Surgical instrument for tying a knot in a length of suture at a remote location

• US 5,391,176 A
• Filed: 06/02/1993
• Issued: 02/21/1995
• Est. Priority Date: 06/02/1993
• Status: Expired due to Term

• Current Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Original Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Inventors: de la Torre, Roger
• Primary Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/071,297
• Time in Patent Office: 629 Days
• Field of Search: 606/1, 606/139, 606/144, 606/147, 606/148, 606/145, 112/169, 112/80.03
• US Class Current: 606/148
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures

Abstract

A surgical instrument and its method of use facilitate tying of a knot in a length of suture material at a remote surgical location. The instrument is comprised of a rod having a slot at one end and a length of suture wrapped over the rod and slot in a particular pattern. A needle is secured to a free end of the suture and the pattern of wrapping the suture on the rod enables loops of suture to move off the rod end and over the needle to form a throw of a knot in the suture.

Claims

1. A method of tying a surgical knot in a length of suture at a remote surgery location using a surgical instrument comprising a rod having opposite first and second ends with a slot formed in the first end, and a length of suture with opposite first and second ends wrapped in a plurality of loops around the first end of the rod, the second end of the suture extending to adjacent the second end of the rod and the first end of the suture having a needle secured thereto, the method comprising the steps of:

positioning the rod first end and the needle proximate to the surgery location by manual manipulation of the second end of the rod;

passing the needle and the attached first end of the suture through the surgery location and thereby forming a stitch through the location;

passing the needle and the attached first end of the suture into the slot in the rod first end and beneath a first loop of suture on the rod;

pulling the needle and the attached first end of the suture out of the slot and away from the rod first end, thereby causing the first loop to be pulled off the rod first end and forming a first throw of a knot in the suture at the stitch;

passing the needle and the attached first end of the suture into the slot in the rod first end and beneath a second loop of suture on the rod; and

pulling the needle and the attached first end of the suture out of the slot and away from the rod first end, thereby causing the second loop to be pulled off the rod first end and forming a second throw of a know in the suture at the stitch.

2. The method of claim 1, further comprising the step of:

passing the needle and the attached first end of the suture into the slot in the rod first end and beneath a third loop of suture on the rod; and

,

pulling the needle and the attached first end of the suture out of the slot and away from the rod first end, thereby causing the third loop to be pulled off the rod first end and forming a third throw of a knot in the suture at the stitch.

3. The method of claim 2, further comprising the step of:

after forming the third throw in the knot, cutting the suture first end and second end and removing the needle and the rod from the surgery location.

4. The method of claim 1, wherein the step of:

positioning the rod first end and the needle proximate to the surgery location further includes inserting the rod first end and the needle through a cannula used in a laparoscopic surgery operation.

5. A surgical instrument for tying a knot in a length of suture, the instrument comprising:

a rod having a longitudinal length with opposite first and second ends and an exterior surface extending between the first and second ends;

a slot formed in the first end of the rod;

a length of suture having opposite first and second ends, the first end of the suture being secured to a needle and the second end of the suture being positioned adjacent the second end of the rod, the length of suture extending from its second to its first end along the rod from the rod second end to the rod first end with at least one loop being formed in the suture and wrapped laterally around the exterior surface of the rod and over the slot formed in the first end of the rod, the loop is formed, in the suture by the suture extending longitudinally along the rod from the rod second end toward the rod first end to a first bend formed in the suture intermediate the rod first and second ends and adjacent the slot, the suture next extending laterally relative to the rod from the first bend and wrapping laterally at least one complete revolution around the exterior surface of the rod and over the slot to a second bend formed in the suture engaging around the first bend, and then the suture extending longitudinally relative to the rod from the second bend toward the rod first end and to the needle secured to the suture first end with a sufficient length of the suture provided between the second bend and the needle enabling the needle to pass through a tissue to be ligated and then through the loop formed in the suture thereby tying a knot in the suture.

6. The instrument of claim 5, wherein

the loop is formed in the suture by the suture extending longitudinally along the rod from the rod second end toward the rod first end to the first bend formed in the suture, the suture next extending from the first bend and wrapping laterally one revolution around the exterior surface of the rod and over the slot to the second bend formed in the suture around the first bend, and then the suture extending longitudinally toward the rod first end.

7. The instrument of claim 5, wherein:

a plurality of loops are formed in the suture and are each wrapped laterally around the exterior surface of the rod and over the slot formed in the first end of the rod.

