Device for providing automatic stitching of an incision

• US 20040092965A1
• Filed: 03/31/2003
• Published: 05/13/2004
• Est. Priority Date: 09/30/2002
• Status: Active Grant

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Parihar, Shailendra K.
• Granted Patent: US 7,323,004 B2
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/06061 Holders for needles or sutures, e.g. racks, stands hand-held holding instruments A61B17/0483; holders for articles A61B50/20; racks for syringes or for hypodermic or infusion needles A61M5/008
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• 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 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2017/3482 inside
• CPC Class Codes: A61B 2017/3492 against the outside of the body

Abstract

An automatic suturing device including: a body for insertion into an opening in tissue; a plurality of hooks movably disposed in the body between retracted and extended positions; a suture holder having sutures disposed therein, the suture holder having a mechanism for engaging a portion of the hooks when in the retracted position and for attaching the sutures to a portion of the plurality of hooks; and an actuator for actuating the plurality of hooks from the retracted position to the extended position and for embedding the exposed plurality of hooks with the attached sutures into the tissue surrounding the opening.

Claims

1. An automatic suturing device comprising:

a body for insertion into an opening in tissue;

a plurality of hooks movably disposed in the body between retracted and extended positions;

a suture holder having sutures disposed therein, the suture holder having means for engaging a portion of the hooks when in the retracted position and for attaching the sutures to a portion of the plurality of hooks; and

actuation means for actuating the plurality of hooks from the retracted position to the extended position and for embedding the exposed plurality of hooks into the tissue surrounding the opening.

2. The automatic suturing device of claim 1, wherein the device further comprises means for providing access into a hollow organ through the opening.

3. The automatic suturing device of claim 2, wherein the means for providing access comprises:

the body having a bore for passage of at least a distal portion of an instrument into an interior of the hollow organ; and

a valve disposed in the bore for allowing passage of the instrument and substantially preventing a fluid in the interior of the hollow organ from leaking outside the hollow organ.

4. The automatic suturing device of claim 1, wherein the body comprises first and second body portions movable relative to each other and wherein the actuation means comprises:

rotatable actuation means for exposing the plurality of hooks upon rotation of one of the first and second body portions relative to the other of the first or second body portions; and

translatable actuation means for embedding the exposed plurality of hooks into the wall upon translation of one of the first and second body portions relative to the other of the first or second body portions.

5. The automatic suturing device of claim 4, further comprising a fluid seal between the first and second body portions.

6. The automatic suturing device of claim 1, wherein the suture holder is separately formed from the body and inserted on a distal portion of the body.

7. The automatic suturing device of claim 1, wherein the means for engaging a portion of the hooks when in the retracted position and for attaching the sutures to a portion of the plurality of hooks comprises:

the suture holder having a first longitudinal channel for holding the sutures therein;

the suture holder having a second longitudinal channel for holding a glue therein; and

a linking channel for linking at least a portion of the first and second longitudinal channels and corresponding to at least a portion of the plurality of hooks when in the retracted position;

wherein the at least a portion of the plurality of hooks are disposed in the linking channel and in communication with both the sutures and glue in the respective first and second longitudinal channels when in the retracted position to adhere at least a portion of a suture to at least a portion of each of the plurality of hooks.

8. The automatic suturing device of claim 7, wherein suture holder has an internal bore and the first and second longitudinal channels are disposed on an inner surface of the internal bore.

9. The automatic suturing device of claim 7, wherein the linking channel is disposed on a distal surface of the suture holder.

10. The automatic suturing device of claim 1, wherein the means for engaging a portion of the hooks when in the retracted position and for attaching the sutures to a portion of the plurality of hooks comprises an adhering means for adhering the sutures to a portion of the plurality of hooks.

11. The automatic suturing device of claim 10, wherein the adhering means comprises:

the suture holder having a longitudinal channel for holding the sutures therein; and

the suture holder having two or more collet assemblies each of which correspond to a frayed end of the sutures, each of the collet assemblies having a collapsible collet having a glue chamber containing a dose of glue disposed in an internal channel and means for collapsing the collapsible collet radially into the internal channel;

wherein the at least a portion of the plurality of hooks and the frayed ends of the sutures are disposed in the interior channel and wherein each of the collapsible collets are collapsed to compress the frayed ends of the sutures and dose of glue against a portion of the hooks disposed in the interior channel to adhere the sutures to the hooks.

12. The automatic suturing device of claim 1, wherein the means for engaging a portion of the hooks when in the retracted position and for attaching the sutures to a portion of the plurality of hooks comprises a fastening means for mechanically fastening the sutures to a portion of the plurality of hooks.

13. The automatic suturing device of claim 1, wherein the fastening means comprises:

the suture holder having a longitudinal channel for holding the sutures therein;

at least a portion of the plurality of hooks having one or more projections; and

the suture holder having two or more collet assemblies each of which correspond to a frayed end of the sutures, each of the collet assemblies having a collapsible collet having an internal channel and means for collapsing the collapsible collet radially into the internal channel;

wherein the at least a portion of the plurality of hooks and the frayed ends of the sutures are disposed in the interior channel and wherein each of the collapsible collets are collapsed to compress the projections against a corresponding hook to capture the frayed ends of the sutures against a portion of the hooks disposed in the interior channel to fasten the sutures to the hooks.

