Endoscopic suture system

• US 5,575,800 A
• Filed: 11/14/1994
• Issued: 11/19/1996
• 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.
• Primary Examiner(s): Buiz, Michael Powell
• Assistant Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/338,247
• Time in Patent Office: 736 Days
• Field of Search: 606/139, 606/144, 606/145, 606/147, 606/148, 606/185, 606/186, 606/187, 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 17/0625 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 approximating tissue, particularly the tissue separated by means of an endosurgical trocar being inserted into a body cavity. The invention provides for the introduction and placement of the device into the body cavity, with the distal end having deployable needle guides, extending the needle guides 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 is then tied to approximate the wound and excess suture material cut off.

Claims

1. A surgical instrument for suturing tissue comprising:

an elongate housing having a longitudinal axis and an internal chamber with a lateral exit opening near a distal end of said elongate housing;

a needle mount dimensioned to accept and hold a surgical needle with a suture attached thereto, said needle mount movably attached to said elongate housing within said internal chamber and dimensioned to fit within said internal chamber in a first configuration; and

means for attaching said needle mount to said internal chamber, said means for attaching configured to permit said needle mount to deploy the needle out of said internal chamber through said lateral exit opening along a path which initially extends away from said housing a predetermined distance to intercept one side of a plane of reference at a first location wherein the plane of reference is substantially parallel to said elongate housing longitudinal axis, said path then passes through the plane of reference at said first location, continues in a direction which extends toward said housing, intercepts the opposite side of the plane of reference at a second location and terminates in a needle catch attached to said housing.

2. A surgical instrument as defined in claim 1 further comprising an actuator means linked to said needle mount and having a control portion located near a proximal end of said elongate housing, said actuator means configured to control the deployment of the needle at said distal end of said housing in response to movement of said control portion at said proximal end of said housing.

3. A surgical instrument as defined in claim 2 wherein said actuator means further comprises a needle deployment controller means linked to said needle mount and configured to control the deployment of the needle and said needle mount out of said elongate housing internal chamber at said distal end of said housing in response to movement of said needle deployment controller means.

4. A surgical instrument as defined in claim 2 wherein said actuator means further comprises a needle driver means linked to said needle mount and configured to push the needle out of said needle mount at said distal end of said housing in response to movement of said needle driver means.

5. A suture instrument comprising:

a hollow elongate body member;

an actuator means movably mounted within said hollow elongate body member, said actuator means having a head which extends exteriorly of said hollow elongate body member at a proximate end thereof; and

a needle deployment mechanism means movably mounted within said hollow elongate body member at a distal end thereof, said needle deployment mechanism means having a needle holder dimensioned to hold a surgical needle, said needle deployment mechanism means having a first configuration wherein said needle deployment mechanism means and the needle in said needle holder are contained substantially entirely within said hollow elongate body member distal end, wherein said needle deployment mechanism means is interconnected with said actuator means such that movement of said actuator means within said hollow elongate body member deploys said needle deployment mechanism means and the surgical needle outside of said hollow elongate body member through a lateral opening in said hollow elongate body member to a predetermined distance away from said hollow elongate body member along a non-linear path which intercepts a first side of a plane of reference at a first location wherein the plane of reference is substantially parallel to a longitudinal axis of said hollow elongate body member, further movement of said actuator means moves the surgical needle through said plane of reference at said first location whereupon said non-linear path continues back toward said hollow elongate body member to intercept a second side of said plane of reference at a second location and passes through the plane of reference at said second location before continuing into a needle catch located near said hollow elongate body member distal end which retains the needle therein in a fixed relationship with respect to said hollow elongate body member, and further movement of said actuator means withdraws said needle holder and needle deployment mechanism means back into said hollow elongate body member.

6. A suture instrument as defined in claim 5 further comprising a needle driver linked to said needle holder and configured to push the needle out of said needle holder at said distal end of said housing in response to movement of said needle driver.

7. A suture application apparatus for suturing tissue with a suture having a needle attached to an end of the suture, said apparatus comprising:

a substantially cylindrical elongate body member having a longitudinal axis and an internal cavity; and

a needle deployment mechanism mounted within said substantially cylindrical elongate body member internal cavity, wherein said needle deployment mechanism further comprises a needle carrier dimensioned to accept and hold a needle, said needle carrier having a first position wherein said needle carrier and the needle are contained within said internal cavity and a second position wherein the needle is deployed outside of said internal cavity through a lateral opening in said substantially cylindrical elongate body member such that the path traversed by the needle from said first position to said second position is along a curved path which first proceeds in a direction away from said substantially cylindrical elongate body member to intercept one side of a plane of reference at a first location wherein the plane of reference is substantially parallel to said substantially cylindrical elongate body member longitudinal axis, said curved path then passes through the plane of reference at said first location, continues in a direction toward said substantially cylindrical elongate body member and then intercepts the opposite side of the plane of reference at a second location.

