Automatic suturing and ligating device

• US 5,417,700 A
• Filed: 03/25/1993
• Issued: 05/23/1995
• Est. Priority Date: 03/30/1992
• Status: Expired due to Term

• Current Assignee: Axya Medical, Inc. (Tornier Incorporated)
• Original Assignee: Thomas D. Egan
• Inventors: Egan, Thomas D.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/037,021
• Time in Patent Office: 789 Days
• Field of Search: 606/27, 606/30, 606/42, 606/45, 606/1, 606/103, 606/228, 606/187, 606/144-147
• US Class Current: 606/144
• 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 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• 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

A device and method of suturing closed an opening and ligating a vessel or duct comprising removable tissue puncturing means (22) or vessel surrounding means establishing a continuous channel (24) through said tissue or around said vessel from each side. A completed channel (24) is formed and suture material (26) is threaded through the channel making a complete loop. The thread is secured at an anvil (30) independent from said puncturing/surrounding means. The puncturing/surrounding means is retracted leaving the thread, which is then tensioned closing the opening or occluding the vessel. The suture thread is secured and cut, forming a closed loop with overlapping ends. An energy transmitting device (38) melts the suture thread ends together forming a weld. The anvil (30) is removed leaving a knot-free completed stitch or ligature.

Claims

1. An automatic device for suturing tissue comprising, in combination:

(a) a housing having proximal and distal ends, said distal end adapted to be placed adjacent to a suturing location,

(b) means for puncturing said tissue, constructed at said distal end of said housing to form a passage through said tissue which suture thread is to be threaded, and where said passage communicates with at least one opening through said housing,

(c) means for threading said suture thread, said threading means constructed on said housing where said suture thread is aligned with and proximate to said passage opening,

(d) means for tightening said suture thread, said tightening means constructed on said housing and connected to the suture thread, external from the passage, for tightening the suture thread, and

(e) means constructed on to the housing adjacent to said passage opening for welding to each other the entering and exiting portions of said suture thread at said passage opening, thereby creating a completed suture proximate said tissue.

2. A device as defined in claim 1 wherein said puncturing means comprises a needle constructed with a hollow or semi-enclosed cross section, said needle, when removably puncturing said tissue, forms said passage.

3. A device as defined in claim 2 wherein said puncturing means comprise two opposing, retractable, curved needles, rotatably mounted where said needles when activated puncture said tissue in a curved manner meeting within said tissue to form a continuous channel through said tissue.

4. A device as defined in claim 1, wherein said welding means comprise ultrasonic welding means.

5. A device as defined in claim 1, further comprising a microprocessor controller wherein said energy and time, introduced into said suture thread ends to be welded, are controlled by said microprocessor thereby producing a reliable, repeatable weld.

6. A device as defined in claim 1, further comprising a shaft with a first opening at the weld area and the shaft with a second opening distal from the weld area arranged and constructed to accept gas that travels through the shaft to dry the weld.

7. A device as defined in claim 1 further comprising means for cutting said suture thread, wherein said cutting means and said welding means are aligned such that said completed stitch has no loose ends.

8. A device as defined in claim 1 further comprising means for storing a continuous supply of suture thread wherein the thread storing means is arranged and constructed to feed the thread to said threading means immediately after a stitch is completed.

9. A device as defined in claim 1 wherein said device is constructed and arranged providing a long narrow shaft suitable for probing hard to reach and internal locations in humans and animals said puncturing means connected at the distal tip of the long shaft, and said threading, tightening and welding means running through said shaft to the tip.

10. A device as defined in claim 9 wherein said long narrow shaft is articulated.

11. An device as defined in claim 1 wherein said suturing device forms a completed suture without repositioning said device.

12. An automatic suturing and ligating device comprising:

(a) housing means,

(b) tubular means fixed within and extending from said housing ending with a tip, wherein said tip contacts tissue where a suture is to be placed or a vessel where a ligature is to be placed,

(c) tubular sheath means slidably fixed and covering said tip thereby protecting said tip from damage,

(d) the tip including dual, opposing curved needles having U-shaped channels in each needle, said channels running the length of the curved needle, and where said needles are positioned on either side of an opening in said tissue or astride said vessel,

(e) linkage movably fixed within said tube means, joined to the proximate end of each needle,

(f) drive means connected to said linkage wherein said linkage is activated and drives said needles into the tissue or around said vessel, wherein said needles penetrate the tissue in a curving manner or surround said vessel, and wherein said needle points meet thereby forming a channel,

(g) a supply of suturing thread, fixed within said housing, wherein said thread extends through said tube means to the tip, and where said thread is positioned to be threaded through the channel,

(h) thread drive means which forces the thread through the channel wherein said thread forms a completed loop, said thread drive means fixed within said housing and constructed and arranged to accept and contact said thread and guide said thread to and through said channel,

(i) an anvil, fixed within said tip, and releasably arranged within said loop such that the suture threads overlap one side of said anvil with the tissue on the other side of said anvil,

