Device and method for suturing tissue

• US 20020095164A1
• Filed: 12/28/2001
• Published: 07/18/2002
• Est. Priority Date: 06/26/1997
• Status: Abandoned Application

• Current Assignee: Bernard H. Andreas, Brian Gore, James W. Vetter, Lewis Isbell, Mark J. Foley, Michael Barrett, Ronald Songer
• Original Assignee: Bernard H. Andreas, Brian Gore, James W. Vetter, Lewis Isbell, Mark J. Foley, Michael Barrett, Ronald Songer
• Inventors: Songer, Ronald, Isbell, Lewis, Andreas, Bernard H., Barrett, Michael, Vetter, James W., Foley, Mark J., Gore, Brian
• Application Number:
  US10/033,689
• Publication Number:
  US 20020095164A1
• Time in Patent Office: Days
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00641 for closing fistulae, e.g. anorectal fistulae
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/047 having at least one proximally pointing needle located at the distal end of the instrument, e.g. for suturing trocar puncture wounds starting from inside the body
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0474 Knot pushers
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61F 2002/30092 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2210/0019 : operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation

Abstract

Systems for suturing a tissue layer having two sides with a suture by releasably retaining at least a portion of the suture in a stationary position on one side of the tissue layer. The portion of the suture is retrieved through the tissue layer from the opposite side whereby the suture is drawn from one side to the opposite side. Systems for suturing the wall of a tubular graft having two sides is also provided using a suture by releasably retaining at least a portion of the suture on one side of the wall. The portion of the length of suture is retrieved through the wall of the graft to the opposite side of the wall.

Claims

1. A method for suturing tissue in the proximity of an aperture in a tissue wall, comprising:

forming a port from the proximal side of the tissue wall;

passing at least a portion of a suture from the distal side of the tissue wall proximally through the port in the tissue wall in the proximity of the aperture; and

forming a loop with the remaining portion of the suture to secure the suture.

2. The method of claim 1, wherein forming a port comprises:

advancing a needle from the proximal side to the distal side of the tissue wall to form the port; and

wherein passing at least a portion of a suture comprises;

engaging the suture with the needle; and

withdrawing the needle and suture through the port.

3. The method of claim 1, further comprising:

introducing a fastener over the portions of the suture.

4. The method of claim 1, further comprising:

passing the remaining portion of the suture through the wall of a graft.

5. The method in claim 1, wherein passing at least a portion of a suture comprises advancing a shaft through the aperture so that a pair of needles having a length of suture therebetween engage suture ports on opposite sides of the aperture, drawing the suture outwardly to guide the needles through the suture port into the tissue tract, and removing the ends of the suture from the needles.

6. The method in claim 1, wherein passing at least a portion of a suture comprises advancing a shaft through the aperture so that at least one needle having a portion of suture engages the port, engaging the suture portion with the needle, drawing the suture portion through the tissue and retracting the needle from the port.

7. The method in claim 1, further comprising:

passing the remaining portion of the suture through the aperture before the step of passing the suture portion through the tissue wall.

8. A method for suturing an aperture in a vessel wall, comprising:

reversibly advancing a plurality of needles through the vessel wall to form ports in the proximity of the aperture;

passing at least a portion of a suture proximally through the ports in the vessel wall disposed on opposite sides of the aperture from the interior of the vessel with the remaining portion of the suture passing out of the vessel; and

securing the ends of the suture to close the aperture.

9. The method as in claim 8, further comprising:

passing the suture portion through the ports as a continuous loop with two ends.

10. The method as in claim 8, further comprising:

passing the suture portion through the ports by passing at least a portion of a pair of needles therethrough while carrying the suture portion therebetween.

11. The method as in claim 10, further comprising:

carrying the suture portion between the pair of needles as a continuous length.

12. The method as in claim 8, further comprising:

passing the needles from the exterior of the vessel, through the ports in the vascular tissue, and external of the vessel so that at least a portion of the suture is external to the vessel.

13. The method as in claim 8, further comprising:

removing the suture portion from the needles after removing the needles from the vessel.

14. The method as in claim 8, wherein the portions of the suture are secured over the wall of the vessel to close an aperture.

15. The method as in claim 8, wherein the portions of the suture are secured to contact the vessel wall with a graft in an anastomosis procedure.

17. The method of claim 16, further comprising:

tying the opposite ends of the length of suture to close an opening in the vessel wall.

18. The method of claim 16, wherein the opposite ends of the suture loop are positioned within the vessel by:

supporting the opposite ends of the length of suture on a distal end of an elongated member; and

advancing the elongated member through the opening in the vessel wall such that the distal end of the elongated member is positioned within the vessel.

19. The method of claim 18, wherein each of the pair of needles moves in a path which is radially angled to the elongated member as the needles pass through the vessel wall.

20. The method of claim 18, wherein the ends of the needles move radially outwardly from the elongated member prior to passing through the vessel wall.

21. The method of claim 16, wherein each needle has a barbed tip.

22. The method of claim 16, wherein the holes are disposed longitudinally along the length of the vessel wall.

23. The method of claim 16, wherein the holes are disposed transversely across the width of the vessel wall.

16. A method of suturing an opening in a vessel wall, comprising:

positioning opposite ends of a length of suture within the vessel;

puncturing holes through the vessel wall with a pair of needles; and

pulling the opposite ends of the length of suture through the vessel wall, wherein each needle pulls an end of the length of suture in a proximal direction through the holes in the vessel wall.