8. The instrument of claim 7, wherein:

each loop of the plurality of loops formed in the suture is formed by the length of suture extending longitudinally along the rod from the rod second end toward the rod first end with a first bend being formed in the suture and the suture extending laterally from the first bend making at least one revolution around the exterior surface of the rod back to the first bend, a second bend being formed in the suture around the first bend and the suture extending longitudinally from the second bend toward the rod first end and subsequent loops of the plurality of loops formed in the suture.

9. The instrument of claim 5, wherein:

a handle having opposite first and second ends is attached to the second end of the rod, the handle having an elongated configuration enabling insertion of the rod and handle through a cannula and to enable manipulation of the rod in laparoscopic surgery by manual manipulation of the handle.

10. The instrument of claim 9, wherein:

the first end of the handle is removably attached to the second end of the rod enabling the rod to be removed from the handle and replaced by a like rod removably attached to the handle first end.

11. The instrument of claim 5, wherein:

the longitudinal length of the rod has an elongated configuration that enables insertion of the first end of the rod through a cannula with the second end of the rod projecting from the cannula enabling remote manipulation of the first end of the rod in laparoscopic surgery by manual manipulation of the rod second end.

12. The instrument of claim 5, wherein:

the slot is configured to enable insertion of the needle secured to the suture first end into the slot and beneath the loop formed in the suture around the exterior surface of the rod, and then removal of the needle from the slot after the needle and the first end of the suture secured thereto have been passed beneath the loop.

13. The instrument of claim 5, wherein:

means are provided on the rod first end for releasably holding the needle to the rod first end.

14. The instrument of claim 13, wherein:

the means for releasably holding the needle to the rod first end includes a magnet secured to the rod first end.

15. A surgical instrument for tying a knot in a length of suture, the instrument comprising:

a rod having a longitudinal length with opposite first and second ends and an exterior surface extending between the first and second ends;

a length of suture having opposite first and second ends, the first end of the suture being secured to a needle and the second end of the suture being positioned adjacent the second end of the rod, the length of suture having at least one loop formed therein, the loop is formed in the suture by the suture extending longitudinally along the rod from the rod second end toward the rod first end to a first bend formed in the suture intermediate the rod first and second ends, the suture next extending laterally relative to the rod from the first bend and wrapping laterally at least one complete revolution around the exterior surface of the rod to a second bend formed in the suture engaging around the first bend, and then the suture extending longitudinally relative to the rod from the second bend toward the rod first end and to the needle secure to the suture first end with a sufficient length of the suture provided between the second bend and the needle enabling the needle to pass through a tissue to be ligated and then through the loop formed in the suture thereby tying a knot in the suture; and

means provided on the rod for enabling the needle to be passed beneath the loop wrapped around the rod pulling the first end of the suture beneath the loop.

16. The instrument of claim 15, wherein:

the longitudinal length of the rod has an elongated configuration that enables insertion of the first end of the rod through a cannula with the second end of the rod projecting from the cannula and enables remote manipulation of the first end of the rod by manual manipulation of the rod second end.

17. The instrument of claim 15, wherein:

a handle is removably attached to the rod second end enabling the rod to be removed from the handle and replaced by a like rod removably attached to the handle, the handle having an elongated configuration enabling insertion of the rod attached to the handle through a cannula in laparoscopic surgery operations with the handle projection from the cannula and enabling remote manipulation of the rod first end by manual manipulation of the handle projecting from the cannula.

18. The instrument of claim 15, wherein:

a plurality of loops are formed in the suture and wrapped around the exterior surface of the rod.

19. The surgical instrument of claim 18, wherein:

each loop of the plurality of loops formed in the suture is formed by the length of suture extending longitudinally along the rod from the rod second end toward the rod first end with a first bend being formed in the suture and the suture extending laterally from the first bend making at least one revolution around the exterior surface of the rod back to the first bend, a second bend being formed in the suture around the first bend and the suture extending longitudinally from the second bend toward the rod first end and subsequent loops of the plurality of loops formed in the suture.

20. The instrument of claim 15, wherein:

the means provided on the rod for enabling the needle to be passed beneath the loop wrapped around the rod includes a recess formed in the exterior surface of the rod beneath the loop.

21. The instrument of claim 20, wherein:

the recess is part of a slot formed in the first end of the rod extending along at least a portion of the longitudinal length of the rod.

22. The instrument of claim 21, wherein:

the loop is formed in the suture by the suture extending longitudinally along the rod from the rod second end toward the rod first end, a first bend being formed in the suture adjacent the slot in the rod first end, the suture from the first bend being wrapped laterally around the exterior surface of the rod and over the slot, then a second bend is formed in the suture around the first bend and the suture extends longitudinally toward the rod first end from the second bend.