LAPAROSCOPIC SURGICAL SYSTEM

• US 20130103057A1
• Filed: 04/13/2011
• Published: 04/25/2013
• Est. Priority Date: 04/13/2010
• Status: Active Grant

• Current Assignee: Sharp Fluidics, LLC
• Original Assignee: Neosurgical Limited
• Inventors: Keating, Ronan, Rabbitte, Gerard, Russell, Barry
• Granted Patent: US 9,775,601 B2
• Time in Patent Office: Days
• US Class Current: 606/146
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• 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 17/06061 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 17/06128 Elongate cylinders, i.e. tubes
• 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 17/3496 Protecting sleeves or inner probes; Retractable tips for protecting body piercing guide needles A61M25/0612
• 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 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/3441 with distal sealing means
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments

Abstract

A laparoscopic port closure device is described. The device allows for the deployment of a suture internally into an abdominal wall and the subsequent use of that deployed suture to effect a closing of the wound that was used for the port. The deployed suture may be used during the surgical procedure to effect a securing or anchoring of the device.

Claims

1. A suture closure system comprising:

a housing defining a lumen for receipt of surgical instrumentation;

the housing further comprising a first needle guide channel and a second needle guide channel provided on opposite sides of the lumen respectively, each of the needle guide channels having an entry port for receiving a needle driver and an exit port through which a suture may exit the housing, the entry and exit ports for each needle wide channel being provided on the same side of the lumen, the guide channels providing a convex surface proximal to the lumen such that the suture will exit away from the lumen on being displaced out of the needle guide channel.

2. The system of claim 1 wherein the lumen is dimensioned for receiving a trocar.

3. The system of claim 1 configured for engagement with an aperture provided in an abdominal wall, the housing comprising an abdominal wall piercing or engaging portion and an outer resting portion which in use will rest against an outer surface of the abdominal wall

4. The system of claim 1 wherein the housing is provided in a multi-part construction comprising first and second parts that are co-operable with one another to encapsulate a third central part.

5. The system of claim 4 wherein the third part comprises a shoulder element that is seatable within a channel provided in inner surfaces of each of the first and second parts.

6. The system of claim 5 wherein on bringing the first and second parts together the channel defines a continuous surface that extends circumferentially about the third part retaining the shoulder therein and restricting vertical movement of the third part relative to the first and second parts.

7. The system of claim 3 wherein each of the guide channels comprise an entry and an exit port, the entry port being positioned above the abdominal wall engaging surface and exit port is provided within the abdominal wall engaging portion.

8. The system of claim 1 comprising a suture securement feature for securing a suture relative to the housing.

9. The system of claim 8 when dependent on claim 4 wherein the suture securement feature comprises two opposing faces formed in each of the first and second parts which when brought together form a cleat.

10. The system of claim 3 wherein the abdominal wall engaging surface comprises first and second cut-away portions provided in faces transverse to the exit ports of the needle guide channels, the cut away portions defining a tissue invagination zone within the abdominal wall engaging portion into which tissue may extend inwardly towards the lumen.

11. The system of claim 1 when dependent on claim 3 wherein the abdominal wall engaging portion comprises a sealing surface which provides a curved surface extending circumferentially about the housing and which in use is located against the abdominal wall.

12. The system of claim 11 wherein the sealing surface is an arcuate curved surface which operably presents a concave surface to the skin against which it contacts, under a compressive force provided by tightened sutures, thereby sealing against the skin.

13. The system of claim 1 wherein the housing defines an O-ring channel within the lumen, the O-ring channel providing a seat for an O-ring whose dimensions are selected to provide a compression fit against inserted surgical instrumentation such that on providing the surgical instrumentation through the lumen its outer surface will compress against a retained o-ring thereby sealing the lumen.

14. The system of claim 1 wherein the housing is integrated into a trocar, the trocar defining the lumen through which a presented obturator may pass.

15. The system of claim 14 wherein the lumen comprises a slit seal which operably secures against the outer surface of the obturator once it is presented within the lumen.

16. The system of claim 1 comprising a spool with suture provided therein, the suture being operably coupled to a needle, the needle operably being deployable with a resultant extension of the suture from its spool, movement of the spool enabling a change in tension on the suture.

24. The system of claim 1 wherein the needle guide channels are tapered such that a needle will exit at a fixed angle, preferably between 5 and 30°

, or more preferably between 10 and 20°

.

25. The system of claim 1 comprising a needle driver by which an operator may operably apply a downward pressure onto a needle.

26. The system of claim 1 wherein the exit port is located such that operably a needle will pass into a subcutaneous layer of the abdominal wall on exiting the needle guide channel.

36. The system of claim 1 wherein the lumen is at least partially filled with or formed from an elastomeric material which provides for a sealing of an abdominal cavity during surgical procedures.

37. The system of claim 36 wherein the material is a polyurethane hydrogel that is configured to expand on exposure to a saline solution so as to both provide lubrication and improved seal.

39. The system of claim 36 comprising at least one slit in the elastomeric material to allow passage of surgical devices through the olive into the abdominal cavity.

40. The system of claim 39 comprising first and second slits of different dimensions, each slit being associated with a different surgical device.

45. The system of claim 1 wherein the housing is configured to receive at least one insufflation port.

46. The system of claim 45 wherein the housing is configured to direct a high pressure source of air from the at least one insufflation port to generate a screen of air across the lumen defined within the housing to create a pressure barrier across the lumen that may prevent the passage of ambient air inwardly into the abdominal cavity.

47. The system of claim 1 wherein the housing comprises a helical or ribbed cone element which is at least partially semi-rigid.

51. The system of claim 1 comprising a trocar, the trocar being receivable into an abdominal cavity through the lumen.

52. The system of claim 51 comprising a needle driver is coupled to the trocar.

53. The system of claim 52 wherein the needle driver is removably attachable to a shaft portion of the trocar.

54. The system of claim 52 wherein the needle driver is receivable through a head portion of the trocar.

129. A laparoscopic surgical method comprising:

a. making an incision and providing a system as claimed in claim 1;

b. providing the surgical instrument through the lumen of the housing;

c. inserting the combined surgical instrument and housing assembly into the incision;

d. insufflating the abdomen;

e. using a needle driver to drive suture needles inside the abdominal cavity, and then withdrawing the needle drivers;

f. anchoring the housing by tautening the sutures, and drawing the needles flush against the peritoneum, at which point the suture is locked;

g. completing the required surgery, at the end of which the housing is removed by unlocking the suture and lifting it away from the abdominal wall; and

h. tying one or multiple knots in the suture pushing the knot subcutaneously.

17-23. -23. (canceled)

27-35. -35. (canceled)

38. (canceled)

41-44. -44. (canceled)

48-50. -50. (canceled)

55-128. -128. (canceled)