Endoscopic suture system

• US 5,540,704 A
• Filed: 03/02/1994
• Issued: 07/30/1996
• Est. Priority Date: 09/04/1992
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Laurus Medical Corporation
• Inventors: Gordon, Norman S., Cooper, Robert P., Gunn, Gordon C.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/205,042
• Time in Patent Office: 881 Days
• Field of Search: 606/139, 606/144, 606/145, 606/147, 606/148, 606/185-187, 604/278, 112/80.03, 112/169
• US Class Current: 606/144
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/0625 the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator A61B17/06109 takes precedence
• CPC Class Codes: A61B 17/2909 Handles
• 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 J-shaped suture needles A61B2017/0608
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0474 Knot pushers
• CPC Class Codes: A61B 2017/0479 Packages or dispensers for MIS suturing instruments
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61B 2017/2901 Details of shaft

Abstract

A method and device for the placement of sutures and for the purpose of approximating tissue. A particular utility is effected in the approximation of the tissue separated by means of an endosurgical trocar being inserted into a body cavity. The invention provides for the loading of suture material including needles into the device, introduction and placement of the device into the body cavity, with the distal end having deployable needle guides, extending the needle guides either simultaneously or individually to the periphery of the wound, engaging the wound with the needle guides, driving the needles and suture material through the tissue to be approximated into a catch mechanism, retracting the needle guides and withdrawing the device, leaving a loop of suture material in the margin of tissue. The suture may then be tied to approximate the wound and excess suture material cut off.

Claims

1. A suturing instrument comprising:

an elongate body member having a longitudinal axis and a substantially straight distal end portion;

a deployment controller having a proximal end and a distal end, said deployment controller extending substantially along the longitudinal axis of said elongate body member to said distal end portion of said elongate body member, wherein said deployment controller has a retracted position and a deployed position; and

a needle deployment system located within the distal end portion of said elongate body member and coupled to said deployment controller, said needle deployment system comprising;

a curved surgical needle slidably positioned in a curved needle channel within said elongate body member, said curved needle channel located substantially in a plane which is substantially parallel to said elongate body member longitudinal axis and having a laterally disposed exit port from said distal end portion of said elongate body member; and

a flexible pusher coupled to the distal end of said deployment controller, said needle deployment system having a retracted configuration when said deployment controller is in said retracted position wherein substantially all of the curved surgical needle is contained within said elongate body member and a deployed configuration when said deployment controller is in said deployed position, wherein said flexible pusher pushes the curved surgical needle through said curved needle channel and said laterally disposed exit port outside of said elongate body member along a path having an initial direction away from said elongate body member longitudinal axis as said deployment controller begins to move from said retracted position toward said deployed position followed by a direction toward said elongate body member longitudinal axis as said deployment controller approaches said deployed position.

2. A suturing instrument as defined in claim 1 further comprising:

a suture channel which intersects said curved needle channel at said distal end of said elongate body member; and

a suture capture projection positioned adjacent said suture channel and said curved needle channel such that a suture lying in said suture channel is captured between said projection and said flexible pusher as said deployment controller moves from said retracted position to said deployed position.

3. A suturing instrument as defined in claim 1 further comprising a needle catch at said distal end of said elongate body member.

4. A suturing instrument as defined in claim 3 wherein said curved surgical needle has a shoulder near a distal point and said needle catch further comprises a first opening dimension sized to allow said shouldered needle to pass therethrough and a second opening dimension sized smaller than said shoulder, thereby capturing said needle at said shoulder.

5. A suturing instrument as defined in claim 3 further comprising:

a needle capture channel at said distal end of said elongate body member;

a cam positioned in said needle capture channel so as to wedge a needle inserted in said needle capture channel between said cam and said channel.

6. A suturing instrument as defined in claim 5 wherein said cam is coupled to said flexible pusher and as said deployment controller moves from said retracted position to said deployed position, said cam increases the capture force applied to said needle.

7. A suturing instrument as defined in claim 1 further comprising a suture channel formed at the distal end of said elongate body member for pushing a knot tied extracorporeally into a body cavity.

8. A suturing instrument comprising:

an elongate body member having a longitudinal axis;

a deployment controller having a proximal end and a distal end, said deployment controller extending substantially along the longitudinal axis of said elongate body member to a distal end of said elongate body member, wherein said deployment controller has a retracted position and a deployed position;

a needle deployment system located within the distal end of said elongate body member and coupled to said deployment controller, said needle deployment system comprising;

a curved surgical needle slidably positioned in a curved needle channel within said elongate body member, said curved needle channel located substantially in a plane which is substantially parallel to said elongate body member longitudinal axis; and

a flexible pusher coupled to the distal end of said deployment controller, said needle deployment system having a retracted configuration when said deployment controller is in said retracted position wherein substantially all of the curved surgical needle is contained within said elongate body member and a deployed configuration when said deployment controller is in said deployed position, wherein said flexible pusher pushes the curved surgical needle through said curved needle channel outside of said elongate body member along a path having an initial direction away from said elongate body member longitudinal axis as said deployment controller begins to move from said retracted position toward said deployed position followed by a direction toward said elongate body member longitudinal axis as said deployment controller approaches said deployed position;

a suture channel which intersects said curved needle channel at said distal end of said elongate body member; and

a suture capture projection positioned adjacent said suture channel and said curved needle channel such that a suture lying in said suture channel is captured between said projection and said flexible pusher as said deployment controller moves from said retracted position to said deployed position.

