Apparatus and method for minimally invasive suturing

• US 20100152751A1
• Filed: 11/20/2009
• Published: 06/17/2010
• Est. Priority Date: 09/20/2004
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: EndoEvolution, LLC
• Inventors: Clark, Richard, DiFrancesco, Francis J., Meade, John C., Griffiths, Jerry R.
• Granted Patent: US 8,123,764 B2
• 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 17/0491 Sewing machines for surgery
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/0625 the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator A61B17/06109 takes precedence
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/34 Trocars; Puncturing needles pointed biopsy instruments A61B10/0233; devices for piercing the ear-lobes A44C7/001; seals or hemostasis valves A61M39/06
• CPC Class Codes: A61B 2017/0023 disposable
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• 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 2017/0474 Knot pushers
• CPC Class Codes: A61B 2017/06028 by means of a cylindrical longitudinal blind bore machined at the suture-receiving end of the needle, e.g. opposite to needle tip
• CPC Class Codes: A61B 2017/0608 J-shaped
• CPC Class Codes: A61B 2017/06085 having a blunt tip
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2943 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2217/007 with irrigation system
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms

Abstract

An apparatus and method for minimally invasive suturing is disclosed. A suturing device for minimally invasive suturing includes proximal section having a proximal end, a distal end, and a longitudinal axis therebetween; a suture head assembly extending from the distal end of the proximal section; a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the proximal section, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle; and an actuator extending from the proximal end of the proximal section to actuate a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Claims

1. A suturing device comprising a suturing head, the suturing head comprising:

a) a needle track housing portion including a needle disposed in a needle track, the needle track being adapted and configured to guide the needle along a curved path about an axis of rotation substantially perpendicular to a longitudinal axis of the suturing head, the needle having;

i) a curved body, the curved body covering an arc greater than about 180°

; and

ii) an engagement surface for driving the needle; and

b) a drive housing portion containing a drive, wherein the drive includes an elongate flexible member, at least a portion of the elongate flexible member being adapted and configured to reciprocate along a direction substantially parallel to the longitudinal axis, the elongate flexible member being further adapted and configured to engage the engagement surface of the needle and advance the needle through a circular arc as the elongate flexible member is advanced along the longitudinal axis in a proximal direction.

2. The device of claim 1, wherein the elongate flexible member is biased to disengage from the engagement surface after advancing the needle along a portion of the needle track.

3. The device of claim 1, wherein the needle track housing portion and drive housing portion are joined along the longitudinal axis of the device.

4. The device of claim 1, wherein the needle track housing portion defines a gap in the needle track for receiving tissue to be sutured by the needle.

5. The device of claim 1, wherein the gap is defined along a lateral edge of the needle track housing portion that is parallel to the longitudinal axis.

6. The device of claim 1, wherein the elongate flexible member includes a distal end having at least one protrusion for engaging with a guide track that follows a path parallel to the needle track.

7. The device of claim 1, wherein the elongate flexible member follows an arcuate path of a first diameter during a first portion of a drive cycle, and follows a second arcuate path of a second, different diameter during a second portion of a drive cycle.

8. The device of claim 1, wherein the elongate flexible member is biased to engage with the engagement surface of the needle after advancing along an arcuate return track.

9. The device of claim 1, wherein the drive is adapted to advance the needle through a 360°

rotation about the axis of rotation in a plurality of drive strokes.

10. The device of claim 9, wherein the drive is adapted to engage a first portion of the needle during a first drive stroke, and engage a second portion of the needle during a second drive stroke.

11. The device of claim 1, wherein the flexible elongate member is adapted and configured to reciprocate at least in part along a curved path proximate the needle.

12. The device of claim 1, wherein the engagement surface includes a notch defined by the curved body.

13. The device of claim 1, wherein the engagement surface for driving the needle is defined on a surface displaced from a radially inner region of the curved body.

14. The device of claim 1, wherein the drive is adapted to advance the needle through a first portion of the needle track out of the housing and into a second portion of the needle track defined in the housing.

15. The device of claim 1, wherein the drive is displaced from a radially inner region of the needle.

16. The device of claim 1, wherein the device defines a bite for receiving tissue, wherein the bite is substantially defined by an area circumscribed by the path of the needle.

17. The device of claim 1, wherein the distal portion of the flexible elongate member follows a path that is parallel to a portion of the needle path.

18. The device of claim 1, wherein the suturing head includes a pawl that is adapted and configured to engage with a portion of the needle to prevent the needle from moving in a desired direction along the needle track.

19. The device of claim 1, wherein the suturing device has a maximum width between about 3 mm and about 20 mm to facilitate introduction of the device into a patient.

20. The device of claim 1, wherein the suturing device has a maximum width of about 12 mm to facilitate introduction of the device into a patient.