Endoscopic suturing device and related method and suture

• US 5,037,433 A
• Filed: 05/17/1990
• Issued: 08/06/1991
• Est. Priority Date: 05/17/1990
• Status: Expired due to Term

• Current Assignee: David Sekons, Peter J. Wilk
• Original Assignee: David Sekons, Peter J. Wilk
• Inventors: Wilk, Peter J., Sekons, David
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Jackson, Gary
• Application Number:
  US07/525,253
• Time in Patent Office: 446 Days
• Field of Search: 606/139, 606/144, 606/147, 606/148, 606/219, 606/222
• US Class Current: 606/139
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/0619 thermoplastic, e.g. for bonding, welding, fusing or cutting the suture by melting it suture cutters A61B17/0467; ultrasonic cutters A61B17/320068; electrically heated instruments A61B18/08

Abstract

An endoscopic suturing device comprises an endoscope and a needle having a spring bias construction tending to bend the needle into an arcuate configuration. The endoscope includes an elongate flexible outer tubular member and a biopsy channel extending longitudinally through the tubular member. A flexible inner tubular member is disposed inside the biopsy channel of the outer tubular member, while the needle is disposed in a straightened configuration at least part partially inside the inner tubular member at a distal end thereof. The surgical instrument further comprises an ejector device in the form of an elongate flexible rod member slidably disposed inside the inner tubular member proximally of the needle for ejecting the needle from the inner tubular member. A suture is provided with an end attached to a proximal end of the needle, while a closure device in the form of a forceps is provided for closing the suture upon an ejection of the needle from the biopsy channel by a distally directed motion of the rod member and a subsequent assumption by the needle of the arcuate configuration.

Claims

1. A surgical instrument comprising:

an endoscope including an elongate flexible outer tubular member and a biopsy channel extending longitudinally through said tubular member;

an elongate flexible rod member slidably disposed inside said biopsy channel;

a needle having a spring bias construction tending to bend said needle into an arcuate configuration, said needle being disposed in a straightened configuration at least partially inside said biopsy channel distally of a distal end of said rod member;

a suture having an end attached to a proximal end of said needle; and

means for closing said suture upon an ejection of said needle from said biopsy channel by a distally directed motion of said rod member and a subsequent assumption by said needle of said arcuate configuration.

2. The surgical instrument set forth in claim 1, further comprising an elongate flexible inner tubular member slidably disposed in said biopsy channel, said rod member being slidably disposed inside said inner tubular member, said needle being disposed in a straightened configuration at least partially inside said inner tubular member distally of a distal end of said rod member.

3. The surgical instrument set forth in claim 2 wherein said biopsy channel includes a pair of parallel elongate main channel portions communicating with one another along their lengths via an elongate connecting channel portion.

4. The surgical instrument set forth in claim 3 wherein said inner tubular member is slidably disposed in one of said main channel portions.

5. The surgical instrument set forth in claim 4 wherein said means for closing includes an elongate flexible forceps member slidably disposed in the other of said main channel portions.

6. The surgical instrument set forth in claim 5 wherein said suture includes a loop member traversed by said elongate flexible forceps member, said suture further including a thread member attached at one end to said needle and at an opposite end to said loop member, said thread member traversing said connecting channel portion.

7. The surgical instrument set forth in claim 6, further comprising means for locking said suture upon closure thereof by said means for closing.

8. The surgical instrument set forth in claim 6 wherein said means for locking includes a series of projections provided along said thread member and an aperture in said suture communicating with an opening defined by said loop member, said thread member having an outer diameter defined by said projections, said opening having a linear dimension substantially larger than said outer diameter, said aperture having a linear dimension smaller than said outer diameter, said means for locking further including means on said suture for preventing a removal of said thread member from said aperture upon a passing of said thread member through said loop member and a subsequent pulling of said thread member into said aperture from said loop member.

9. The surgical instrument set forth in claim 5 wherein said rod member, said inner tubular member, said forceps member, and said main channel portions are all substantially cylindrical.

10. The surgical instrument set forth in claim 2, further comprising arrest means for preventing said rod member from moving more than a predetermined distance in a distal direction relative to said inner tubular member.

11. The surgical instrument set forth in claim 10 wherein said arrest means includes a shoulder on said rod member engageable with a shoulder internal to said inner tubular member.

12. The assembly set forth in claim 1 wherein said arrest means includes a shoulder on said rod member engageable with a shoulder internal to said tubular member.

13. The surgical instrument set forth in claim 1, further comprising means for severing a portion of said suture upon a closing thereof.

14. The surgical instrument set forth in claim 13 wherein said means for severing includes a laser device with an optical fiber insertable through a longitudinal opening in said outer tubular member.

