SUTURING DEVICES AND METHODS

• US 20100174296A1
• Filed: 01/07/2009
• Published: 07/08/2010
• Est. Priority Date: 01/07/2009
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Vakharia, Omar J., Zwolinski, Andrew M.
• Granted Patent: US 8,317,827 B2
• Time in Patent Office: Days
• US Class Current: 606/144
• 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 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

Methods and devices are provided for delivering a preloaded loop of suture extending from a knotting element to tissue to be ligated within a body. The knotting element can be threaded with a loop of suture and loaded onto a deployment device using a loading device. A protective sheath can be placed around the knotting element and the loop of suture to facilitate safe insertion of the loop of suture through a working channel of a minimally invasive device.

Claims

1. A tissue ligation system, comprising:

a deployment device having a knotting element coupled thereto;

a strand of suture passed through the knotting element to form a loop extending from the knotting element; and

a sheath slidably disposed over the deployment device, the knotting element, and the loop.

2. The system of claim 1, wherein the loop extends from a distal end of the knotting element and the deployment device is coupled to a proximal end of the knotting element.

3. The system of claim 1, wherein a size of the loop extending from the knotting element is adjustable relative to the knotting element.

4. The system of claim 3, wherein the size of the loop extending from the knotting element is increasable.

5. The system of claim 1, wherein the loop is configured to be placed around tissue and tightened to ligate tissue.

6. The system of claim 1, wherein the loop is bendable out of a plane containing the loop to reorient the loop to better receive tissue therethrough.

7. The system of claim 1, wherein the knotting element includes an inner member and an outer member slidably movable relative to the inner member.

8. The system of claim 7, wherein the inner member and the outer member are moveable between an open configuration in which the strand of suture is freely adjustable relative to the knotting element and a locked configuration in which the inner and outer members engage the strand of suture therebetween.

9. The system of claim 7, wherein the inner and outer members are positioned substantially concentrically to grip the strand of suture in the locked configuration.

10. The system of claim 8, wherein the deployment device is configured to move the knotting element to the locked position.

11. The system of claim 1, wherein the sheath is configured to protect the loop of suture during delivery through tissue.

12. The system of claim 1, wherein the sheath is retractable from around the loop of suture.

13. A method for deploying a suture locking device, comprising:

positioning a knotting element and a loop of suture extending from the knotting element in a delivery sheath;

inserting the delivery sheath through tissue; and

retracting the delivery sheath from around the loop of suture.

14. The method of claim 13, further comprising positioning the loop of suture around tissue to be ligated and deploying the knotting element to engage the loop of suture.

15. The method of claim 14, wherein positioning the loop of suture comprises manipulating the loop of suture to position the loop of suture around tissue.

16. The method of claim 14, wherein positioning the loop of suture comprises pulling tissue to be ligated through the loop of suture and deploying the knotting element to engage the loop of suture.

17. The method of claim 13, wherein positioning the knotting element comprises advancing the delivery sheath over a deployment device having the knotting element coupled to a distal end thereof.

18. The method of claim 17, further comprising, prior to positioning, threading the suture through the knotting element and loading the knotting element onto the deployment device using a loading device.

19. The method of claim 14, further comprising activating a deployment device to deploy the knotting element to engage the suture.

20. The method of claim 19, further comprising, prior to activating, advancing the knotting element along the suture to engage the tissue with the loop of suture.

21. The method of claim 20, further comprising releasing the knotting element from the deployment device and reloading a second knotting element with a suture loop extending therefrom onto the deployment device using the loading device.

22. The method of claim 13, further comprising increasing a size of the loop of suture.

23. The method of claim 13, further comprising bending the loop of suture out of a plane containing the loop of suture to better orient the loop of suture to receive tissue therethrough.

24. The method of claim 13, wherein the delivery sheath is inserted through a working channel of a minimally invasive device.

25. A loading device, comprising:

a housing having a suture loading portion for loading a loop of suture into a knotting element and a knot loading portion for loading the knotting element onto a delivery device for delivering the knotting element and the loop of suture through tissue.

26. The device of claim 25, wherein the suture loading portion includes a single thread of suture and a suture loading wheel.

27. The device of claim 25, wherein the knot loading portion includes a port for receiving the delivery device to be loaded with the knotting element loaded with a loop of suture.

28. A kit, comprising:

a loading device having a knotting element disposed therein and a strand of suture disposed therein configured to be threaded through the knotting element; and

a delivery device configured to receive the knotting element with suture threaded therethrough and to deliver the knotting element and suture through tissue.

29. The kit of claim 28, wherein the delivery device includes a deployment device for deploying the knotting element to engage the suture, and a sheath disposed over the deployment device.