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

• US 5,527,323 A
• Filed: 07/20/1994
• Issued: 06/18/1996
• 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: Scott, James S., Hermann, George D., Mollenauer, Kenneth H., Jervis, James E., Van Dyk, Karl, de la Torre, Roger A.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/277,987
• Time in Patent Office: 699 Days
• Field of Search: 606/139, 606/144, 606/145, 606/147, 606/148, 606/151, 606/140, 606/141, 606/205-208, 289/17, 112/80.03, 112/169
• 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 facilitates tying of a knot in a length of suture material at a remote surgical location. The instrument is comprised of an inner rod having a length of suture wrapped over the rod in a particular pattern. A needle may be 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 knot in the suture. The inner rod is received in an interior bore of an outer rod for manually controlled reciprocating movement therein. The inner rod is manually retracted into the interior bore of the outer rod to cause the outer rod to move the loops of suture off the inner rod end and over the needle in forming a knot in the suture.

Claims

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

an outer rod having a longitudinal length with opposite distal and proximal ends, the outer rod having a hollow interior bore extending therethrough;

a sealing cap attached to the outer rod proximal end providing a seal over the interior bore at the outer rod proximal end;

an inner rod having a longitudinal length with opposite distal and proximal ends, the inner rod being received in the interior bore of the outer rod for reciprocating movement therein between an extended position of the inner rod relative to the outer rod and the sealing cap where a portion of the inner rod adjacent the inner rod distal end projects from the outer rod interior bore at the outer rod distal end and the inner rod proximal end is positioned in the outer rod interior bore, and a retracted position of the inner rod relative to the outer rod and the sealing car where the portion of the inner rod is at least partially retracted into the outer rod interior bore and the inner rod proximal end is positioned in the outer rod interior bore; and

an exterior surface on one of the inner and outer rods providing a surface for a length of suture to be wrapped in a pattern of loops thereon, the exterior surface providing a surface which maintains the length of suture in the pattern of wrapped loops as the pattern of loops is slipped over and off from the surface in response to relative movement between the inner rod and the outer rod.

2. The instrument of claim 1, wherein:

the exterior surface is on the portion of the inner rod, the pattern of loops is capable of being wrapped on the exterior surface with the inner rod in the extended position relative to the outer rod, and the pattern of loops is slipped over and off the exterior surface by the outer rod distal end in response to the inner rod moving from the extended position to the retracted position.

3. The instrument of claim 2, further comprising:

a cartridge having an exterior surface, the cartridge exterior surface having a length of suture wrapped in a pattern of loops thereon and the cartridge exterior surface having a configuration that is complementary to the inner rod exterior surface thereby enabling the pattern of suture loops wrapped on the cartridge exterior surface to be slipped off the cartridge and onto the portion of the inner rod exterior surface.

4. The instrument of claim 1, further comprising:

means connected to the outer rod and the inner rod for biasing the inner rod toward the extended position of the inner rod relative to the outer rod, the means for biasing the inner rod maintaining a biasing force on the inner rod while the inner rod is moved between the extended and retracted positions.

5. The instrument of claim 4, wherein:

the means for biasing the inner rod includes a spring with opposite first and second ends where the first end of the spring acts on the inner rod and the second end of the spring acts on the outer rod.

6. The instrument of claim 4, wherein:

the outer rod has an exterior surface and an opening is provided in the outer rod extending from the outer rod exterior surface to the outer rod interior bore; and

a handle is mounted on the outer rod exterior surface for movement relative thereto, the handle extending through the opening in the outer rod to the inner rod received in the outer rod interior bore and being connected to the inner rod.

7. The instrument of claim 6, wherein:

the handle includes a lever mounted on the handle for movement of the lever relative to the handle between first and second positions, and the lever is configured so that it extends through the opening in the outer rod and connects with the inner rod when in the first position and so that the lever is retracted out of the opening in the outer rod disconnecting the handle from the inner rod when the lever is in the second position.

8. The instrument of claim 6, wherein:

the inner rod exterior surface has a portion that covers over and closes the opening in the outer rod exterior surface from the outer rod interior bore as the inner rod is reciprocated between the extended position and the retracted position of the inner rod relative to the outer rod.

