Endoscopic suture system

• US 5,578,044 A
• Filed: 09/26/1994
• Issued: 11/26/1996
• Est. Priority Date: 09/04/1992
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Laurus Medical Corporation
• Inventors: Gordon, Norman S., Cooper, Robert P.
• Primary Examiner(s): Buiz, Michael Powell
• Assistant Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/311,967
• Time in Patent Office: 792 Days
• Field of Search: 606/139, 606/144, 606/145, 606/147, 606/148, 606/151, 606/205-207, 112/169, 112/80.03
• 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
• 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. The invention also provides for the placement of sutures for the endoscopic approximation, fixation, and ligation of tissues within a body cavity including the driving and retrieval of needle and suture combinations, and facilitating the tying of knots.

Claims

1. A suturing instrument comprising:

an elongate body member, said elongate body member having a substantially straight distal end portion;

a concave curved driver pathway coupled to a convex curved needle channel located within said substantially straight distal end portion of said elongate body member; and

a flexible driver member slidably disposed in said concave curved driver pathway.

2. A suturing instrument comprising:

a curved needle channel having a needle retention zone with a needle retention zone cross sectional dimension and a needle guidance zone with a needle guidance zone cross sectional dimension, said needle guidance zone cross sectional dimension being smaller than said needle retention zone cross sectional dimension; and

a curved surgical needle slidably positioned in said curved needle channel, said curved surgical needle having a first radius of curvature along a proximate end portion thereof and a second radius of curvature, different from said first radius of curvature, along a distal end portion thereof.

3. A suturing instrument as defined in claim 2 wherein said first radius of curvature along said proximate end portion of said curved surgical needle is greater than said second radius of curvature along said distal end portion of said curved surgical needle.

4. A suturing instrument as defined in claim 2 wherein said first radius of curvature along said proximate end portion of said curved surgical needle is substantially larger than said second radius of curvature along said distal end portion of said curved surgical needle such that said proximate end portion of said curved surgical needle is substantially linear in comparison to said distal end portion of said curved surgical needle.

5. A suturing instrument comprising:

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

a concave curved driver pathway coupled to a convex curved needle channel located within said substantially straight distal end portion of said elongate body member wherein said convex curved needle channel is substantially semi circular.

6. A suturing instrument comprising:

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

a concave curved driver pathway coupled to a convex curved needle channel located within said substantially straight distal end portion of said elongate body member wherein said convex curved needle channel further comprises a needle retention zone with a needle retention zone cross sectional dimension and a needle guidance zone with a needle guidance zone cross sectional dimension, said needle guidance zone cross sectional dimension being smaller than said needle retention zone cross sectional dimension.

7. A passive needle catch for receiving and retaining a shouldered surgical needle, said catch comprising:

a substantially planar foundation having a first surface, a second surface and a thickness determined by a linear dimension separating said first and second surfaces; and

at least one flexible aperture formed in said substantially planar foundation, wherein a first surface lateral dimension of said flexible aperture on said first surface of said foundation is larger than a second surface lateral dimension of said flexible aperture on said second surface of said foundation and said first and second surface lateral dimensions are substantially equal to or greater than said thickness of said substantially planar foundation, wherein said flexible aperture expands to allow passage of the needle shoulder into said aperture and contracts after the needle shoulder has passed through said aperture.

8. A suturing instrument comprising:

an elongate body member having a longitudinal axis;

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

a curved needle carrier movably positioned in said curved needle carrier channel, said curved needle carrier having a mount for a needle point on a distal end and a peripheral groove along a portion of its periphery extending from a proximate end of said curved needle carrier; and

a flexible pusher coupled to said deployment controller at one end and to said curved needle carrier at another end such that said flexible pusher engages said curved needle carrier peripheral groove as said deployment controller moves from said retracted position to said deployed position whereby said flexible pusher pushes said curved needle carrier through said curved needle channel.

9. A suturing instrument comprising:

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

a curved needle channel located within said substantially straight distal end portion of said elongate tubular body member 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 elongate body member longitudinal axis, said curved needle channel forming a needle exit port in a side wall of said elongate tubular body member proximal to said substantially straight distal end portion; and

a suture slot formed in said elongate tubular body member substantially straight distal end portion wherein said suture slot intersects said needle exit port and said curved needle channel periphery along a substantial portion of the length of said curved needle channel, wherein said suture slot has a width which is selected to be substantially smaller than a lateral dimension of said needle channel such that a length of suture can be inserted into said curved needle channel through said slot and said needle exit port.

10. 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 proximal to said distal end portion of said elongate body member, said curved needle channel having a needle retention zone with a needle retention zone cross sectional dimension and a needle guidance zone with a needle guidance zone cross sectional dimension, said needle guidance zone cross sectional dimension smaller than said needle retention zone cross sectional dimension; 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.

11. A suturing instrument comprising:

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

a concave curved driver pathway coupled to a convex curved needle channel located within said substantially straight distal end portion of said elongate body member wherein said concave curved driver pathway is substantially C-shaped and said convex curved needle channel is substantially C-shaped and said C-shaped concave curved driver pathway is connected to said C-shaped convex curved needle channel such that the combination of said C-shaped concave curved driver pathway and said C-shaped convex curved needle channel form a substantially S-shaped pathway having a laterally disposed exit from said elongate body member distal end portion.

12. A suturing instrument comprising:

an elongate body member having a substantially straight distal end portion and an internal driver pathway extending along an elongate body member longitudinal axis from a proximate end to said distal end portion of said elongate body member, said internal driver pathway comprising a substantially linear pathway section which is substantially parallel with said longitudinal axis connected to a substantially C-shaped pathway section near said distal end portion of said elongate body member;

a substantially C-shaped needle channel located at the distal end portion of said elongate body member and connected to said C-shaped pathway section of said internal driver pathway such that the combination of said C-shaped pathway section of said internal driver pathway and said C-shaped needle channel form a substantially S-shaped pathway having a laterally disposed exit from said elongate body member substantially straight distal end portion; and

a needle driver member slidably disposed within said internal driver pathway.

13. A suturing instrument as defined in claim 12 further comprising a flexible driver member coupled to said needle driver member, said flexible member slidably disposed in said C-shaped pathway section of said internal driver pathway.

14. A suturing instrument as defined in claim 12 wherein said C-shaped needle channel is substantially semi circular.

15. A suturing instrument as defined in claim 12 wherein said C-shaped curved needle channel further comprises a needle retention zone with a needle retention zone cross sectional dimension and a needle guidance zone with a needle guidance zone cross sectional dimension, said needle guidance zone cross sectional dimension being smaller than said needle retention zone cross sectional dimension.