Surgical suturing instrument and method of use

• US 20030105476A1
• Filed: 09/13/2002
• Published: 06/05/2003
• Est. Priority Date: 09/14/2001
• Status: Active Grant

• Current Assignee: DVL Acquisition Sub, Inc. (Becton, Dickinson & Co)
• Original Assignee: DVL Acquisition Sub, Inc. (Becton, Dickinson & Co)
• Inventors: Sancoff, Gregory E., DiCarlo, Joseph A., Fogg, Douglas A., Field, Frederic P.
• Granted Patent: US 7,037,315 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/0498 for advancing a suture filament along a helical path through tissue
• CPC Class Codes: A61B 2017/0646 for insertion into cartillege, e.g. meniscus
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft

Abstract

A device is disclosed for introducing a flexible elongated element through at least two portions of a subject. In an embodiment, the device includes a proximal end and a distal end, as well as an advancement unit for longitudinally advancing the flexible elongated element toward the distal end such that a proximal end of the elongated element may pass from the distal end of said device with sufficient force to pass through the portions of the subject. The device also includes a securing unit for variably adjusting a securing force applied by the flexible elongated element to secure together the portions of the subject.

Claims

1. A suturing device comprising:

a housing;

a shaft extending distally from said housing, at least a portion of said shaft being flexible;

a pair of opposing jaws located at a distal end of said shaft;

a suture drive mechanism located in said housing and adapted to advance suture material through said shaft, through one of said jaws, through a subject to be sutured, and into the other jaw; and

a jaw rotation mechanism located in said housing and adapted to rotate said jaws so as to secure the suture material to the subject.

2. A suturing device according to claim 1 wherein said shaft is formed out of a flexible material.

3. A suturing device according to claim 1 wherein said shaft is formed out of a plastic material.

4. A suturing device according to claim 3 wherein said plastic material is reinforced with a metal material.

6. A suturing device according to claim 1 wherein said shaft is made more flexible by removing a portion of said shaft.

7. A suturing device according to claim 1 wherein said shaft comprises a distal section, a proximal section and a flexible spine section connecting said distal section to said proximal section.

8. A suturing instrument according to claim 7 wherein said spine section is located on the periphery of said shaft.

9. A suturing instrument according to claim 7 wherein said spine section is located along the center axis of said shaft.

10. A suturing device comprising:

a housing;

a shaft extending distally from said housing;

a pair of opposing jaws located at a distal end of said shaft, said opposing jaws being (i) pivotally connected to said distal end of said shaft, and (ii) pivotally connected to an inner yoke movable relative to said distal end of said shaft, whereby movement of said inner yoke in a distal direction causes said opposing jaws to open relative to one another, and movement of said inner yoke in a proximal direction causes said opposing jaws to close relative to one another;

a suture drive mechanism located in said housing and adapted to advance suture material through said shaft, through one of said jaws, through a subject to be sutured, and into the other jaw; and

a jaw rotation mechanism located in said housing and adapted to rotate said jaws so as to secure the suture material to the subject.

11. A suturing device comprising:

a housing;

a shaft extending distally from said housing, at least a portion of said shaft being flexible;

a pair of movable jaws pivotally connected to the distal end of said shaft in opposing relation such that said jaws can open and close relative to one another;

a suture drive mechanism located in said housing and adapted to advance suture material through said shaft, through one of said jaws, through a subject to be sutured, and into the other jaw;

a jaw rotation mechanism located in said housing and adapted to rotate said jaws so as to secure the suture material to the subject.

12. A suturing device according to claim 11 wherein said device further comprises a cutting mechanism adapted for selective movement through said one of said jaws for engagement with, and severing of, suture material extending through said one of said jaws.

13. A suturing device according to claim 11 wherein said cutting mechanism is withdrawn from said one of said jaws when it is not engaged in severing the suture material.

14. A suturing device according to claim 11 wherein said cutting mechanism comprises a cutting rod formed out of a flexible material.

