Surgical instrument

• US 5,545,170 A
• Filed: 04/28/1994
• Issued: 08/13/1996
• Est. Priority Date: 10/09/1992
• Status: Expired due to Term

• Current Assignee: Innovasive Devices Inc. (Johnson & Johnson)
• Original Assignee: Innovasive Devices Inc. (Johnson & Johnson)
• Inventors: Hart, Rickey D.
• Primary Examiner(s): Sykes, Angela D.
• Assistant Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US08/234,642
• Time in Patent Office: 838 Days
• Field of Search: 606/41, 606/45-52, 606/205-208, 606/144-148, 606/139
• US Class Current: 606/148
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• 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 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3201 Scissors for biopsy A61B10/02
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 2017/2931 with releasable head
• CPC Class Codes: A61B 2018/1253 monopolar

Abstract

A surgical tool including a handle having a movable tool-operating member engaged therewith, a tool head having first and second members, and a coupling attaching the tool head to the handle. The first and second members of the tool head each include a cutting blade having a portion of a suture throw rundown tool extending distally therefrom. The cutting blades abut one another so as to act as a scissors when the first and second members are moved between open and closed positions. Further, the suture throw rundown tool portions mate with one another when the first and second members are in their closed position. The handle member also is adapted to rotate the inner shaft about its longitudinal axis. A method of using the surgical tool in the course of tying off lengths of suture extending from a surgical site also is provided.

Claims

1. A surgical instrument comprising:

a handle assembly;

a tool head comprising first and second cooperating tool members movable between a first position wherein said tool members are spaced from one another and a second position wherein said tool members are proximate to one another, said first and second tool members comprising first means for running surgical suture throws toward a surgical site to form a knot, and second means for severing excess lengths of suture adjacent to said knot; and

drive means attached to said handle assembly and connected to said tool head for moving said first and second cooperating tool members between said first position and said second position;

wherein said first means comprise a substantially semi-cylindrical portion on each of said first and second cooperating tool members, said substantially cylindrical portions being configured to substantially abut one another in mating relationship when said first and second tool members are located in said second position so as to form a cavity having an open distal end and a sidewall, said sidewall comprising a first bore extending at an angle therethrough and a second bore extending substantially radially through an opposing portion of said sidewall, said second bore being connected to the distal end of said cavity sidewall by a slot, and said first bore, said second bore, and said slot all being substantially aligned.

2. A surgical instrument according to claim 1 wherein said handle assembly is adapted to operate said drive means.

3. A surgical instrument according to claim 1 wherein said drive means comprises a discrete subassembly that is detachable as a unit from said handle assembly.

4. A surgical instrument according to claim 3 wherein said discrete subassembly is releasably locked to said handle assembly by a spring-biased locking member.

5. A surgical instrument according to claim 1 further including rotating means for rotating said tool head relative to said handle assembly.

6. A surgical instrument according to claim 1 wherein said drive means comprises an elongate rod, a hollow tube surrounding said rod, means for securing one end of said rod to said handle assembly, means for securing said tool head to the opposite end of said rod, support means for slidably supporting said tube for sliding axial movement relative to said rod, said support means comprising a first housing releasably secured to said handle assembly, said first housing defining an elongate chamber, and a second housing slidably mounted in said elongate chamber, said tube being secured to and movable with said second housing, and said rod extending through said second housing and being secured to said first housing, said rod and said tube cooperating to move said first and second cooperating tool members in response to axial movement of said tube relative to said rod.

7. A surgical instrument according to claim 6 wherein said handle assembly comprises a hollow body portion with said first housing extending therein.

8. A surgical instrument according to claim 1 wherein said second means comprises a cutting blades on each of said first and second tool members, said cutting blades being arranged to engage one another when said first and second tool members are moved to said second position.

