Insertable suture passing grasping probe and methodology for using same

• US 5,496,335 A
• Filed: 08/25/1993
• Issued: 03/05/1996
• Est. Priority Date: 08/25/1993
• Status: Expired due to Term

• Current Assignee: Coopersurgical Incorporated (The Cooper Cos., Inc.)
• Original Assignee: Inlet Medical, Inc. (The Cooper Cos., Inc.)
• Inventors: Carter, James E., Thomason, Rodger, Legome, Mark J., Naves, Neil H.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): MULCARE, NANCY C
• Application Number:
  US08/112,585
• Time in Patent Office: 923 Days
• Field of Search: 606/205, 606/206, 606/207, 606/144, 606/148, 606/151
• US Class Current: 606/148
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/282 Jaws
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/047 having at least one proximally pointing needle located at the distal end of the instrument, e.g. for suturing trocar puncture wounds starting from inside the body
• CPC Class Codes: A61B 2017/2825 Inserts of different material in jaws
• CPC Class Codes: A61B 2090/0813 Accessories designed for easy sterilising, i.e. re-usable

Abstract

A surgical instrument and method capable of being used for closure of peritoneum fascia, occlusion of bleeding vessels such as inferior epigastric, and for all uses related to passing of suture through tissue with the tip of the surgical instrument in a standard suture/needle driving position with a sharp tip that opens and closes with the surgeon grasping suture material with the sharp tip and inserting the tip/suture through tissue until the tip is seen through the peritoneum by direct vision wherein the suture is released by opening and withdrawing the tip and recovered by puncturing the tissue opposite the first point of insertion wherein the tip grasps the suture and pulls the suture outside the wound providing for rapid closure of the surgical incision.

Claims

1. A laparoscopic instrument for grasping, carrying and passing suture through a patient'"'"'s skin for suturing an open wound comprising:

a hollow tube having a first end and a second end;

a first jaw element having a tip end and a base section, said base section fixedly engaging said first end of said hollow tube and including a pivot rod means, said tip end tapering downwardly to said base section and defining a lower surface, said lower surface partially cross hatched having a partial nonhatched area at said tip end, said lower surface having an arcuate spring attached thereto from said tip end to said base section;

a second jaw element having a pivot hole pivotally engaging said pivot rod means of said base section of said first jaw element, and a second through-hole in said second jaw element;

a thin wire rod having a first and second end, said first end of said rod having engaging means, said engaging means engaging said second through-hole in said second jaw element; and

driving means engaging said second end of said rod for imparting reciprocal motion to said rod relative to said tube for pivotal motion of said second jaw element, wherein said second jaw element pivotally engages said first jaw element defining a shaped tip for grasping, carrying and passing the suture through a patient'"'"'s skin for suturing an open wound and said tube, rod, first and second jaw elements and said actuating means detachable for cleaning.

2. A laparoscopic instrument for passing through a patient'"'"'s peritoneum and fascia, and closing an open wound with suture material comprising:

(a) detachable piercing, carrying and grasping means having a sharp tip for insertion below skin level and grasping and carrying the suture material;

(b) driving means for driving said detachable means through the patient'"'"'s peritoneum and fascia at a first point and actuating said detachable means for gripping the suture material, said detachable piercing and grasping means comprises first and second forcep jaws pivotally engaged to each other, said first jaw fixedly engaging a hollow tube and said second jaw engaging a thin wire rod concentrically located within said hollow tube;

(c) said first and second forcep jaws comprising interior upper and lower jaw surfaces having partially knurled areas and a partially unknurled area at a tip point, said upper and lower interior jaw surfaces are inclined downwardly by a small angle from said tip point to the rear of said jaw surfaces; and

(d) said lower interior jaw surface bas an arcuate spring attached thereto from said tip point to the rear of said jaw surfaces for gripping various size suture while allowing the jaws to close completely, whereby the suture material is carried by said detachable means and recovered by driving said detachable means through the patient'"'"'s peritoneum and fascia at a second point and actuating said detachable means for gripping and pulling the suture material outside the wound providing for rapid closure of the open wound.

3. A laparoscopic instrument according to claim 2, wherein said detachable piercing and grasping means comprises a laparoscopic grasper defining a sharp knife shaped tip at a distal end.

4. A laparoscopic instrument according to claim 2, wherein said detachable piercing and grasping means comprises a laparoscopic grasper defining a sharp cone shaped tip at a distal end.

5. A laparoscopic instrument according to claim 2, wherein said detachable piercing and grasping means comprises a laparoscopic grasper defining a sharp chisel shaped tip at a distal end.

6. A laparoscopic instrument according to claim 2, wherein said driving means comprises a housing means and a lever means pivotally engaging said housing means, wherein said lever means detachable from said housing means for cleaning prior to surgery.

7. A laparoscopic instrument for grasping, carrying and passing suture through a patient'"'"'s skin for suturing an open wound comprising:

a hollow tube having a first end and a second end;

a first jaw element having a tip end and a base section, said base section fixedly engaging said first end of said hollow tube and including a pivot rod means, said tip end tapering downwardly to said base section;

a second jaw element having a pivot hole pivotally engaging said pivot rod means of said base section of said first jaw element;

a thin wire rod having a first and second end, said first end of said rod having engaging means for engaging said second jaw element;

driving means engaging said second end of said rod for imparting reciprocal motion to said rod relative to said tube for pivotal motion of said second jaw element, said driving means comprises a housing means fixedly engaging said second end of said hollow tube and a lever means fixedly engaging said second end of said rod and pivotally engaging said housing means, said housing means detachable from said second end of said hollow tube and said lever means detachable from said second end of said rod and housing means; and

said base section of said first jaw element detachable from said first end of said hollow tube and said second jaw element detachable from said pivot rod means of said base section and said engaging means of said first end of said rod, whereby said second jaw element pivotally engages said first jaw element defining a shaped tip for grasping, carrying and passing the suture through a patient'"'"'s skin for suturing an open wound and said tube, rod, first and second jaw elements and said engaging means detachable for cleaning.

8. An instrument for grasping, carrying, and passing suture through a patient'"'"'s tissue comprising

(a) a handle/actuator means for holding and activating the instrument from a closed to an open position and vice-versa;

and

(b) a forcep means which opens and closes for grasping the suture and having forcep jaws with a tapering end for insertion into a place of suturing, and wherein said forcep means holds the suture in a fully closed position while carrying the suture without displacement of the forcep jaws, and allowing said tapering end to be insertable through the patient'"'"'s tissue to the place of suturing.