Methods and apparatus for suturing tissue
First Claim
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1. A suturing apparatus comprisinga needle having a sharp distal end for penetrating anatomical tissue;
- a length of filamentous suture material having an end received by said needle; and
a knotting element having an attachment site secured to a first segment of said suture material and a grasping site including a pair of opposed surfaces for grasping a second segment of said suture material, said opposed surfaces having a first position for receiving said second segment of said suture material therebetween and a second position for non-releasably grasping said second segment of said suture material therebetween to effect a knot after said needle has penetrated the anatomical tissue and said suture material has been tensioned and received between said opposed surfaces.
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Abstract
Method and apparatus for suturing and ligating anatomical tissue utilizes one or more knotting elements carried by a length of filamentous suture material for tying the suture material to create one or more adjustably tensioned stitches. The knotting elements are carried by the suture material at fixed spaced positions or can be movable along the suture material, and suture instruments are provided to facilitate the formation of a plurality of stitches, particularly during endoscopic procedures.
597 Citations
54 Claims
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1. A suturing apparatus comprising
a needle having a sharp distal end for penetrating anatomical tissue; -
a length of filamentous suture material having an end received by said needle; and a knotting element having an attachment site secured to a first segment of said suture material and a grasping site including a pair of opposed surfaces for grasping a second segment of said suture material, said opposed surfaces having a first position for receiving said second segment of said suture material therebetween and a second position for non-releasably grasping said second segment of said suture material therebetween to effect a knot after said needle has penetrated the anatomical tissue and said suture material has been tensioned and received between said opposed surfaces. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A suture supply comprising
a length of filamentous suture material; - and
a plurality of knotting elements each having an attachment site for receiving a segment of said suture material and a grasping site for grasping another segment of said suture material, said knotting elements being arranged in series along said suture material. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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- 26. A knotting element for tying first and second segments of a length of filamentous suture material comprising a unitary body made of plastically deformable material and having an attachment site for immovable fixation to the first suture material segment and a grasping site including opposed jaws plastically deformable to grasp the second suture material segment.
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31. A suture supply comprising
a length of suture material; - and
a plurality of knotting elements secured to said suture material at spaced positions therealong to define stitch segments between two of said knotting elements, each of said knotting elements including means for selectively engaging said suture material to act as a knot for said stitch segments of said suture material. - View Dependent Claims (32, 33)
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34. A suturing apparatus for suturing anatomical tissue comprising
a hollow needle having a lumen and a sharp distal end for penetrating anatomical tissue; -
a length of suture material received in said needle; and a plurality of knotting elements secured to said suture material at spaced positions to define stitch segments between the knotting elements, said knotting elements having grasping sites for grasping a segment of said suture material to effect a knot for said stitch segments, said knotting elements being initially disposed proximally of said needle distal end and being positionable individually beyond said needle distal end to effect a knot for said stitch segments. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45)
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46. A method of suturing tissue comprising the steps of
providing a length of filamentous suture material carrying a knotting element and a needle coupled with said suture material; -
penetrating the tissue with the needle from an entry point to an exit point to pass a portion of the suture material through the tissue to be sutured at the exit point; moving the suture material to be received in the knotting element to form a stitch segment extending from the knotting element through the tissue and back to the knotting element; tightening the stitch segment to a desired tension; and plastically deforming the knotting element to grasp the suture material and form a knot for the stitch segment.
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47. A method of forming a plurality of suture stitches in tissue comprising the steps of
providing a length of suture material having a plurality of knotting elements spaced therealong to define stitch segments between a distalmost knotting element and an end of the suture material and a needle receiving the suture material; -
penetrating the tissue with the needle by moving the needle forwardly from an entry point to an exit point to allow positioning of a portion of the suture material at the exit point; grasping the suture material adjacent the exit point; withdrawing the needle from the tissue by moving the needle rearwardly and out of the entry point; engaging the grasped portion of the suture material with the distalmost knotting element to knot the stitch segment between the end of the suture material and the distalmost knotting element to form a first stitch; cutting the suture material proximally of the distalmost knotting element to define a new end for the suture material and a new distalmost knotting element; and forming one or more additional stitches in tissue by repeating said penetrating, grasping, withdrawing, engaging and cutting steps. - View Dependent Claims (48, 49)
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50. A knotting element for tying first and second segments of a length of filamentous suture material comprising a body having an attachment site for fixation to the first suture material segment, a grasping site for grasping the second suture material segment and a filamentous tail extending from said body for manipulating said body to facilitate grasping of the second suture material segment at said grasping site.
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51. An instrument for forming and tying a plurality of stitches comprising
a suture supply including a length of suture material carrying a plurality of knotting elements each having a grasping site for tying the suture material; -
a pair of jaws disposed at a distal end of said instrument for holding the knotting elements during tying of stitches; and means for selectively placing individual knotting elements in said jaws. - View Dependent Claims (52, 53, 54)
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Specification