AUTOMATICALLY RELOADING SUTURE PASSER DEVICES AND METHODS

• US 20150196294A1
• Filed: 12/16/2014
• Published: 07/16/2015
• Est. Priority Date: 12/16/2013
• Status: Active Grant

• Current Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Original Assignee: Michael J. Hendricksen, Michael Murillo, Yoav Ben-Haim
• Inventors: MURILLO, Michael, HENDRICKSEN, Michael J., BEN-HAIM, Yoav
• Granted Patent: US 9,492,162 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/0053 Loading magazines or sutures into applying tools
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/06047 located at the middle of the needle
• CPC Class Codes: A61B 2017/06095 pliable
• CPC Class Codes: A61B 2017/2933 camming or guiding means
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument

Abstract

Suture passers and methods of use. Described herein are suture passers preloaded with suture, including cartridges that couple to a suture passer to form a loaded suture passer; the suture passer may be operated to pass one or more lengths of suture without having to be manually reloaded. In particular, described herein are preloaded and automatically reloading apparatuses typically.

Claims

1. A replaceable jaw cartridge that is preloaded with suture, for use with a suture passer device, the jaw cartridge comprising:

a jaw housing configured to releasably engage the suture passer device;

a tissue penetrator configured to slide distally and proximally within the jaw housing;

a suture within the jaw housing, the suture comprising a first bight region loaded in a suture engagement region at a distal end region of the tissue penetrator, and a second bight region loaded in a suture holding region within the jaw housing; and

a releasable hold on the tissue penetrator that releasably secures a first end region of the suture against the tissue penetrator;

wherein the releasable hold is configured to hold the portion of the suture between the first end portion and the second bight region in tension when the tissue penetrator is withdrawn proximally so that the second bight region is loaded into the suture engagement region after the first bight region has been removed from the suture engagement region.

2. The jaw cartridge of claim 1, further comprising a deflection surface near an exit through the jaw housing, wherein the deflection surface is configured to deflect the tissue penetrator away from the jaw housing as the tissue penetrator slides distally out of the exit.

3. The jaw cartridge of claim 1, wherein the jaw housing is configured to completely enclose the suture and tissue penetrator until the tissue penetrator is extended from the jaw housing.

4. The jaw cartridge of claim 1, wherein the jaw housing comprises a keyed connector configured for coupling with an elongate member of the suture passer device.

5. The jaw cartridge of claim 1, wherein the suture holding region comprises a notched region between the tissue penetrator and an inner surface of the jaw housing.

6. The jaw cartridge of claim 1, wherein the suture holding region is configured to hold the first bight region within the housing so that the tissue penetrator can move relative to the suture holding region.

7. The jaw cartridge of claim 1, wherein the suture holding region is positioned opposite from the suture engagement region of the tissue penetrator when the tissue penetrator is withdrawn proximally within the jaw housing.

8. The jaw cartridge of claim 1, wherein the first bight region comprises a bend in the suture near a distal end of the suture and the second bight region comprises a bend in the suture near the proximal end of the suture.

9. The jaw cartridge of claim 1, wherein the releasable hold comprises one or more of:

a sled, an O-ring, a clip, a friction releasable hold, a band, a clamp, a frangible hold, a wax hold, and a releasable adhesive.

10. The jaw cartridge of claim 1, wherein the releasable hold comprises a sled configured to couple with the tissue penetrator to facilitate sliding of the tissue penetrator within the jaw cartridge and to hold the first end region of the suture against the tissue penetrator.

11. The jaw cartridge of claim 1, further comprising a suture capsule region at the proximal end of the cartridge that is configured to store a portion of the suture.

12. The jaw cartridge of claim 1, further comprising a connector configured to couple the jaw cartridge to the suture passer device and to uncouple the jaw cartridge from the suture passer device.

13. The jaw cartridge of claim 1, further comprising a suture guide within the jaw housing positioned intermediate of the distal end of the jaw housing and the releasable hold.

14. The jaw cartridge of claim 1, wherein the jaw housing is configured to couple to and uncouple from a suture passer to form a sliding lower jaw member on the suture passer so that the tissue penetrator can extend from the jaw housing to an upper jaw member.

