Apparaus and method for suturing body tissue

• US 5,562,686 A
• Filed: 04/19/1995
• Issued: 10/08/1996
• Est. Priority Date: 04/19/1995
• Status: Expired due to Term

• Current Assignee: LSI Solutions, Inc.
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Hammond, John F., Sauer, Jude S., Greenwald, Roger J., Hinchliffe, Peter W. J., Tiberio, Theodore J., Shaw, Jeffrey M.
• Primary Examiner(s): Buiz, Michael Powell
• Assistant Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/424,946
• Time in Patent Office: 538 Days
• Field of Search: 606/139, 606/144, 606/145, 606/147, 606/148, 112/169, 112/80.03
• US Class Current: 606/144
• 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 2017/00637 for sealing trocar wounds through abdominal wall
• 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 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61B 2017/2926 Details of heads or jaws

Abstract

An apparatus for suturing body tissue is provided having an elongated housing, first and second jaws pivotably mounted to the distal portion of elongated housing, and first and second needles movable with respect to the first and second jaws. A first actuating mechanism is operatively associated with the first and second jaws such that actuation moves the jaws from the first position to a second position. A second actuating mechanism is operatively associated with the first and second needles wherein actuation advances the first and second needles into body tissue. Each of the jaws has a recess for receiving body tissue and a ferrule attached to each end of the suture such that advancement of the needles engages the ferrule to pull the ferrule and suture through the body tissue when the needle is retracted.

Claims

1. An apparatus for suturing body tissue comprising:

an elongated body portion having a proximal and distal portion and defining a longitudinal axis;

first and second jaws movably mounted to the distal portion of the elongated body portion;

first and second needles movable with respect to the first and second jaws, respectively;

a first actuator operatively associated with the first and second jaws, wherein actuation of the first actuator moves the jaws from a first position substantially aligned with each other to a second position substantially non-aligned with each other; and

a second actuator operatively associated with the first and second needles, wherein actuation of the second actuator advances the first and second needles into body tissue, the second actuator being capable of advancing the first and second needles when the jaws are in the second position.

2. An apparatus for suturing body tissue according to claim 1, wherein in the first position the jaws are closed and in the second position the jaws are spread apart to an angle with respect to the longitudinal axis of the body portion.

3. An apparatus for suturing body tissue according to claim 2, further comprising first and second flexible rods operatively connected to the second actuator to drive the first and second needles distally into body tissue, a portion of the rods movable to an angle with respect to the longitudinal axis of the body portion when the jaws are moved to the open position.

4. An apparatus for suturing body tissue according to claim 2, wherein each of the jaws has an recess for receiving body tissue.

5. An apparatus for suturing body tissue according to claim 2, wherein in the second position the jaws are in an open position, and further comprising a safety latch, wherein the safety latch prevents actuation of the second actuator if the jaws are not in the open position.

6. An apparatus for suturing body tissue according to claim 5, further comprising a driver member operatively connected to the first actuator, wherein the safety latch has a blocking surface engagable with a portion of the driver member to block movement thereof if the first actuator has not been actuated to move the jaws to the open position, wherein sliding movement of the first actuator to open the jaws automatically cams the safety latch out of blocking engagement with the driver member.

7. An apparatus for suturing body tissue according to claim 1, wherein the first actuator is slidable longitudinally to move the jaws between the first and second position.

8. An apparatus for suturing body tissue according to claim 7, further comprising an elongated plunger operatively connected to the first actuator, such that movement of the first actuator longitudinally distally causes a distal end of the plunger to cam the first and second jaws to the second position, wherein in the second position the jaws are spread apart.

9. An apparatus for suturing body tissue according to claim 8, wherein the second actuator is slidable longitudinally and is operatively connected to first and second elongated rods, the first and second rods being operatively connected to the first and second needles, respectively.

10. An apparatus for suturing body tissue according to claim 1, wherein the second actuator is slidable longitudinally to advance the first and second needles distally.

11. An apparatus for suturing body tissue according to claim 10, further comprising first and second elongated rods operatively connecting the second actuator and the first and second needles.

12. An apparatus for suturing body tissue according to claim 1, wherein each of the jaws has a recess portion for receiving body tissue, a needle guide positioned proximally of the recess portion, and a needle engaging member positioned distally of the recess portion and attached to a suture.

13. An apparatus for suturing body tissue according to claim 12, wherein said first and second needles are configured and dimensioned such that upon movement of the second actuator, each needle is forced from the needle guide, through body tissue positionable in the recess portion, and into frictional engagement with the needle engaging member.

14. An apparatus for suturing body tissue according to claim 13, wherein said first and second needles are further configured and dimensioned such that upon return of the second actuator to a retracted position, each needle pulls the engaged needle engaging member proximally.

15. An apparatus for suturing body tissue according to claim 14, wherein the suture extends within a slot formed in an outer surface of each jaw and within the elongated body portion.

