of the present invention.
FIG. 19 is a side perspective view of a distal portion of a suture anchor device formed from assembling the components shown in FIG. 18.
FIG. 20 is a side perspective view of another alternate embodiment of a visceral anchor and reinforcing member component of a suture anchor device of the present invention.
FIG. 21 is a side perspective view of a distal portion of a suture anchor device formed from assembling the components shown in FIG. 20.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
For the purposes of promoting an understanding of the principles of the invention, reference will now be made to preferred embodiments and specific language will be used to describe the same. It will nevertheless be understood that no limitation
of the scope of the invention is thereby intended, such alterations and further modifications of the invention, and such further applications of the principles of the invention as illustrated herein, being contemplated as would normally occur to one
skilled in the art to which the invention relates.
As described above, the present invention relates to a suture anchor device, a visceral anchor for anchoring a viscus to a body wall, a kit for anchoring a viscus to a body wall and a method for anchoring a viscus to a body wall of a patient.
The device deploys a visceral anchor that anchors a viscus to a body wall so that fluids from intra-abdominal viscera do not spill into the peritoneal cavity during draining procedures. Referring to FIGS. 1-4, one embodiment of a suture anchor device is
shown. Suture anchor device 1 includes sheath 10, reinforcing member 20 and anchor 30 with attached suture 40. Device 1 may also include a suture securing means, including cap 80 having locking slot 83. As best seen in FIG. 2, sheath 10 is an
elongated member 11 having a proximal end 12 and a distal end 13. Lumen 14 extends longitudinally through sheath 10. Sheath 10 is advantageously constructed from a flexible material as known in the art, including polyethylene, polyurethane, nylon,
polytetrafluoroethylene (Teflon) or a combination thereof, but is preferably constructed from polytetrafluoroethylene. The inside and outside diameters and length of sheath 10 may be chosen by one skilled in the art depending on the situation. However,
the inside diameter of sheath 10 is advantageously about 1.0 mm (3 French) whereas the outside diameter is advantageously about 1.67 mm (5 French). The length of sheath 10 is typically about 15 cm.
Turning now to FIG. 3, reinforcing member 20 includes an elongated member 21 that has a proximal end 22, a distal end 23, and a lumen 24 extending longitudinally therethrough. Reinforcing member 20 is preferably a cannula and is advantageously
made from materials as known in the art, including metals such as stainless steel, Nitinol and Inconel. However, reinforcing member 20 is preferably made from stainless steel. A luer-lock fitting 25 as known in the art is mounted on proximal end 22 of
reinforcing member 20 and communicates with lumen 24. The inside and outside diameter of reinforcing member 20 and its length may be chosen by one skilled in the art depending on the situation. However, the inside diameter of reinforcing member 20 is
typically about 0.025 in and the outside diameter is typically about 0.035 in (20 gauge). Moreover, the length of reinforcing member 20 is advantageously about 18 cm.
Turning now to FIG. 4, visceral anchor 30 includes a sheath 31 that is an elongated member that is advantageously constructed from the same material as sheath 10. Sheath 31 includes a proximal end 32, a distal end 33 and a lumen 34 extending
longitudinally therethrough. The diameter of the sheath may be uniform along its length. However, it is preferred that distal end 33 of sheath 31 is configured for entering a passageway in a body made by incising a region of the body. For example,
distal end 33 of sheath 31 is preferably tapered to precisely fit the micro wire guide and may have other configurations as known in the art, such as a pyramidal (3 or 4 sided, for example) or conical. The taper may be elongated to 1 cm or longer to
facilitate entry into the patient. Further, the tapered end may be circular or polygonal in cross section. Distal end 33 may also be either straight as shown in FIG. 4 or curved as shown in FIG. 5. A curved end may be useful in making it easier to
insert the suture anchor device through a puncture made in the patient's body and makes the tapered end of the anchor less traumatic to the interior of the viscera. The extent of the curvature may vary, but the angle of curvature between distal end 33'
of visceral anchor 30' and the central longitudinal axis of the anchor is preferably about 25.degree.. The length of sheath 31 may vary but is advantageously about 3.5 cm. Visceral anchor 30' also includes sheath 31' having proximal end 32' and lumen
34' extending longitudinally therethrough. It is further preferred that sheath 31 have aperture 36 that is configured for passage of suture 40. Aperture 30 is advantageously located at a point equidistant from proximal end 32 and distal end 33 of
sheath 31. The diameter of aperture 36 may be chosen as one skilled in the art would appreciate, but is advantageously about 0.9 mm (0.035 in). Visceral anchor 30 further includes an attachment member 50 disposed in lumen 34 of sheath 31 as seen in
FIG. 6. It is noted here that the same numerical designations for various elements depicted in FIG. 5 refer to the same elements as detailed in FIG. 4.
