Suturing device with split arm and method of suturing tissue

• US 20050149066A1
• Filed: 12/23/2003
• Published: 07/07/2005
• Est. Priority Date: 12/23/2003
• Status: Active Grant

• Current Assignee: Abbott Laboratories
• Original Assignee: Abbott Laboratories
• Inventors: Stafford, Joshua
• Granted Patent: US 7,449,024 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 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 2017/00672 Locating means therefor, e.g. bleed back lumen
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures

Abstract

A device for suturing an opening in a tissue, having an elongated shaft, at least two arms movable to a deployed positioning which the arms are non-perpendicular to the shaft, the arms having needle receiving portions; and needles advanceable longitudinally along the shaft toward the needle receiving portions, the needles exiting through side walls of the shaft at a location proximal to the arms.

Claims

1. A device for suturing an opening in a tissue, the device comprising:

an elongated shaft having a longitudinal axis;

at least two arms movable between a compact position and a deployed position, wherein the arms are generally parallel to the axis of the shaft when in the compact position, wherein at least one of the arms is at a non-perpendicular angle with respect to the axis of the shaft when in the deployed position, and wherein at least one of the arms defines a needle receiving portion; and

at least one needle advanceable longitudinally along the shaft toward the needle receiving portion, the needle exiting the shaft through a side wall of the shaft at a location proximal to the arms.

2. The device of claim 1, wherein the at least two arms comprise:

a first arm that is pivoted less than 90 degrees to the longitudinal axis of the elongated shaft when in the deployed position; and

a second arm that is pivoted more than 90 degrees to the longitudinal axis of the elongated shaft when in the deployed position.

3. The device of claim 1, wherein the arms are independently deployable.

4. The device of claim 1, further comprising:

a first deployment linkage connected to the first arm; and

a second deployment linkage connected to the second arm.

5. The device of claim 4, wherein each deployment linkage comprises a member that is pulled proximally to deploy one of the arms, and is pushed distally to move the arm to the compact position.

6. The device of claim 4, wherein each deployment linkage comprises a wire.

7. The device of claim 1, further comprising:

a pivot stop on the distal end of the elongated shaft, wherein the pivot stop limits rotation of the arms when they reach the deployed position.

8. The device of claim 7, wherein the at least two arms comprise an anterior arm and a posterior arm, wherein the anterior arm has an extension portion that contacts the pivot stop when the anterior arm is in its deployed position, and wherein the posterior arm has a stop surface that contacts the pivot stop when the posterior arm is in its deployed position.

9. Apparatus for suturing a puncture in a blood vessel having a longitudinal axis, comprising:

an elongated body;

a first arm mounted to move relative to the elongated body, the first arm having a needle receiving portion which mounts a first end portion of a suture, the first arm having an extended position in which the arm extends away from the body and a retracted position in which the arm is against the body;

a first needle having a distal end, the first needle mounted to move relative to the elongated body, the distal end of the first needle movable from a position adjacent the elongated body to a position spaced outwardly from the body and within the first needle receiving portion of the first arm when the first arm is in the extended position, such that the end portion of the suture is engaged by the distal end of the first needle;

a second arm mounted to move relative to the elongated body, the second arm having a needle receiving portion which mounts a second end portion of a suture, the second arm having an extended position in which the second arm extends away from the body and a retracted position in which the second arm is against the body; and

a second needle having a distal end, the second needle mounted to move relative to the elongated body, the distal end of the second needle movable from a position adjacent the elongated body to a position spaced outwardly from the body and within the needle receiving portion of the second arm when the second arm is in the extended position, such that the second end portion of the suture is engaged by the distal end of the second needle;

wherein the first arm is adapted to be positioned at a non-perpendicular angle to the elongated body when in the extended position, and the second arm is adapted to be positioned at a non-perpendicular angle to the elongated body when in the extended position, such that the elongated body will be positioned at a non-perpendicular angle relative to the longitudinal axis of the blood vessel while the first and second arms are positioned longitudinally along the inside of the wall of the blood vessel for placement of the suture across the puncture.

10. The apparatus of claim 9, wherein one needle is adapted to be connected to a first end of a length of suture, the suture having a second end and a bight between the first and second ends, the bight being prearranged on the elongate body to define a pre-tied knot when the first end of the suture passes through the bight.

11. The apparatus of claim 9, wherein the elongated body is sufficiently rigid to maintain alignment of the first needle with the first arm and the second needle with the second arm, respectively.

12. The apparatus of claim 9, wherein the first and second needles have different lengths.

13. The apparatus of claim 9, wherein the first and second end portions of the suture have cuffs disposed thereon.

14. A method of suturing a blood vessel, comprising:

advancing a suturing device having an elongated shaft through a tissue tract, and through an opening in the blood vessel, the tissue tract being situated at a non-perpendicular angle relative to a longitudinal axis of the blood vessel;

extending a first arm at a non-perpendicular angle from the distal end of the elongated body, the first arm having a needle receiving portion thereon;

extending a second arm at a non-perpendicular angle from the distal end of the elongated body, the second arm having a needle receiving portion thereon, wherein the first and second arms extend longitudinally within the blood vessel while the elongated body is positioned within the tissue tract; and

advancing a first needle from a position adjacent to the elongated body to a position spaced outwardly from the elongated body, such that the first needle is received into the needle receiving portion on the first arm.

15. The method of claim 14, wherein the needle receiving portion of the first arm is dimensioned to receive an end portion of a suture.

16. The method of claim 15, wherein a first end portion of the suture is engaged by the distal end of the first needle.

17. The method of claim 14, further comprising:

advancing a second needle from a position adjacent to the elongated body to a position spaced outwardly from the elongated body, such that the second needle is received into the needle receiving portion on the second arm, such that a second end portion of the suture is engaged by the distal end of the second needle.

18. The method of claim 14, further comprising:

positioning a loop of suture longitudinally across the opening of the blood vessel to close the opening.

19. The method of claim 14, further comprising:

providing a length of suture having two ends and a bight therebetween, the bight prearranged on the device to define a pre-tied knot when the first end portion of the suture is advanced through the bight.