9. A suturing instrument comprising:

an elongate body member having a longitudinal axis;

a deployment controller having a proximal end and a distal end, said deployment controller extending substantially along the longitudinal axis of said elongate body member to a distal end of said elongate body member, wherein said deployment controller has a retracted position and a deployed position;

a needle deployment system located within the distal end of said elongate body member and coupled to said deployment controller, said needle deployment system comprising;

a curved surgical needle slidably positioned in a curved needle channel within said elongate body member, said curved needle channel located substantially in a Diane which is substantially parallel to said elongate body member longitudinal axis; and

a flexible pusher coupled to the distal end of said deployment controller, said needle deployment system having a retracted configuration when said deployment controller is in said retracted position wherein substantially all of the curved surgical needle is contained within said elongate body member and a deployed configuration when said deployment controller is in said deployed position, wherein said flexible pusher pushes the curved surgical needle through said curved needle channel outside of said elongate body member along a path having an initial direction away from said elongate body member longitudinal axis as said deployment controller begins to move from said retracted position toward said deployed position followed by a direction toward said elongate body member longitudinal axis as said deployment controller approaches said deployed position; and

a needle catch at said distal end of said elongate body member.

10. A suturing instrument as defined in claim 9 wherein said curved surgical needle has a shoulder near a distal point and said needle catch further comprises a first opening dimension sized to allow said shouldered needle to pass therethrough and a second opening dimension sized smaller than said shoulder, thereby capturing said needle at said shoulder.

11. A suturing instrument as defined in claim 9 further comprising:

a needle capture channel at said distal end of said elongate body member;

a cam positioned in said needle capture channel so as to wedge a needle inserted in said needle capture channel between said cam and said channel.

12. A suturing instrument as defined in claim 11 wherein said cam is coupled to said flexible pusher and as said deployment controller moves from said retracted position to said deployed position, said cam increases the capture force applied to said needle.

13. A suturing instrument comprising:

an elongate body member having a longitudinal axis;

a deployment controller having a proximal end and a distal end, said deployment controller extending substantially along the longitudinal axis of said elongate body member to a distal end of said elongate body member, wherein said deployment controller has a retracted position and a deployed position;

a needle deployment system located within the distal end of said elongate body member and coupled to said deployment controller, said needle deployment system comprising;

a curved surgical needle slidably positioned in a curved needle channel within said elongate body member, said curved needle channel located substantially in a plane which is substantially parallel to said elongate body member longitudinal axis; and

a flexible pusher coupled to the distal end of said deployment controller, said needle deployment system having a retracted configuration when said deployment controller is in said retracted position wherein substantially all of the curved surgical needle is contained within said elongate body member and a deployed configuration when said deployment controller is in said deployed position, wherein said flexible pusher pushes the curved surgical needle through said curved needle channel outside of said elongate body member along a path having an initial direction away from said elongate body member longitudinal axis as said deployment controller begins to move from said retracted position toward said deployed position followed by a direction toward said elongate body member longitudinal axis as said deployment controller approaches said deployed position; and

a suture channel formed at the distal end of said elongate body member for pushing a knot tied extracorporeally into a body cavity.

14. A suturing instrument comprising:

an elongate body member having a longitudinal axis;

a deployment controller having a proximal end and a distal end, said deployment controller extending substantially along the longitudinal axis of said elongate body member to a distal end of said elongate body member, wherein said deployment controller has a retracted position and a deployed position; and

a needle deployment system located within the distal end of said elongate body member and coupled to said deployment controller, said needle deployment system comprising;

a curved needle carrier channel and a curved needle carrier movably positioned therein and having a needle point mounted on a distal end thereof, said curved needle channel located substantially in a plane which is substantially parallel to said elongate body member longitudinal axis; and

a flexible pusher coupled to said deployment controller, said needle deployment system having a retracted configuration when said deployment controller is in said retracted position wherein substantially all of the curved needle carrier is contained within said elongate body member and a deployed configuration when said deployment controller is in said deployed position, wherein said flexible pusher pushes the curved needle carrier along said curved needle channel outside of said elongate body member along a path having an initial direction away from said elongate body member longitudinal axis as said deployment controller begins to move from said retracted position toward said deployed position followed by a direction toward said elongate body member longitudinal axis as said deployment controller approaches said deployed position.