15. A surgical suturing assembly comprising:

an elongate flexible tubular member having a diameter sufficiently small so that said tubular member is slidably insertable into a biopsy channel extending longitudinally through a flexible tubular endoscope member;

an elongate flexible rod member slidably disposed inside said elongate flexible tubular member;

a needle having a spring bias construction tending to bend said needle into an arcuate configuration, said needle being disposed in a straightened configuration at least partially inside said tubular member distally of a distal end of said rod member; and

a suture having an end attached to a proximal end of said needle.

16. The assembly set forth in claim 15, further comprising means for closing said suture upon an ejection of said needle from said tubular member by a distally directed motion of said rod member and a subsequent assumption by said needle of said arcuate configuration.

17. The assembly set forth in claim 16 wherein said means for closing includes an elongate flexible forceps member.

18. The assembly set forth in claim 17 wherein said suture includes a loop member traversed by said elongate flexible forceps member, said suture further including a thread member attached at one end to said needle and at an opposite end to said loop member.

19. The assembly set forth in claim 18, further comprising means for locking said suture upon closure thereof by said means for closing.

20. The assembly set forth in claim 19 wherein said means for locking includes a series of projections provided along said thread member and an aperture in said suture communicating with an opening defined by said loop member, said thread member having an outer diameter defined by said projections, said opening having a linear dimension substantially larger than said outer diameter, said aperture having a linear dimension smaller than said outer diameter, said means for locking further including means on said suture for preventing a removal of said thread member from said aperture upon a passing of said thread member through said loop member and a subsequent pulling of said thread member into said aperture from said loop member.

21. The assembly set forth in claim 15 wherein said rod member and said tubular member are cylindrical.

22. The assembly set forth in claim 15, further comprising arrest means for preventing said rod member from moving more than a predetermined distance in a distal direction relative to said tubular member.

23. A surgical instrument comprising:

an endoscope including an elongate flexible outer tubular member and a biopsy channel extending longitudinally through said tubular member;

a needle having a spring bias construction tending to bend said needle into an arcuate configuration, said needle being disposed in a straightened configuration at least partially inside said biopsy channel at a distal end thereof;

means for ejecting said needle from said biopsy channel;

a suture having an end attached to a proximal end of said needle; and

means for closing said suture upon an ejection of said needle from said biopsy channel by a distally directed motion of said rod member and a subsequent assumption by said needle of said arcuate configuration.

24. The surgical instrument set forth in claim 23 wherein said means for ejecting includes an elongate flexible rod member slidably disposed inside said biopsy channel.

25. The surgical instrument set forth in claim 24 wherein said means for ejecting further includes an elongate flexible inner tubular member slidably disposed in said biopsy channel, said rod member being slidably disposed inside said inner tubular member, said needle being disposed in a straightened configuration at least partially inside said inner tubular member distally of a distal end of said rod member.

26. The surgical instrument set forth in claim 23 wherein said means for closing includes an elongate flexible forceps member slidably disposed in said endoscope.

27. The surgical instrument set forth in claim 26 wherein said suture includes a loop member traversed by said elongate flexible forceps member, said suture further including a thread member attached at one end to said needle and at an opposite end to said loop member.

28. The surgical instrument set forth in claim 23, further comprising means for locking said suture upon closure thereof by said means for closing.

29. The surgical instrument set forth in claim 28 wherein said means for locking includes a series of projections provided along said thread member and an aperture in said suture communicating with an opening defined by said loop member, said thread member having an outer diameter defined by said projections, said opening having a linear dimension substantially larger than said outer diameter, said aperture having a linear dimension smaller than said outer diameter, said means for locking further including means on said suture for preventing a removal of said thread member from said aperture upon a passing of said thread member through said loop member and a subsequent pulling of said thread member into said aperture from said loop member.

30. The surgical instrument set forth in claim 23, further comprising means for severing a portion of said suture upon a closing thereof.

31. A suture device comprising:

a thread member provided along at least a portion of its length with a series of resilient projections, said thread member having an outer diameter defined by said projections;

a loop member defining an opening having a linear dimension substantially larger than said outer diameter; and

joining means for connecting one end of said thread member to said loop member, at least one of said joining means and said loop member defining at least in part an aperture having a linear dimension smaller than said outer diameter, said aperture communicating with said opening defined by said loop;

locking means, provided on at least one of said joining means and said loop member, for preventing a removal of said thread member from said aperture upon a passing of said thread member through said loop member and a subsequent pulling of said thread member into said aperture from said loop member; and

a needle having a spring bias construction tending to bend said needle into an arcuate configuration, said needle having a sharp end and being attached at an opposite end to a free end of said thread member.

32. The suture device set forth in claim 31 wherein said aperture is formed on said loop member at a point therealong spaced from said joining means.