14. An automatic suturing device comprising:

an access device for providing access into a hollow organ during an open surgical procedure, the access device comprising;

a body having a distal portion for insertion into an opening in a wall of the hollow organ, the body further having a bore for passage of at least a distal portion of an instrument into an interior of the hollow organ;

a valve disposed in the bore for allowing passage of the instrument and substantially preventing a fluid in the interior of the hollow organ from leaking outside the hollow organ;

a plurality of hooks movably disposed in the body between retracted and extended positions; and

actuation means for actuating the plurality of pins from the retracted position to an extended position and for embedding the exposed plurality of hooks into the wall to secure the body to the wall; and

a suture holder having an internal bore disposed on the distal portion of the body, the suture holder having sutures disposed therein and means for engaging a portion of the plurality of hooks when in the retracted position and for attaching the sutures to a portion of the plurality of hooks.

15. The automatic suturing device of claim 14, wherein the body comprises first and second body portions movable relative to each other and wherein the actuation means comprises:

rotatable actuation means for exposing the plurality of hooks upon rotation of one of the first and second body portions relative to the other of the first or second body portions; and

translatable actuation means for embedding the exposed plurality of hooks into the wall upon translation of one of the first and second body portions relative to the other of the first or second body portions.

16. The automatic suturing device of claim 15, further comprising a fluid seal between the first and second body portions.

17. The automatic suturing device of claim 14, wherein the body has a low-profile length in an axial direction of the bore to increase a manipulative capability of the instrument through the bore.

18. The automatic suturing device of claim 17, wherein the length of the body in the axial direction of the bore is substantially within a range of 1.5 T to 5 T, where T is a thickness of the wall.

19. The automatic suturing device of claim 14, wherein the means for engaging a portion of the hooks when in the retracted position and for attaching the sutures to a portion of the plurality of hooks comprises an adhering means for adhering the sutures to a portion of the plurality of hooks.

20. The automatic suturing device of claim 19, wherein the adhering means comprises:

the suture holder having a first longitudinal channel for holding the sutures therein;

the suture holder having a second longitudinal channel for holding a glue therein; and

a linking channel for linking at least a portion of the first and second longitudinal channels and corresponding to at least a portion of the plurality of hooks when in the retracted position;

wherein the at least a portion of the plurality of hooks are disposed in the linking channel and in communication with both the sutures and glue in the respective first and second longitudinal channels when in the retracted position to adhere at least a portion of a suture to at least a portion of each of the plurality of hooks.

21. The automatic suturing device of claim 14, wherein the means for engaging a portion of the hooks when in the retracted position and for attaching the sutures to a portion of the plurality of hooks comprises a fastening means for mechanically fastening the sutures to a portion of the plurality of hooks.

22. The automatic suturing device of claim 21, wherein the fastening means comprises:

the suture holder having a longitudinal channel for holding the sutures therein;

at least a portion of the plurality of hooks having one or more projections; and

the suture holder having two or more collet assemblies each of which correspond to a frayed end of the sutures, each of the collet assemblies having a collapsible collet having an internal channel and means for collapsing the collapsible collet radially into the internal channel;

wherein the at least a portion of the plurality of hooks and the frayed ends of the sutures are disposed in the interior channel and wherein each of the collapsible collets are collapsed to compress the projections against a corresponding hook to capture the frayed ends of the sutures against a portion of the hooks disposed in the interior channel to fasten the sutures to the hooks.

23. The automatic suturing device of claim 20, wherein the suture holder has an internal bore and the first and second longitudinal channels are disposed on an inner surface of the internal bore.

24. The automatic suturing device of claim 20, wherein the linking channel is disposed on a distal surface of the suture holder.

25. A method for automatically stitching an opening in tissue, the method comprising:

inserting a portion of a device into the opening;

extending a plurality of hooks from the device and through the tissue surrounding the opening;

inserting at least a portion of each of the plurality of hooks back into the device;

attaching the at least a portion of each of the plurality of hooks to a suture;

withdrawing the plurality of hooks and attached suture from the tissue surrounding the opening and through the opening;

severing the sutures from the at least portion of each of the plurality of hooks; and

pulling the sutures to close the opening.

26. The method of claim 25, further comprising tying the sutures together after closing the opening.

27. The method of claim 25, wherein the attaching comprises adhering the at least a portion of each of the plurality of hooks to the sutures.

28. The method of claim 25, wherein the attaching comprises mechanically fastening the at least a portion of each of the plurality of hooks to the sutures.

29. A method for providing access into an interior of a hollow organ for manipulation of an instrument therein, the method comprising:

providing access to the hollow organ;

making an opening in a wall of the hollow organ;

inserting a body of an access device in the opening;

securing the body to the wall;

passing at least a distal portion of an instrument through a bore in the access device to an interior of the hollow organ;

substantially preventing a fluid in the interior of the hollow organ from leaking outside the hollow organ;

removing the access device from the opening; and

automatically closing the hole in the wall of the internal organ upon removal of the access device from the opening.

30. The method of claim 29, wherein the automatically closing comprises:

inserting a portion of the access device into the opening;

extending a plurality of hooks from the access device and through the tissue surrounding the opening;

inserting at least a portion of each of the plurality of hooks back into the access device;

attaching the at least a portion of each of the plurality of hooks to a suture;

withdrawing the plurality of hooks and attached suture from the tissue surrounding the opening and through the opening;

severing the sutures from the at least portion of each of the plurality of hooks; and

pulling the sutures to close the opening.

31. The method of claim 30, further comprising tying the sutures together after closing the opening.