9. The instrument of claim 1, wherein:

a segment of the inner rod distal end is detachable from the inner rod; and

a like segment of the inner rod distal end having a length of suture wrapped in a pattern of loops thereon is attachable to the inner rod to replace the detached segment of the inner rod distal end.

10. The instrument of claim 1, wherein:

the interior bore of the outer rod extends completely through the outer rod and the inner rod has an interior bore that extends completely therethrough, whereby a second surgical instrument can be inserted completely through the interior bores of the outer rod and inner rod.

11. The instrument of claim 1, wherein:

the sealing cap has an opening therethrough that is dimensioned sufficiently large as to permit insertion of a separate surgical instrument through the sealing cap opening while sealing around the instrument.

12. The instrument of claim 11, wherein:

the sealing cap is constructed of an elastic material that enables the sealing cap opening to stretch to accommodate insertion of the separate surgical instrument through the sealing cap opening while sealing around the instrument.

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

an outer tubular rod having a longitudinal length with opposite distal and proximal ends and a hollow interior bore extending completely therethrough;

a sealing cap attached to the outer rod proximal end and covering over the interior bore at the outer rod proximal end;

an inner tubular rod having a longitudinal length with opposite distal and proximal ends and a hollow interior bore extending completely therethrough, the inner rod is received in the interior bore of the outer rod for reciprocating movement therein between an extended position of the inner rod relative to the outer rod and the sealing cap where a portion of an exterior surface of the inner rod adjacent the inner rod distal end projects from the outer rod interior bore at the outer rod distal end and the inner rod proximal end is positioned in the outer rod interior bore, and a retracted position of the inner rod relative to the outer rod where the portion of the inner rod exterior surface is at least partially retracted into the outer rod interior bore and the inner rod proximal end is positioned in the outer rod interior bore, the portion of the inner rod exterior surface providing a surface for a length of suture to be wrapped in a pattern of loops thereon with the inner rod in the extended position relative to the outer rod, and the portion of the inner rod exterior surface providing a surface which maintains the length of suture in the pattern of wrapped loops as the pattern of loops is slipped over the exterior surface and off the inner rod distal end by the outer rod distal end in response to the inner rod moving from the extended position to the retracted position.

14. The instrument of claim 13, wherein:

the hollow interior bores of the outer and inner rods are dimensioned sufficiently large to enable another surgical instrument to be inserted through the interior bores of the outer and inner rods.

15. The instrument of claim 13, further comprising:

a cartridge separate from the outer and inner rods and having a cylindrical exterior surface conforming to the portion of the inner rod exterior surface, the cartridge exterior surface having a length of suture wrapped in a pattern of loops thereon and the exterior surface of the cartridge enabling the cartridge to be positioned against the distal end of the inner rod in the extended position of the inner rod and enabling the pattern of suture loops wrapped on the cartridge exterior surface to be slipped off the cartridge and onto the inner rod exterior surface.

16. The instrument of claim 13, wherein:

the outer rod has an exterior surface and an opening is provided in the outer rod that extends from the outer rod exterior surface through to the interior bore of the outer rod; and

a handle is mounted on the exterior surface of the outer rod for movement of the handle relative thereto, the handle extends through the opening in the outer rod and is connected to the inner rod in the outer rod interior bore.

17. The instrument of claim 16, wherein:

the handle includes a lever mounted on the handle for movement of the lever relative to the handle between first and second positions, and the lever is configured so that it extends through the opening in the outer rod and connects with the inner rod when in the first position and so that the lever is retracted out of the opening in the outer rod disconnecting the handle from the inner rod when the lever is in the second position.

18. The instrument of claim 16, wherein:

a shoulder is mounted on the exterior surface of the outer rod at the proximal end of the outer rod; and

a spring is mounted between the handle and the shoulder and biases the handle away from the shoulder and thereby, through the connection of the handle to the inner rod, biases the inner rod to the extended position relative to the outer rod.