16. An apparatus for suturing body tissue according to claim 12, further comprising a shield positioned on at least one of the jaws to reduce the amount of effluent from the surgical site.

17. An apparatus for suturing body tissue comprising;

an elongated body portion having a proximal and distal portion and defining a longitudinal axis;

first and second jaws movably mounted to the distal portion of the elongated body portion;

first and second needles movable with respect to the first and second jaws, respectively;

a first actuator operatively associated with the first and second jaws, wherein actuation of the first actuator moves the jaws from a first position wherein the jaws are closed to a second position wherein the jaws are spread apart to an angle with respect to the longitudinal axis of the body portion;

a second actuator operatively associated with the first and second needles, wherein actuation of the second actuator advances the first and second needles into body tissue; and

a first ferrule positioned in the first jaw and a second ferrule positioned in the second jaw, and a suture connected at one end to the first ferrule and connected at the other end to the second ferrule, wherein actuation of the second actuator to advance the first and second needles advances the first needle into engagement with the first ferrule and the second needle into engagement with the second ferrule.

18. An apparatus for suturing body tissue comprising:

an elongated body portion defining a longitudinal axis and having a proximal end portion and a distal end portion;

first and second needles movable with respect to the elongated body portion, the first and second needles being movable in a distal direction and at an angle relative to each other to penetrate body tissue; and

a suture associated with said elongated body portion initially spaced from the first and second needles, wherein movement of the first and second needles distally connects the first and second needles to the suture.

19. An apparatus for suturing body tissue according to claim 18, wherein the suture is connected at each end to a ferrule such that movement of the first and second needles distally moves the needles into engagement with the ferrule to thereby connect the first and second needles to the suture.

20. An apparatus for suturing body tissue according to claim 19, further comprising a pair of elongated drive rods operatively connected to the needles, the drive rods actuable from the proximal end portion of the elongated body portion for moving the needles distally.

21. An apparatus for suturing body tissue according to claim 20, further comprising a pair of jaws pivotably mounted to the elongated body portion, wherein each of the jaws contains one of the ferrules.

22. An apparatus for suturing body tissue according to claim 20, wherein the ferrules and suture are removably and replaceably positioned in the apparatus and can be replaced with fresh ferrules and suture.

23. An apparatus for suturing body tissue comprising:

an elongated body portion;

first and second jaws extending from a distal end portion of the elongated body portion and mounted for relative movement with respect to one another between an open and closed position;

first and second needles movable with respect to the first and second jaws;

wherein the needles are movable in a distal direction to penetrate body tissue when the first and second jaws are disposed in the open position.

24. An apparatus for suturing body tissue according to claim 23, further comprising at least one suture, wherein movement of the needles in a distal direction connects the needles to the at least one suture.

25. An apparatus for suturing body tissue according to claim 24, further comprising a first longitudinally slidable actuating mechanism for moving the first and second jaws and a second longitudinally slidable driving mechanism for moving the first and second needles.

26. A method for closing trocar wounds comprising:

a) inserting an apparatus having first and second jaws and first and second needles into the body cavity through the trocar wound;

b) spreading the first and second jaws of the apparatus to an open position;

c) advancing the first needle through the first jaw and the second needle through the second jaw to penetrate body tissue.

27. A method for closing trocar wounds according to claim 26, wherein the step of advancing the first and second needles includes the step of advancing the needles in a distal direction.

28. A method for closing trocar wounds according to claim 27, wherein the step of advancing the needles includes the step of advancing the needles distally at an angle to a longitudinal axis of the apparatus.

29. A method for closing trocar wounds according to claim 28, wherein the step of advancing the first and second needles includes the step of connecting each needle to a portion of a suture positioned in a distal end portion of the jaws.

30. A method for closing trocar wounds according to claim 29, wherein the step of connecting each needle to a portion of the suture includes frictionally engaging each needle to a ferrule connected to the suture.

31. A method for closing trocar wounds according to claim 30, further comprising the steps of:

a) moving the jaws to the closed position;

b) withdrawing the apparatus from the body cavity to pull the suture through the tissue;

c) removing the suture from the ferrules; and

d) forming a knot in the suture outside the body cavity.

32. A method for closing trocar wounds according to claim 31, wherein the step of inserting the apparatus through the body cavity includes the step of inserting the apparatus through a trocar cannula positioned in the trocar opening.

33. A method for closing trocar wounds according to claim 30, further comprising the steps of:

a) moving the jaws to the closed position;

b) withdrawing the apparatus from the body cavity to pull the suture through the body tissue;

c) removing the suture from the ferrules; and

d) wrapping the suture around a cannula fastening device.

34. A method for closing trocar wounds according to claim 33, further comprising the step of reinserting the apparatus into the body cavity prior to the step of wrapping the suture.