9. A surgical instrument comprising;

a handle assembly;

a tool head comprising first and second cooperating tool members movable between a first position wherein said tool members are spaced from one another and a second position wherein said tool members are proximate to one another, said first and second tool members comprising first means for running, surgical suture throws toward a surgical site to form a knot, and second means for severing excess lengths of suture adjacent to said knot; and

drive means attached to said handle assembly and connected to said tool head for moving said first and second cooperating tool members between said first position and said second position;

wherein said first means comprise a substantially semi-cylindrical portion located distally of said second means on each of said first and second cooperating tool members, said substantially cylindrical portions being configured to substantially abut one another in mating relationship when said first and second tool members are located in said second position so as to form a cavity having an open distal end and a sidewall, said sidewall comprising a first bore extending at an angle therethrough and a second bore extending substantially radially through an opposing portion of said sidewall, said second bore being connected to the distal end of said cavity sidewall by a slot, and said first bore, said second bore, and said slot all being substantially aligned; and

wherein said second means comprises a cutting blade on each of said first and second tool members, said cutting blades being arranged to engage one another when said first and second tool members are moved to said second position.

10. A surgical instrument comprising a handle and trigger assembly and an operating tool assembly separably connected to said handle and trigger assembly;

said handle and trigger assembly comprising a handle housing having a chamber therein and a trigger member pivotally mounted to said handle housing;

.

said operating tool comprising at one end thereof a tool head including first means for running surgical suture throws toward a surgical site to form a knot and second means for severing excess suture lengths adjacent to said knot, and at the opposite end thereof a tubular housing that extends into said chamber;

said handle and trigger assembly having locking means engaged with said operating tool assembly for releasably locking said tubular housing to said handle housing;

said operating tool assembly further comprising a mechanism for moving portions of said first means for running suture throws and said second means for severing excess suture toward and away from one another, said mechanism including movable means in said tubular housing engaged and movable by said trigger member for causing said mechanism to move said portions of said first means for running suture throws and said second means for severing excess suture toward and way from one another in response pivotal movement of said trigger assembly;

wherein said mechanism includes first and second cooperating tool members, and

wherein said second means comprises opposing cutting blades on said first and second cooperating tool members, and

said first means comprises a substantially semi-frustoconical portion located distally of said cutting blade on each of said first and second cooperating tool members, said substantially frustoconical portions being configured to substantially abut one another in mating relationship when said first and second cooperating tool members are located in [their second]a closed position so as to form a distally facing open cylindrical cavity having an open distal end and a sidewall, [and]said sidewall defining a first bore extending therethrough and an opposing second bore extending substantially radially therethrough, said second bore being connected to said distal end of said cavity sidewall by a longitudinal slot, and said first bore, said second bore and said slot all being substantially aligned.

11. A method for forming a surgical knot in lengths of suture extending from a surgical site, said method comprising the steps of:

(a) providing a surgical instrument comprising a tool head having first and second cooperating tool members movable between a first open position wherein said tool members are spaced from one another and a second closed position wherein said tool members are proximate to one another, said first and second tool members comprising first means for running surgical suture throws toward the surgical site and second means for severing excess lengths of suture adjacent to said knot;

said first means comprising a substantially semi-cylindrical portion on each of said tool members, configured to abut each other in mating relationship in said second position so as to form a cavity having an open distal end and a sidewall, said sidewall having a bore extending therethrough and a slot extending therethrough, said slot having an open end at said distal end of said cavity and a closed end opposed to said bore; and

drive means for moving said first and second cooperating tool members between said first open position and said second closed position;

(b) forming a surgical throw in lengths of suture extending from the surgical site;

(c) with said tool members in said first open position, capturing one of said lengths of suture in said bore disposed in said first tool member;

(d) moving said tool members to said second closed position and capturing the other length of said suture in said slot disposed in said second tool member;

(e) while holding said lengths of suture taut, running said surgical throw toward the surgical site with said surgical instrument;

(f) moving said tool members to said first open position, thereby allowing said first and second members to pull said surgical throw taut;

(g) withdrawing said surgical instrument from the vicinity of the surgical site to permit said other length of said suture to drop from said slot; and

(h) disengaging said one of said lengths of suture from said first tool member by drawing said one length of suture through said bore.