15. A replaceable jaw cartridge that is preloaded with suture, for use with a suture passer device, the jaw cartridge comprising:

an elongate jaw housing from a distal end to a proximal end in a first axis;

a keyed region of the jaw housing configured to releasably engage the suture passer device;

a tissue penetrator configured to slide distally and proximally within the jaw housing;

an exit through the jaw housing near the distal end from which the distal tip of the tissue penetrator may extend;

a deflection surface near the exit configured to deflect the tissue penetrator away from the first axis as it slides distally to extend from the exit;

a suture within the jaw housing, the suture comprising a first bight region loaded in a suture engagement region at a distal end region of the tissue penetrator, and a second bight region loaded in a suture holding region within the jaw housing; and

a releasable hold on the tissue penetrator that releasably secures a first end region of the suture against the tissue penetrator and is configured to slide with the tissue penetrator;

wherein the releasable hold is configured to hold the portion of the suture between the first end portion and the second bight region in tension when the tissue penetrator is withdrawn proximally so that the second bight region is loaded into the suture engagement region after the first bight region has been removed from the suture engagement region.

16. The jaw cartridge of claim 15, wherein the keyed region comprises a keyed connector configured for coupling within a track region of an elongate member of the suture passer device.

17. The jaw cartridge of claim 15, wherein the jaw housing is configured to completely enclose the suture and tissue penetrator until the tissue penetrator is extended from the jaw housing.

18. The jaw cartridge of claim 15, wherein the suture holding region comprises a notched region between the tissue penetrator and an inner surface of the jaw housing.

19. The jaw cartridge of claim 15, wherein the suture holding region is positioned opposite from the suture engagement region of the tissue penetrator when the tissue penetrator is withdrawn proximally within the jaw housing.

20. The jaw cartridge of claim 15, wherein the releasable hold comprises one or more of:

a sled, an O-ring, a clip, a friction releasable hold, a band, a clamp, a frangible hold, a wax hold, and a releasable adhesive.

21. The jaw cartridge of claim 15, wherein the releasable hold comprises a sled configured to couple with the tissue penetrator to facilitate sliding of the tissue penetrator within the jaw cartridge and to hold the first end region of the suture against the tissue penetrator.

22. The jaw cartridge of claim 15, further comprising a connector configured to couple the jaw cartridge to the suture passer device and to uncouple the jaw cartridge from the suture passer device.

23. The jaw cartridge of claim 15, further comprising a suture guide within the jaw housing positioned intermediate of the distal end of the jaw housing and the releasable hold.

24. The jaw cartridge of claim 15, wherein the jaw housing is configured to couple to and uncouple from a suture passer to form a sliding lower jaw member on the suture passer so that the tissue penetrator can extend from the jaw housing to an upper jaw member.

25. The jaw cartridge of claim 15, wherein the first bight region is located near a distal end of the suture and the second bight region is located near the proximal end of the suture.

26. The jaw cartridge of claim 15, further comprising a suture capsule region storing a portion of the suture extending between the first and second bights.

27. A suture passer system with a preloaded suture, the system comprising:

an elongate body extending distally and proximally;

a first jaw coupled to a distal end of the elongate body; and

a second jaw, wherein the second jaw houses;

a tissue penetrator configured to slide distally and proximally within the second jaw,

a suture within the second jaw, the suture comprising a first bight region loaded in a suture engagement region at a distal end region of the tissue penetrator, and a second bight region loaded in a suture holding region within the second jaw, and

a releasable hold on the tissue penetrator configured to hold a first end portion of the suture in tension when the tissue penetrator is withdrawn proximally so that the second bight region is drawn into the suture engagement region after the first bight region has been removed.

28. A method of operating a suture passer that is preloaded with a suture, the method comprising:

coupling a jaw cartridge to an elongate body of the suture passer, wherein the suture passer includes a first jaw pivotally coupled to a distal end region of the elongate body, further wherein the jaw cartridge comprises a second jaw;

forming a distal-facing opening between the first jaw and the second jaw by sliding the second jaw distally relative to the elongate body;

extending a distal tip of a tissue penetrator from within the second jaw and across the distal-facing opening, wherein the tissue penetrator comprises a suture engagement region that is preloaded with a first bight region of the suture;

holding the first bight region with the first jaw and retracting the distal tip of the tissue penetrator into the second jaw;

withdrawing the tissue penetrator distally within the second jaw to apply tension to the suture between an end region of the suture that is held by a releasable hold on the tissue penetrator and a second bight region of the suture, so that the second bight region is drawn into the suture engagement region of the tissue penetrator; and

extending the distal tip of the tissue penetrator from the second jaw and across the distal-facing opening, wherein the tissue penetrator is carrying the second bight region of the suture.

29. The method of claim 28, wherein coupling the jaw cartridge comprises engaging a housing engagement region on the cartridge to the elongate body of the suture passer to slideably couple the cartridge to the elongate body.