Percutaneous suturing apparatus and method

• US 20030195528A1
• Filed: 06/02/2003
• Published: 10/16/2003
• Est. Priority Date: 07/20/2001
• Status: Abandoned Application

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: Opus Medical, Inc. (Smith & Nephew PLC)
• Inventors: Ritchart, Mark A.
• Application Number:
  US10/452,889
• Publication Number:
  US 20030195528A1
• Time in Patent Office: Days
• US Class Current: 606/144
• 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 2017/0472 Multiple-needled, e.g. double-needled, instruments

Abstract

A suturing instrument and methods for placing stitches in soft tissues combines the functions of both independently grasping the tissue and passing sutures through the tissue to form a mattress stitch therein. The endoscopic suturing instrument comprises a clamping portion having a longitudinal axis, which is adapted for percutaneous entry into an operative site. The clamping portion further comprises a plurality of jaw members that are movable relative to one another between a closed position wherein the jaw members are disposed in close proximity to one another and an open position wherein the jaw members are spaced apart. A needle portion is disposed at an angle relative to the longitudinal axis, and is adapted for percutaneous entry into said operative site. The needle portion comprises a needle, and preferably a pair of needles, for passage through a portion of soft tissue disposed between the jaw members of the clamping portion.

Claims

1. A suturing device for use endoscopically, comprising:

a clamping portion having a longitudinal axis, which is adapted for percutaneous entry into an operative site and which comprises a plurality of jaw members that are movable relative to one another between a closed position wherein the jaw members are disposed in close proximity to one another and an open position wherein the jaw members are spaced apart; and

a needle portion disposed at an angle relative to said longitudinal axis, which is adapted for percutaneous entry into said operative site;

said needle portion comprising a needle for passage through a portion of soft tissue disposed between the jaw members of said clamping portion.

2. The suturing device as recited in claim 1, and further comprising suturing material disposed in one of said jaw members, said needle being adapted for engaging said suturing material at said operative site.

3. The suturing device as recited in claim 2, wherein said needle comprises a distal end which is configured for engaging said suturing material.

4. The suturing device as recited in claim 3, wherein said distal end is hooked for gaffing said suturing material.

5. The suturing device as recited in claim 2, wherein the suturing material disposed in the one jaw member comprises a suture loop.

6. The suturing device as recited in claim 5, wherein there are two suture loops disposed on opposing sides of said one jaw member.

7. The suturing device as recited in claim 5, and further comprising a second needle, each of said needles engaging a respective one of said two suture loops.

8. The suturing device as recited in claim 1, wherein said angle is between about 30 and about 90 degrees.

9. The suturing device as recited in claim 1, wherein said clamping portion and said needle portion enter the operative site through different percutaneous locations.

10. The suturing device as recited in claim 1, wherein said needle portion includes a needle guide having a needle guide channel for guiding said needle to the operative site.

11. The suturing device as recited in claim 10, wherein the needle guide is telescopically fixed to the needle portion to adjust for different patient dimensions.

12. A suturing device for use endoscopically, comprising:

a clamping portion having a longitudinal axis, which is adapted for percutaneous entry into an operative site and which comprises a plurality of jaw members that are movable relative to one another between a closed position wherein the jaw members are disposed in close proximity to one another and an open position wherein the jaw members are spaced apart;

one of said jaw members comprising first and second slots on opposing sides thereof, wherein a first looped end of a length of suturing material is disposed in said first slot and a second looped end of a length of suturing material is disposed in said second slot.

13. The suturing device as recited in claim 12, and further comprising a needle portion having first and second needles adapted for engagement with said first and second looped ends, respectively.

14. The suturing device as recited in claim 13, wherein said first and second needles are disposed at an angle relative to said longitudinal axis.

15. The suturing device as recited in claim 14, wherein said angle is between about 30 degrees and about 90 degrees.

16. A suturing device for use endoscopically, comprising:

a tissue retaining portion having a longitudinal axis, which is adapted for percutaneous entry into an operative site through a cannula; and

a suture engagement portion spaced from said tissue retaining portion, which is adapted for percutaneous entry into said operative site through a location spaced from said cannula.

17. The suturing device as recited in claim 16, wherein said tissue retaining portion comprises a clamping portion having means for retaining soft tissue which is to be attached to bone within said operative site.

18. The suturing device as recited in claim 17, wherein said retaining means comprises first and second jaw members which are movable relative to one another between a closed position wherein the jaw members are disposed in close proximity to one another and an open position wherein the jaw members are spaced apart.

19. A method of placing sutures in tissue, using a suturing device which comprises a clamping portion having a longitudinal axis and a needle portion spaced from said clamping portion, the method comprising:

inserting a distal end of said clamping portion percutaneously into an operative site until a distal working end thereof is adjacent to tissue which is to be repaired;

engaging said tissue with said distal working end;

inserting a distal end of said needle portion percutaneously into the operative site, so that at least one needle of said needle portion extends through said engaged tissue and through a suture loop disposed on a distal side of said engaged tissue; and

withdrawing said at least one needle proximally to thereby pull said suture loop proximally through said engaged tissue to form a stitch through said tissue.