15. A suturing device according to claim 11 wherein said one of said jaws is pivotally connected to said distal end of said shaft by a pivot pin, wherein said device further comprises a wire guide for supporting the suture wire between said suture drive mechanism and said one of said jaws, and further wherein said wire guide is positioned outboard of said pivot pin.

16. A suturing mechanism according to claim 15 wherein the distal end of said wire guide is attached to said one of said jaws by a floating mount.

17. A suturing device comprising:

a housing;

a shaft extending distally from said housing;

a pair of opposing jaws located at a distal end of said shaft;

a suture drive mechanism located in said housing and adapted to advance suture material through said shaft, through one of said jaws, through a subject to be sutured, and into the other jaw;

a jaw rotation mechanism located in said housing and adapted to rotate said jaws so as to secure the suture material to the subject; and

a source of suture material located in the device, said suture material comprising (i) a distal portion having properties favorable for penetrating, twisting and cutting operations, and (ii) a proximal portion having properties favorable for driving operations, said source of suture material being located in the device so that said proximal portion is engaged by said suture drive mechanism.

18. A suturing device according to claim 17 wherein said distal portion of said suture material comprises a metal having a tensile strength of under 200 kpsi.

19. A suturing device according to claim 17 wherein said proximal portion of said suture material comprises a metal having a tensile strength in excess of 200 kpsi.

20. A suturing device according to claim 17 wherein said distal portion of said suture material comprises 316L stainless steel having a tensile strength of 160 kpsi.

21. A suturing device according to claim 17 wherein said proximal portion of said suture material comprises 304 stainless steel having a tensile strength of 430 kpsi.

24. A method according to claim 20 wherein the suturing device is advanced into the patient'"'"'s stomach through the esophagus.

25. A method according to claim 20 wherein the suturing device is advanced into the patient'"'"'s stomach through an endoscope.

22. A suture material, comprising:

a distal portion having properties favorable for penetrating, twisting and cutting operations; and

a proximal portion having properties favorable for driving operations.

23. A method for treating gastroesophogeal reflux disease (GERD), comprising:

providing a suturing device comprising;

a housing;

a shaft extending distally from said housing;

a pair of opposing jaws located at a distal end of said shaft;

a suture drive mechanism located in said housing and adapted to advance suture material through said shaft, through one of said jaws, through a subject to be sutured, and into the other jaw; and

a jaw rotation mechanism located in said housing and adapted to rotate said jaws so as to secure the suture material to the subject;

advancing the distal end of the suturing device into a patient'"'"'s stomach so that the distal end of the suturing device is adjacent to the wall of the stomach below the lower esophageal sphincter (LES);

gathering together portions of the stomach wall below the LES with the pair of opposing jaws;

operating the suture drive mechanism so as to advance suture material through the gathered-together portions of the stomach wall; and

operating the jaw rotation mechanism so as to secure the suture material to the subject and thereby secure together the gathered-together portions of the stomach wall.

26. A method for effecting hemostasis, comprising:

providing a suturing device comprising;

a housing;

a shaft extending distally from said housing;

a pair of opposing jaws located at a distal end of said shaft;

a suture drive mechanism located in said housing and adapted to advance suture material through said shaft, through one of said jaws, through a subject to be sutured, and into the other jaw; and

a jaw rotation mechanism located in said housing and adapted to rotate said jaws so as to secure the suture material to the subject;

advancing the distal end of the suturing device into a patient adjacent to tissue which would benefit by effecting hemostasis;

gathering together portions of the tissue which would benefit by effecting hemostasis with the pair of opposing jaws;

operating the suture drive mechanism so as to advance suture material through the gathered-together portions of the tissue; and

operating the jaw rotation mechanism so as to secure the tissue and thereby effect hemostasis.

27. A method according to claim 26 wherein the suturing device is advanced into the patient'"'"'s stomach through the esophagus.

28. A method according to claim 26 wherein the suturing device is advanced into the patient'"'"'s stomach through an endoscope.