19. The instrument of claim 16, wherein:

the inner rod exterior surface has a portion that covers over and closes the opening in the outer rod exterior surface from the outer rod interior bore as the inner rod is reciprocated between the extended position and the retracted position of the inner rod relative to the outer rod.

20. The instrument of claim 13, wherein:

a segment of the inner rod distal end is detachable from the inner rod and replaceable by a like segment of the inner rod distal end having a length of suture wrapped in the pattern of loops thereon.

21. The instrument of claim 13, wherein:

the sealing cap has an opening therethrough that is dimensioned sufficiently large as to permit insertion of a separate surgical instrument through the sealing cap opening while sealing around the instrument.

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

an outer rod having a longitudinal length with opposite distal and proximal ends and a hollow interior bore extending at least partially therethrough from the outer rod distal end, the outer rod having an exterior surface with an opening therein, the opening extending from the exterior surface through to the interior bore;

an inner rod having a longitudinal length with opposite distal and proximal ends, the inner rod is received in the interior bore of the outer rod for longitudinal reciprocating movement therein between an extended position of the inner rod relative to the outer rod where a portion of an exterior surface of the inner rod adjacent the inner rod distal end projects from the outer rod interior bore at the outer rod distal end, and a retracted position of the inner rod relative to the outer rod where the portion of the inner rod exterior surface is retracted into the outer rod interior bore, the portion of the inner rod exterior surface providing a surface for a length of suture to be wrapped in a pattern of loops thereon with the inner rod in the extended position relative to the outer rod, and the portion of the inner rod exterior surface providing a surface which maintains the length of suture in the pattern of wrapped loops as the pattern of loops is slipped over the exterior surface and off the inner rod distal end by the outer rod distal end in response to the inner rod moving from the extended position to the retracted position, the inner rod exterior surface having a second portion that covers over and closes the opening in the outer rod exterior surface from the outer rod interior bore as the inner rod is reciprocated between the extended position and the retracted position of the inner rod relative to the outer rod; and

a handle mounted on the exterior surface of the outer rod for longitudinal sliding movement of the handle relative to the outer rod, the handle extending through the opening in the outer rod and being connected to the inner rod in the interior bore of the outer rod whereby longitudinal reciprocating sliding movement of the handle on the outer rod imparts longitudinal reciprocating movement to the inner rod in the outer rod interior bore.

23. The instrument of claim 22, wherein:

the handle includes a lever mounted on the handle for movement of the lever relative to the handle between first and second positions, and the lever is configured so that it extends through the opening in the outer rod and connects with the inner rod when in the first position and so that the lever is retracted out of the opening in the outer rod disconnecting the handle from the inner rod when the lever is in the second position.

24. The instrument of claim 22, wherein:

the handle is mounted on the outer rod in a position intermediate the distal and proximal ends of the outer rod and a shoulder is affixed to the outer rod proximal end, a spring is mounted between the shoulder and the handle and biases the handle longitudinally away from the shoulder and thereby, through the connection between the handle and the inner rod, biases the inner rod to the extended position relative to the outer rod.

25. The instrument of claim 22, further comprising:

a cartridge separate from the outer and inner rods and having a cylindrical exterior surface conforming to the portion of the inner rod exterior surface, the cartridge exterior surface having a length of suture wrapped in a pattern of loops thereon and the exterior surface of the cartridge enabling the cartridge to be positioned against the distal end of the inner rod in the extended position of the inner rod and enabling the pattern of suture loops wrapped on the cartridge exterior surface to be slipped off the cartridge and onto the inner rod exterior surface.

26. The instrument of claim 22, wherein:

a segment of the inner rod having the portion of the inner rod exterior surface thereon is detachable from the inner rod and replaceable by a like segment of the inner rod having a length of suture wrapped in the pattern of loops on the like segment.

27. The instrument of claim 22, wherein:

a sealing cap is attached to the outer rod proximal end and provides a seal over the interior bore of the outer rod at the outer rod proximal end, and the sealing cap has an opening therethrough that is dimensioned sufficiently large as to permit insertion of a separate surgical instrument through the sealing cap opening while sealing around the instrument.