15. A suturing instrument as defined in claim 14 further comprising:

a bullet needle having a suture attachment point, said bullet needle inserted in said curved needle carrier;

a suture attached to said bullet needle suture attachment point; and

a needle capture system located on said elongate body member at a location which intercepts said portion of said needle carrier path which approaches toward said elongate body member.

16. A suturing instrument for placing sutures inside a body cavity comprising:

an elongate body member having a longitudinal axis and a substantially straight distal end portion;

needle deployment means for deploying a surgical needle outside a distal end of said elongate body member along a path having an initial direction away from said elongate body member longitudinal axis followed by a direction toward said elongate body member longitudinal axis, wherein said needle deployment means further comprises a substantially semi-circular shaped needle channel located within said distal end portion of said elongate body member, said substantially semi-circular shaped needle channel having a laterally disposed exit port from said distal end portion of said elongate body member; and

needle capture means attached to said elongate body member for capturing the surgical needle after deployment.

17. A suturing instrument as defined in claim 16 further comprising a knot pushing means located at the distal end of said elongate body member for pushing a knot tied extracorporeally into the body cavity.

18. A suturing instrument comprising:

a tubular body member, said tubular body member having a substantially straight distal end portion; and

a curved needle channel located within said substantially straight distal end portion of said tubular body member configured such that a curved surgical needle may be slidably positioned therein, said curved needle channel having a laterally disposed exit port proximal to said tubular body member distal end portion.

19. A suturing instrument as defined in claim 18 further comprising:

a deployment controller having a proximal end and a distal end, said deployment controller extending substantially along a longitudinal axis of said tubular body member to said distal end portion of said tubular body member, wherein said deployment controller has a retracted position and a deployed position; and

a needle deployment system located within said distal end portion of said tubular body member and coupled to said deployment controller, said needle deployment system comprising a flexible pusher coupled to the distal end of said deployment controller, said needle deployment system having a retracted configuration when said deployment controller is in said retracted position wherein substantially all of the curved surgical needle is contained within said tubular body member and a deployed configuration when said deployment controller is in said deployed position, wherein said flexible pusher pushes the curved surgical needle through said curved needle channel and said laterally disposed exit port outside of said tubular body member along a path having an initial direction away from said tubular body member longitudinal axis as said deployment controller begins to move from said retracted position toward said deployed position followed by a direction toward said tubular body member longitudinal axis as said deployment controller approaches said deployed position.

20. A suturing instrument as defined in claim 18 further comprising a needle catch at said distal end of said tubular body member.

21. A suturing instrument comprising:

an tubular body member having a longitudinal axis and a substantially straight distal end portion;

a deployment controller having a proximal end and a distal end, said deployment controller extending substantially along said longitudinal axis of said tubular body member to a distal end of said tubular body member, wherein said deployment controller has a retracted position and a deployed position; and

a needle deployment system located within said substantially straight distal end portion of said tubular body member and coupled to said deployment controller, said needle deployment system comprising;

a curved needle channel configured such that a curved surgical needle may be slidably positioned therein, said curved needle channel located substantially in a plane which is substantially parallel to said tubular body member longitudinal axis and having a laterally disposed exit port from said tubular body member distal end portion; and

a flexible pusher coupled to the distal end of said deployment controller, said needle deployment system having a retracted configuration when said deployment controller is in said retracted position wherein substantially all of the curved surgical needle is contained within said tubular body member and a deployed configuration when said deployment controller is in said deployed position, wherein said flexible pusher pushes the curved surgical needle through said curved needle channel and said laterally disposed exit port outside of said tubular body member along a path having an initial direction away from said tubular body member longitudinal axis as said deployment controller begins to move from said retracted position toward said deployed position followed by a direction toward said tubular body member longitudinal axis as said deployment controller approaches said deployed position.

22. A suturing instrument as defined in claim 21 further comprising:

a suture channel which intersects said curved needle channel at said distal end portion of said tubular body member; and

a suture capture projection positioned adjacent said suture channel and said curved needle channel such that a suture lying in said suture channel is captured between said projection and said flexible pusher as said deployment controller moves from said retracted position to said deployed position.

23. A suturing instrument as defined in claim 21 further comprising a needle catch at said distal end of said tubular body member.

24. A suturing instrument as defined in claim 23 wherein said curved surgical needle has a shoulder near a distal point and said needle catch further comprises a first opening dimension sized to allow said shouldered needle to pass therethrough and a second opening dimension sized smaller than said shoulder, thereby capturing said needle at said shoulder.

25. A suturing instrument as defined in claim 23 further comprising:

a needle capture channel at said distal end of said tubular body member; and

a cam positioned in said needle capture channel so as to wedge a needle inserted in said needle capture channel between said cam and said channel.

26. A suturing instrument as defined in claim 25 wherein said cam is coupled to said flexible pusher and as said deployment controller moves from said retracted position to said deployed position, said cam increases the capture force applied to said needle.

27. A suturing instrument as defined in claim 21 further comprising a suture channel formed at the distal end of said tubular body member for pushing a knot tied extracorporeally into a body cavity.