12. The method of claim 11 further including the step of releasably locking said tool members in said second closed position during the running of said surgical suture throws along said lengths of suture extending from said surgical site.

13. A surgical instrument comprising:

a drive means disposed in a tube;

first and second tool members fixed, respectively, at one end to said drive means and biased away from each other and movable by said drive means between a first position in which said tool members are extended from said tube and biased away from each other and a second position in which said tool members are in part drawn into said tube and thereby forced toward and proximate each other;

a first head portion disposed at a distal end of said first tool member, said first head portion having a bore therethrough for receiving and retaining a first suture strand such that the first suture strand is slidable lengthwise through said bore, said bore being spaced from a distal end of said first head portion; and

a second head portion disposed at a distal end of said second tool member, said second head portion having a slot therethrough with an open end at a distal end of said second head portion and a closed end opposed to said bore for receiving and retaining a second suture strand such that the second suture strand is receivable by said slot generally widthwise of said second suture strand through said open end of said slot, and said second suture strand is slidable lengthwise through said slot;

whereby said first and second tool members in said second position are adapted for running said suture strands toward a surgical site, and are movable by said drive means from said second position to said first position to pull said suture strands taut to form a knot.

14. The instrument in accordance with claim 13 wherein said slot at said closed end thereof is provided with an enlarged portion opposed to said bore.

15. The instrument in accordance with claim 13 wherein each of said tool members is provided with blade means for cutting the suture strands.

16. The instrument in accordance with claim 13 wherein said first head portion is devoid of an opening therethrough, other than said bore, and said second head portion is devoid of an opening therethrough, other than said slot.

17. The instrument in accordance with claim 16 wherein said first and second head portions each comprise a substantially semi-cylindrical portion configured such that said first and second head portions abut each other in mating relationship when said head portions are in said second position, to form a cavity having an open distal end and a sidewall, said sidewall having therethrough said bore and said slot.

18. The instrument in accordance with claim 17 wherein said bore extends through said sidewall at an angle to an axis of said head portion when in said mating relationship.

19. The instrument in accordance with claim 17 wherein said bore extends through said sidewall at an angle to an axis of said head portions when in said mating relationship and said enlarged portion of said slot extends substantially radially through said sidewall.

20. A surgical instrument comprising:

first and second tool members fixed to a drive assembly and movable thereby;

a first head portion disposed at a distal end of said first tool member, said first head portion having a bore therethrough for receiving and retaining a first suture strand such that the first suture strand is slidable lengthwise through said bore, said bore being spaced from a distal end of said first head portion; and

a second head portion disposed at a distal end of said second tool member, said second head portion having a slot therethrough with an open end at a distal end of said second head portion and a closed end opposed to said bore for receiving and retaining a second suture strand such that the second suture strand is receivable by said slot generally widthwise of said second suture strand through said open end of said slot, and said second suture strand is slidable lengthwise through said slot.

21. The instrument in accordance with claim 20 wherein said slot at said closed end thereof is provided with an enlarged portion opposed to said bore.

22. The instrument in accordance with claim 20 wherein said first head portion is devoid of an opening therethrough, other than said bore, and said second head portion is devoid of an opening therethrough, other than said slot.

23. The instrument in accordance with claim 22 wherein said first and second head portions each comprise a substantially semi-cylindrical portion configured such that said first and second head portions abut each other in mating relationship when said head portions are in said second position, to form a cavity having an open distal end and a sidewall, said sidewall having therethrough said bore and said slot.

24. The instrument in accordance with claim 23 wherein said bore extends through said sidewall at an angle to an axis of said head portion when in said mating relationship.

25. The instrument in accordance with claim 21 wherein said bore extends through said sidewall at an angle to an axis of said head portions when in said mating relationship and said enlarged portion of said slot extends substantially radially through said sidewall.

26. The instrument in accordance with claim 20 wherein blade means are disposed on each of said tool members.