8. A suture device as defined in claim 7 wherein said needle deployment mechanism further comprises a needle guide dimensioned to hold said needle carrier and configured to direct said needle carrier along said curved path.

9. A suture device as defined in claim 8 wherein said needle guide has a substantially semi-circular shape.

10. A suture device as defined in claim 7 wherein said needle deployment mechanism further comprises a first elongate flexible member means for pushing said needle along said curved path.

11. A suture device as defined in claim 7 further comprising a needle catch attached to said substantially cylindrical elongate body member at a location which intercepts the curved path traversed by the needle in the vicinity of said second position, said needle catch dimensioned to capture and hold said needle.

12. A suture device comprising:

an elongate cannular body member having a longitudinal axis, an internal chamber and a lateral opening; and

a needle carrier means having a needle mount for holding a needle, said needle carrier means movably mounted within said internal chamber and having a retracted configuration wherein said needle carrier means and the needle are contained within said internal chamber and a deployed configuration wherein a substantial portion of the needle is located outside of said internal chamber, wherein said needle carrier means includes means for moving the needle along a curved path from the retracted configuration to the deployed configuration which has an initial direction through said lateral opening in said elongate cannular body member away from said cannular body member to intercept one side of a plane of reference at a first location wherein the plane of reference is substantially parallel to said elongate cannular body member longitudinal axis, followed by a direction toward said cannular body member and then intercepts the opposite side of the plane of reference at a second location.

13. A suturing apparatus comprising:

a substantially cylindrical elongate body member having a longitudinal axis and an internal chamber; and

a needle deployment mechanism means mounted within said substantially cylindrical elongate body member internal chamber, wherein said needle deployment mechanism means further comprises a needle carrier dimensioned to accept and hold a surgical needle, said needle carrier having a first position wherein said needle carrier and the needle are contained within said internal chamber and a second position wherein the needle is deployed outside of said internal chamber through a lateral opening in said substantially cylindrical elongate body member, wherein said needle deployment mechanism means moves said needle along a curved path traversed by the needle from the first position to the second position which has an initial direction away from said substantially cylindrical elongate body member to intercept a first side of a plane of reference and pass through the plane of reference at a first location wherein the plane of reference is substantially parallel to said longitudinal axis of said substantially cylindrical elongate body member followed by a direction toward said substantially cylindrical elongate body member and then intercepts a second side of the plane of reference at a second location.

14. A suturing apparatus comprising:

a substantially cylindrical elongate body member having an internal cavity; and

a needle deployment mechanism dimensioned to accept and hold a needle, said needle deployment mechanism mounted within said substantially cylindrical elongate body member internal cavity, said needle deployment mechanism having a first position wherein said needle deployment mechanism and the needle are contained within said internal cavity of said substantially cylindrical elongate body member and a second position wherein the needle is deployed outside of said internal cavity of said substantially cylindrical elongate body member through a lateral opening in said substantially cylindrical elongate body member such that the needle traverses a path from said first position to said second position which first proceeds in a direction away from said substantially cylindrical elongate body member to intercept a first side of a plane of reference at a first location wherein the plane of reference is substantially parallel to a longitudinal axis of said substantially cylindrical elongate body member, said path then passes through the plane of reference at said first location, continues in a direction toward said substantially cylindrical elongate body member and then intercepts a second side of the plane of reference at a second location.

15. A suture application apparatus for suturing tissue with a suture having a needle attached to an end of the suture, said apparatus comprising:

an elongate body member having an internal cavity;

a needle deployment mechanism mounted within said elongate body member internal cavity, wherein said needle deployment mechanism further comprises a needle carrier dimensioned to accept and hold a needle, said needle carrier having a first position wherein said needle carrier and the needle are contained within said internal cavity and a second position wherein the needle is deployed outside of said internal cavity through a lateral opening in said elongate body member such that the path traversed by the needle from said first position to said second position is along a path which first intercepts one side of a plane of reference, passes through the plane, reverses direction and then intercepts the opposite side of the plane; and

a needle catch attached to said elongate body member at a location which intercepts the path traversed by the needle in the vicinity of said second position, said needle catch dimensioned to capture and hold said needle.

16. A suturing apparatus comprising:

a substantially cylindrical elongate body member having an internal cavity; and

a needle deployment mechanism mounted within said substantially cylindrical elongate body member internal cavity, wherein said needle deployment mechanism further comprises a needle carrier dimensioned to accept and hold a needle, said needle carrier having a first position wherein said needle carrier and the needle are contained within said internal cavity and a second position wherein the needle is deployed outside of said internal cavity through a lateral opening in said substantially cylindrical elongate body member such that the path traversed by the needle from said first position to said second position is along a path which first proceeds in a direction away from said substantially cylindrical elongate body member to intercept a first side of a plane of reference at a first location wherein the plane of reference is substantially parallel to a longitudinal axis of said substantially cylindrical elongate body member, said path then passes through the plane of reference at said first location, continues in a direction toward said substantially cylindrical elongate body member and then intercepts a second side of the plane of reference at a second location.