Referring to FIG. 6, it is seen that attachment member 50 includes an elongated member 51 having a proximal end 52, a distal end 53, a lumen 54 extending longitudinally therethrough and a central region 55. In a preferred embodiment, attachment
member 50 preferably has at least one sleeve 60 disposed about elongated member 51 that is advantageously manufactured from the same material as reinforcing member 20. Sleeve 60 is an elongated member that may be advantageously disposed
circumferentially about elongated member 51 and may be secured to elongated member 51 by methods known in the art, including soldering and use of adhesives. If sleeve 60 is secured to elongated member 51 with solder 68, it is preferable that sleeve 60
is secured to elongated member 51 by making a thru-hole 63 that extends from outer surface 64 of sleeve 60 into lumen 69 (defined by the inner surface of the sleeve) of sleeve 60 and soldering sleeve 60 to outer surface 56 of elongated member 51 in the
region of thru-hole 63. Thru-hole 63 may be circular or have any other shape that will allow solder 68 to contact both outer surface 56 of elongated member 51 and sleeve 60 to secure the sleeve to the elongated member. Thru-hole 63 is further
preferably made in a central region of sleeve 60 equidistant from proximal end 61 and distal end 62 of sleeve 60. Moreover, the diameter of thru-hole 63 may be chosen by one skilled in the art after reading this disclosure but is advantageously about
0.025 in. The length of sleeve 60 may vary as one skilled in the art would appreciate but is advantageously about 1 cm. In this embodiment, distal end 62 of sleeve 60 may be placed any distance, as one skilled in the art would appreciate, from distal
end 33 of sheath 31. However, distal end 62 of sleeve 60 is advantageously about 1.5 cm from distal end 33 of sheath 31. In a further preferred embodiment, a second sleeve 65, an elongated member having lumen 69' defined by the inner surface of the
sleeve, is disposed about, preferably circumferentially around, elongated member 51 and is in spaced relation with sleeve 60. That is, sleeves 60 and 65 are preferably longitudinally aligned about longitudinal axis Z of elongated member 51. Sleeve 65
may also have a thru-hole 63 so that sleeve 65 may be secured to outer surface 56 of elongated member 51 with solder 68. Sleeve 65 is further preferably disposed about distal end 53 of elongated member 51 and further preferably extends past the distal
end of elongated member 51. However, distal end 67 of sleeve 65 may be aligned with distal end 53 of elongated member 51 or may be proximal to distal end 53 of elongated member 51 as one skilled in the art would appreciate. The length of sleeve 65 may
vary as one skilled in the art would appreciate. However, the length of sleeve 65 is advantageously about 7 mm to about 8 mm. Sleeves 60 and 65 preferably function to limit the distance that distal end 23 of reinforcing member 20 travels over proximal
end 52 of elongated member 51 when forming a telescopic joint as more fully explained below with reference to FIGS. 9 and 10. Moreover, in certain embodiments, the sleeves may increase the outer diameter of attachment member 50 so it will fit snugly
within sheath 31.
In yet another embodiment, the outside diameter of attachment member 50 may be such that it is held securely in place within lumen 34 of sheath 31, without the need for sleeves 60 or 65. In this embodiment, an annular extension of the inner
surface of attachment member 50 or a ring snugly disposed within lumen 54 may act to limit the distance that distal end 23 of reinforcing member 20 travels in lumen | | |