33. The suture device set forth in claim 31 wherein said locking means includes at least one protuberance on said loop.

34. The suture device set forth in claim 33 wherein said protuberance projects towards said aperture.

35. The suture device set forth in claim 34 wherein said protuberance is undercut on a side facing said aperture.

36. The suture device set forth in claim 31 wherein said joining means comprises a Y-shaped connector piece between said one end of said thread member and said loop member.

37. The suture device set forth in claim 31 wherein said projections are tapered from a larger transverse dimension down towards an end of said thread member opposite said joining means.

38. The suture device set forth in claim 31 wherein said projections are substantially hollow.

39. A suture device comprising:

a thread member provided along at least a portion of its length with a series of resiliently collapsible projections, said thread member having an outer diameter defined by said projections;

a loop member defining an opening having a linear dimension substantially larger than said outer diameter;

joining means for connecting one end of said thread member to said loop member, at least one of said joining means and said loop member defining at least in part an aperture having a linear dimension smaller than said outer diameter, said aperture communicating with said opening defined by said loop;

locking means, provided on at least one of said joining means and said loop member, for preventing a removal of said thread member from said aperture upon a passing of said thread member through said loop member and a subsequent pulling of said thread member into said aperture from said loop member; and

a needle having a spring bias construction tending to bend said needle into an arcuate configuration, said needle having a sharp end and being attached at an opposite end to a free end of said thread member.

40. The suture device set forth in claim 39 wherein said projections are collapsible under force applied along said thread member in one direction and expandable under force applied along said thread member in an opposite direction.

41. The suture device set forth in claim 40 wherein said projections are substantially hollow conical elements.

42. A surgical needle having a spring bias construction tending to bend said needle into an arcuate configuration, said needle being bendable into a straightened configuration, said needle having a sharp tip at one end, said needle being provided at an opposite end with means for attaching said needle to a suture.

43. A method for performing a surgical operation on internal body tissues of a patient, comprising the steps of:

inserting a tubular endoscope member through an aperture in the patient'"'"'s body;

using said endoscope to visually locate the internal body tissues inside the patient'"'"'s body;

upon locating said surgical site, pushing an elongate flexible rod member in a distal direction through a biopsy channel in said tubular endoscope member to eject a needle disposed in a straightened configuration inside said channel at a distal end of said tubular endoscope member, said needle having a spring bias construction tending to bend said needle into an arcuate configuration, said needle having a proximal end attached to a suture;

upon ejection of said needle from said channel, passing said needle in said arcuate configuration through the internal body tissues;

upon passing of said needle through the internal body tissues, closing said suture; and

upon closure of said suture, withdrawing said tubular endoscope member out of the patient'"'"'s body though said aperture.

44. The method set forth in claim 43 wherein said needle has a sharp end opposite said proximal end and wherein said suture has a thread member and a loop member attached to said thread member at an end thereof opposite said needle, said step of closing comprising the steps of grasping said sharp end and pulling said needle and a portion of said thread member through said loop member.

45. The method set forth in claim 44 wherein said step of grasping includes the step of operating a forceps device.

46. The method set forth in claim 45 wherein said step of pulling comprises the step of pulling a portion of said forceps device through said loop member.

47. The method set forth in claim 43, further comprising the step of locking said suture in a closed configuration upon closure of said suture.

48. The method defined in claim 43 wherein said aperture is a natural body opening.

49. The method defined in claim 43, further comprising the step of piercing the patient'"'"'s body to form said aperture.

50. The method defined in claim 49 wherein said step of piercing is performed by using a trocar.

51. A surgical instrument comprising:

an endoscope including an elongate flexible outer tubular member and a first biopsy channel and a second biopsy channel both extending longitudinally through said tubular member, said outer tubular member being formed with an elongate connecting channel connecting said first biopsy channel to said second biopsy channel along their lengths;

a suture device comprising

a thread member provided along at least a portion of its length with a series of resilient projections, said thread member having an outer diameter defined by said projections;

a loop member defining an opening having a linear dimension substantially larger than said outer diameter; and

joining means for connecting one end of said thread member to said loop member, at least one of said joining means and said loop member defining at least in part an aperture having a linear dimension smaller than said outer diameter, said aperture communicating with said opening defined by said loop;

locking means, provided on at least one of said joining means and said loop member, for preventing a removal of said thread member from said aperture upon a passing of said thread member through said loop member and a subsequent pulling of said thread member into said aperture from said loop member; and

a first elongate flexible member slidably inserted in said first biopsy channel, said first elongate flexible member including holding means at a distal end for holding said thread member of said suture device; and

a second elongate flexible member slidably inserted in said second biopsy channel, said second elongate flexible member being provided at a distal end with grasping means for grasping a free end of said thread member upon a moving of at least an end portion of said thread member out from said first biopsy channel upon a distally directed motion of said first elongate flexible member,

said loop member being traversed in said second biopsy channel by said second elongate flexible member, said thread member extending from said loop member through said connecting channel to said first biopsy channel.