(j) a clamping member, movably fixed to and extending through said tube means, arranged to contact the anvil with the suture thread therebetween, securing said threads to said anvil such that said needles can be extracted from the tissue leaving the suture thread in place,

(k) a mechanical assembly fixed to said housing and grasping said thread, and activation means for said assembly wherein said assembly when activated draws said thread and tightens the loop thereby closing said tissue opening,

(l) tension controlling means connected to said mechanical assembly and arranged and constructed to measure the tension in the suture thread wherein said activation means draws said thread tight until said tension equals a preset level,

(m) a second clamping member movably fixed to and extending through said tube means which when activated clamps said thread loop, where the two threads on either side of said loop overlap, such that both threads are secured by said second clamp,

(n) a welding horn fixed within said tip and constructed and arranged for compressing said suture material at said overlap area between said clamping means,

(o) an edge means interferently fixed adjacent to the path of said second clamping member wherein said welding horn strikes the edge means with the suture thread therebetween and shears off said thread from said spool,

(p) a drying gas supply and regulating means fed through said tube means and positioned adjacent and drying said overlap region,

(q) an ultrasonic generator connected to the welding horn and means to transfer said energy down said welding horn into said suture threads at the overlap, such that when activated said energy welds said threads together, proximate said tissue, thereby forming a closed loop stitch, and

(r) computer and programming means arranged and constructed to connect to and control;

said power (energy per unit time) into said suture threads whereby reliable welds are made, and said clamping members such that said suture thread is held until said weld has solidified, and

(t) means for releasing connected to said anvil said suturing and ligating device whereby said anvil is retracted, freeing said closed loop stitch from said suturing and ligating device.

13. A method for suturing an opening in tissue comprising the steps of:

simultaneously puncturing said tissue from each side of said opening, said puncturing forming a passage through said tissue through which suture thread is to be threaded,

threading said suture thread through said passage in said tissue,

tightening said suture thread, and

welding the portions of said suture thread that emerge from said tissue to each other proximate said tissue, thereby creating a completed suture where said welding step includes controlling the energy introduced into said suture material therein producing a reliable, repeatable weld.

14. A method for ligating a vessel comprising the steps of:

simultaneously surrounding said vessel from each side of said vessel forming a passage around said vessel through which suture thread is to be threaded,

threading said suture thread through said passage,

tightening said suture thread, and

welding the portions of said suture thread that emerge from said tissue to each other, thereby creating a completed ligature, where said welding step includes controlling the energy introduced into said suture material therein producing a reliable, repeatable weld.

15. An automatic ligating device for vessels comprising, in combination:

(a) a housing with a distal end adapted to be placed adjacent to where a ligature is to be placed around said vessel,

(b) means for surrounding said vessel constructed at said distal end of said housing and having a passage therethrough in which said ligature thread is to be threaded, and where said passage communicated with at least one opening through said housing,

(c) means for threading said ligature thread, said means for threading constructed on said housing where said ligature thread is aligned with and proximate to said passage opening,

(d) means for tightening said ligature thread, said tightening means constructed on said housing and connected to said ligature thread, external from the passage, for tightening said ligature thread, and

(e) means constructed on the housing adjacent to said passage opening for welding to each other the entering and exiting portions of said ligature thread at said passage opening, thereby creating a completed ligature proximate said tissue.

16. A device as defined in claim 15 wherein said surrounding means comprises a needle constructed with a hollow or semi-enclosed cross section, said needle, when surrounding said vessel, forms said passages.

17. A device as defined in claim 16 wherein said surrounding means comprise two opposing, retractable, curved needles, rotatably mounted where said needles when activated surround in a curved manner the vessel to form a continuous channel.

18. A device as defined in claim 15, wherein said welding means comprises ultrasonic welding means.

19. A device as defined in claim 15, further comprising a microprocessor controller wherein said energy and time, introduced into said suture thread ends to be welded, are controlled by said microprocessor thereby producing a reliable, repeatable weld.

20. A device as defined in claim 15, further comprising a shaft with a first opening at the weld area and the shaft with a second opening distal from the weld area arranged and constructed to accept gas that travels through the shaft to dry the weld.

21. A device as defined in claim 15 further comprising means for cutting said suture thread wherein said cutting means and said welding means are aligned such that said completed stitch has no loose ends.

22. A device as defined in claim 15 further comprising means for storing a continuous supply of suture thread wherein the thread storing means is arranged and constructed to feed the, thread to said threading means immediately after a stitch is completed.

23. A device as defined in claim 15 wherein said device is constructed and arranged providing a long narrow shaft suitable for probing hard to reach and internal locations in humans and animals said puncturing means connected at the distal tip of the long shaft, and said threading, tightening and welding means running through said shaft to the tip.

24. A device as defined in claim 15 wherein said long narrow shaft is articulated.

25. An device as defined in claim 15 wherein said ligating device forms a completed ligature without repositioning said device.