SUTURE PASSERS ADAPTED FOR USE IN CONSTRAINED REGIONS

• US 20150313589A1
• Filed: 04/27/2015
• Published: 11/05/2015
• Est. Priority Date: 09/28/2011
• Status: Active Grant

• Current Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Original Assignee: Mark Y. Hirotsuka, Michael J. Hendricksen, Michael Murillo, Stephen J. Peter
• Inventors: HENDRICKSEN, Michael J., MURILLO, Michael, BENDER, Christopher P., HIROTSUKA, Mark Y., PETER, Stephen J.
• Granted Patent: US 10,524,778 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 17/062 Needle manipulators
• 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 2017/00371 Multiple actuation, e.g. pushing of two buttons, or two working tips becoming operational
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• 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 2017/0646 for insertion into cartillege, e.g. meniscus

Abstract

Described herein suture passer apparatus (devices and systems) that may be used to suture tissue within a narrow, confined space. In particular, described herein are suture passers having an elongate body and a bent lower jaw member that houses a tissue penetrator that is adapted to extend laterally through the bend region, and then be laterally deflected from the lower jaw member to a second jaw (e.g. bendable or pivoting) upper member.

Claims

1. A suture passer apparatus adapted for insertion into a knee joint, the apparatus comprising:

an elongate body having a proximal end connected to a proximal handle and a distal end region, wherein the elongate body extends in a long axis;

a lower jaw member extending from the distal end region of the elongate body, the lower jaw including a bend relative to the long axis of the elongate body at a proximal end of the lower jaw, wherein a bottom surface of the lower jaw from the bend to the distal end of the lower jaw is flat and extends in a straight line to a rounded distal end region;

an upper jaw member extending from a distal end region of the elongate body and bendable relative to the elongate body, wherein the upper jaw member bends away from the long axis of the elongate body in a same direction as the bend in the lower jaw member; and

a tissue penetrator housed within the lower jaw member configured to slide distally in the lower jaw member beyond the bend and extend laterally out of the lower jaw member to transfer a loop of suture from the lower jaw member through the upper jaw member.

2. The apparatus of claim 1, wherein the bend is between 5 degrees and 40 degrees relative to the long axis of the elongate body.

3. The apparatus of claim 1, wherein the tissue penetrator is a thin, flat and elongate Nitinol member.

4. The apparatus of claim 1, wherein the lower jaw member is fixed relative to the elongate body.

5. The apparatus of claim 1, wherein the lower jaw member is configured to pivot relative to the elongate body.

6. The apparatus of claim 1, wherein the upper jaw member comprises a suture capture region adapted to receive the loop of suture on the upper jaw when the tissue penetrator is retracted proximally after contacting the upper jaw member.

7. The apparatus of claim 1, wherein the upper jaw comprises a suture capture comprising a clamping member.

8. The apparatus of claim 1, wherein the lower jaw member comprises a deflection surface within the lower jaw member to deflect the tissue penetrator laterally out of the lower jaw member when the tissue penetrator is slid distally.

9. The apparatus of claim 1, wherein the lower jaw member is thinner than a width of the lower jaw member over most of the proximal to distal length of the lower jaw member.

10. A suture passer apparatus adapted for insertion into a knee joint, the apparatus comprising:

an elongate body having a proximal end connected to a proximal handle and a distal end region, wherein the elongate body extends in a long axis;

a lower jaw member extending from the distal end region of the elongate body, the lower jaw including a bend of between 5 degrees and 40 degrees relative to the long axis of the elongate body at a proximal end of the lower jaw, wherein a bottom surface of the lower jaw from the bend to the distal end of the lower jaw is flat and extends in a straight line to a rounded distal end region;

an upper jaw member extending from a distal end region of the elongate body and pivotable relative to the elongate body, wherein the upper jaw member pivots away from the long axis of the elongate body in a same direction as the bend in the lower jaw member; and

an elongate, thin and flat tissue penetrator housed within the lower jaw member configured to slide distally in the lower jaw member beyond the bend and extend a distal tip region laterally out of the lower jaw member to transfer a loop of suture from the lower jaw member and through the upper jaw member.

11. A method of suturing tissue, the method comprising:

loading a loop of suture into a lower jaw member of a suture passer, wherein the suture passer comprises an elongate body extending in a long axis, an upper jaw pivotally connected relative to the lower jaw, wherein the lower jaw member extends from a distal end region of the elongate body, the lower jaw including a bend relative to the long axis of the elongate body at a proximal end of the lower jaw, wherein a bottom surface of the lower jaw from the bend to the distal end of the lower jaw is flat and extends in a straight line to a rounded distal end region;

positioning a target tissue in between the lower jaw and the upper jaw;

closing the first jaw towards the second jaw to at least partially clamp the target tissue between the first jaw and the second jaw; and

pushing a distal end region of a tissue penetrator from within the lower jaw to deflect laterally out of the lower jaw through the target tissue and through the upper jaw, wherein the distal end region of the tissue penetrator is carrying the loop of suture.

12. The method of claim 11, wherein positioning the target tissue in between the lower jaw and the upper jaw comprises positioning a torn knee meniscus between the lower jaw and the upper jaw.

13. The method of claim 11, wherein positioning the target tissue in between the lower jaw and the upper jaw comprises sliding the lower jaw under an inferior surface of a knee meniscus and placing the upper jaw against the superior surface of the knee meniscus.

14. The method of claim 11, wherein loading the loop of suture into the lower jaw member of the suture passer comprises loading the loop of suture into the distal end of the tissue penetrator.

15. The method of claim 11, wherein closing the first jaw towards the second jaw comprises squeezing a first control on a proximal handle of the suture passer.

16. The method of claim 15, wherein pushing the distal end region of the tissue penetrator from within the lower jaw to deflect laterally out of the lower jaw through the target tissue and through the upper jaw comprises squeezing a second control on the proximal handle of the suture passer.

17. The method of claim 11, wherein pushing the distal end region of the tissue penetrator from within the lower jaw to deflect laterally out of the lower jaw through the target tissue and through the upper jaw comprises retaining a proximal portion of the tissue penetrator within the lower jaw as the distal end region is extended through the upper jaw.

18. The method of claim 11, further comprising stripping the loop of suture from the tissue penetrator and retaining the loop of suture on the upper jaw after retracing the tissue penetrator back into the lower jaw.

19. The method of claim 11, wherein pushing the distal end region of the tissue penetrator from within the lower jaw to deflect laterally out of the lower jaw through the target tissue and through the upper jaw comprises pushing the distal end region of the tissue penetrator against a clamping mechanism in the upper jaw as the distal end region is extended through and out of the upper jaw.

20. The method of claim 11, further comprising releasing the loop of suture from the suture passer as the suture passer is removed from the tissue.