ENDOSCOPIC SUTURING TENSION CONTROLLING AND INDICATION DEVICES

• US 20090299409A1
• Filed: 05/30/2008
• Published: 12/03/2009
• Est. Priority Date: 05/30/2008
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Schwemberger, Richard F., Cropper, Michael S., Coe, Jonathan A.
• Granted Patent: US 8,317,806 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension

Abstract

Various exemplary methods and devices are provided for tensioning sutures. The methods and devices are particularly useful in surgical suturing applications in which it is desirable to maintain tension on a suture being delivered. In various embodiments, the device is incorporated into the handle of a suture device configured to deliver a suture to a surgical site. Other embodiments comprise a device that is separate from, but may be used in connection with, a suture device configured to deliver a suture to a surgical site. A suture locking device is also provided which enables the surgeon to ascertain when a desired amount of tension has been applied to a suture prior to affixing knotting tying elements thereto.

Claims

1. A suture tensioning device, comprising:

a housing;

a movable tensioning member constrained to move axially within said housing, said movable tensioning member configured to have a portion of a suture wound therearound such that a distal portion of the suture extends in a distal direction from the movable tensioning member to be anchored to tissue and a proximal portion of the suture protrudes from the movable tensioning member to have tension applied thereto;

a first resilient member for applying a first resistive force to said movable tensioning member in a first direction; and

a second resilient member applying a second resistive force to said movable tensioning member in a second direction opposite to said first direction.

2. The suture tensioning device of claim 1 wherein said first resilient member comprises a first coil spring and wherein said second resilient member comprises a second coil spring.

3. The suture tensioning device of claim 2 wherein said first coil spring has a first spring constant and wherein said second coil spring has a second spring constant that is substantially equal to said first spring constant.

4. The suture tensioning device of claim 1 wherein said housing comprises a portion of a handle of a suturing device configured to deliver a suture to a surgical site.

5. The suture tensioning device of claim 1 wherein said housing has a passage therethrough for receiving a catheter of a suturing device.

6. The suture tensioning device of claim 1 wherein said movable tensioning member comprises:

a mounting block constrained to move axially within an axial passage in said housing; and

a shaft portion protruding from said mounting block and configured to have a portion of the suture wound therearound.

7. The suture tensioning device of claim 6 further comprising a spool attached to said shaft portion such that the portion of the suture may be wound therearound.

8. The suture tensioning device of claim 6 wherein said mounting block is centrally disposed between said first and second resilient members.

9. A suture application and management kit, comprising:

a suturing device configured to deliver a suture to a surgical site; and

a suture tensioning device of claim 1.

10. The suture application and management kit of claim 9 wherein the suturing device includes at least one end effector configured to apply at least one fastener to tissue, the suture being coupled to the at least one fastener.

11. The suture application and management kit of claim 9 wherein the suture tensioning device is coupled to the suturing device configured to deliver a suture to a surgical site.

12. A method for processing an instrument for surgery, the method comprising:

obtaining the suture tensioning device of claim 1;

sterilizing the suture tensioning device; and

storing the suture tensioning device in a sterile container.

13. A suture locking device, comprising:

a housing member;

a first locking element operably supported within said housing member and having a suture extending therethrough;

a second locking element supported relative to said first locking element and configured to retainingly engage said first locking element upon application of a firing motion to said first locking element to thereby cause a portion of the suture extending through said first locking element to be locked between said first and second locking elements; and

an indicator member supported within said housing member and configured to only be viewable through an external wall thereof when an excessive amount of tension has been applied to the suture material prior to applying the firing motion to said first locking member.

14. The suture locking device of claim 13, further comprising:

a handle; and

a drive cable operably coupled to said handle and said first locking element for applying said firing motion thereto.

15. The suture locking device of claim 14 wherein said drive cable is coupled to said indicator member and wherein said indicator member operably interfaces with said first locking element.

16. The suture locking device of claim 13 further comprising at least one indicator window in said external wall of said housing such that when an excessive amount of tension has been applied to the suture prior to the application of said firing motion, said indicator member is viewable through said at least one indicator window.

17. The suture locking device of claim 16 wherein said indicator member has a color that is readily viewable through said at least one indicator window.

18. The suture locking device of claim 14 wherein said drive cable extends through a catheter extending between said handle and said housing member and wherein said suture locking device comprises a second indicator member interfacing with said drive cable and configured to only be viewable through said catheter adjacent said handle when an excessive amount of tension has been applied to the suture material prior to applying the firing motion to said first locking member.

19. A suture locking device, comprising:

a handle member configured to generate a firing motion;

an elongated catheter extending from said handle member;

a drive cable extending through said elongated catheter and operably interfacing with said handle member for transmitting said firing motion to a first locking element operably coupled thereto, said first locking element having a suture extending therethrough;

a second locking element supported relative to said first locking element and configured to retainingly engage said first locking element upon application of a firing motion to said first locking element to thereby cause a portion of the suture extending through said first locking element to be locked between said first and second locking elements; and

an indicator member supported within said catheter and interfacing with said drive cable, said indicator member configured to only be viewable through an external wall of said catheter when an excessive amount of tension has been applied to the suture material prior to applying the firing motion.

20. A suture application device, comprising:

a handle assembly;

a catheter operably supported by said handle assembly and configured to be operably coupled to an end effector for applying a suture to a surgical site;

a movable tensioning member constrained to move axially within a portion of said handle assembly, said movable tensioning member configured to have a portion of a suture wound therearound such that a distal portion of the suture extends in a distal direction from the movable tensioning member to be anchored to tissue and a proximal portion of the suture protrudes from the movable tensioning member to have tension applied thereto;

a first resilient member for applying a first resistive force to said movable tensioning member in a first direction; and

a second resilient member applying a second resistive force to said movable tensioning member in a second direction that is opposite to said first direction.