Needle guidance system for endoscopic suture device

• US 5,713,910 A
• Filed: 11/07/1995
• Issued: 02/03/1998
• 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., Quick, Richard L., Cooper, Robert P.
• Primary Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/554,743
• Time in Patent Office: 819 Days
• Field of Search: 606/139, 606/144, 606/145, 606/147, 606/148, 606/185, 606/186, 606/187, 606/278, 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 17/062 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 having a longitudinal axis;

a needle deployment system located within a distal end portion of said elongate body member, said needle deployment system comprising;

a curved needle carrier channel having a guide groove formed therein;

a curved needle carrier movably positioned in said curved needle carrier channel, said curved needle carrier having a guide wing which engages said guide groove formed in said curved needle carrier channel thereby guiding and stabilizing said curved needle carrier within said curved needle carrier channel; and

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 the distal end of said elongate body member where it is coupled to said curved needle carrier and moves said curved needle carrier through said curved needle carrier channel as it moves between said retracted position and said deployed position.

2. A suturing instrument as defined in claim 1 wherein said deployment controller further comprises an internal driver pathway extending from a proximate end portion of said elongate body member to said distal end portion of said elongate body member, wherein said internal driver pathway composes a curved pathway section near said distal end portion of said elongate body member, said curved pathway section having a distal end curvature.

3. A suturing instrument as defined in claim 2 further comprising a channel intersection at a location where a protection of a centerline of said distal end curvature of said curved pathway section from said distal end of said curved pathway section into said curved needle carrier channel is substantially tangent to a centerline of said curved needle carrier channel.

4. A suturing instrument as defined in claim 3 wherein said deployment controller further comprises a flexible driver member coupled to said curved needle carrier, said flexible driver member being slidably disposed in said curved pathway section of said internal driver pathway.

5. A suturing instrument as defined in claim 4 wherein said flexible driver member further comprises an alloy of nickel and titanium.

6. A suturing instrument as defined in claim 1 wherein said curved needle carrier guide wing further comprises a plurality of pins.

7. A suturing instrument as defined in claim 4 further comprising a rolling bearing member positioned adjacent said curved pathway section of said internal driver pathway and said channel intersection such that said flexible driver member contacts said rolling bearing member.

8. A suturing instrument comprising:

an elongate body member having a longitudinal axis;

a curved needle carrier channel positioned in said elongate body member wherein said curved needle carrier channel has a guide groove formed therein; and

a curved needle carrier movably positioned in said curved needle carrier channel, said curved needle carrier having a guide wing which engages said guide groove formed in said curved needle carrier channel thereby guiding and stabilizing said curved needle carrier within said curved needle carrier channel.

9. A suturing instrument as defined in claim 8 further comprising an internal driver pathway extending from a proximate end portion of said elongate body member to a distal end portion of said elongate body member, wherein said internal driver pathway comprises a curved pathway section near said distal end portion of said elongate body member, said curved pathway section having a distal end curvature.

10. A suturing instrument as defined in claim 9 further comprising a channel intersection at a location where a projection of a centerline of said distal end curvature of said curved pathway section from said distal end of said curved pathway section into said curved needle carrier channel is substantially tangent to a centerline of said curved needle carrier channel.

11. A suturing instrument as defined in claim 10 further comprising a flexible driver member coupled to said curved needle carrier, said flexible driver member being slidably disposed in said curved pathway section of said internal driver pathway.

12. A suturing instrument as defined in claim 11 wherein said flexible driver member further comprises an alloy of nickel and titanium.

13. A suturing instrument as defined in claim 8 wherein said curved needle carrier guide wing further comprises a plurality of pins.

14. A suturing instrument as defined in claim 11 further comprising a rolling bearing member positioned adjacent said internal driver pathway and said channel intersection such that said flexible driver member contacts said rolling bearing member.

15. A method of stabilizing and guiding a curved needle carrier movably positioned in a curved needle carrier channel, said method comprising:

providing a first guide groove and a second guide groove in the curved needle carrier channel;

providing a first guide wing and a second guide wing on the curved needle carrier; and

positioning the curved needle carrier within the curved needle carrier channel such that the first guide wing on the curved needle carrier slidably engages the first guide groove in the curved needle carrier channel and the second guide wing on the curved needle carrier slidably engages the second guide groove in the curved needle carrier channel.

16. A suturing instrument comprising:

an elongate body member;

a curved tubular channel positioned in a distal end portion of said body member, wherein said curved tubular channel further comprises;

a length defined by a proximate end and a distal end; and

a bearing groove formed along at least a portion of said curved tubular channel length; and

a curved needle carrier movably positioned in said curved tubular channel, said curved needle carrier having a bearing wing which engages said bearing groove formed in said curved tubular channel thereby guiding and stabilizing said curved needle carrier movably positioned within said curved tubular channel.

17. A suturing instrument as defined in claim 16 further comprising an internal driver pathway extending from a proximate end portion of said elongate body member to a distal end portion of said elongate body member, wherein said internal driver pathway comprises a curved pathway section near said distal end portion of said elongate body member, said curved pathway section having a distal end curvature.

18. A suturing instrument as defined in claim 17 further comprising a channel intersection at a location where a projection of a centerline of said distal end curvature of said curved pathway section from said distal end of said curved pathway section into said curved tubular channel is substantially tangent to a centerline of said curved tubular channel.

19. A suturing instrument as defined in claim 18 further comprising a flexible driver member coupled to said curved needle carrier, said flexible driver member being slidably disposed in said curved pathway section of said internal driver pathway.

20. A suturing instrument as defined in claim 19 wherein said flexible driver member further comprises an alloy of nickel and titanium.

21. A suturing instrument as defined in claim 19 further comprising a rolling bearing member positioned adjacent said internal driver pathway and said channel intersection such that said flexible driver member contacts said rolling bearing member.

22. A suturing instrument as defined in claim 16 wherein said curved needle carrier bearing wing further comprises a plurality of pins.

23. A suturing instrument comprising:

an elongate body member having a longitudinal axis;

an internal driver pathway extending from a proximate end portion to a distal end portion of said elongate body member, wherein said internal driver pathway comprises a curved pathway section near said distal end portion of said elongate body member, said curved pathway section having a distal end curvature;

a curved needle carrier channel located near the distal end portion of said elongate body member; and

a channel intersection at a location where a projection of a centerline of said distal end curvature of said curved pathway section from said distal end of said curved pathway section into said curved needle carrier channel is substantially tangent to a centerline of said curved needle carrier channel.

24. A suturing instrument as defined in claim 23 further comprising a curved needle carrier movably positioned in said curved needle carrier channel.

25. A suturing instrument as defined in claim 24 further comprising a flexible driver member coupled to said curved needle carrier, said flexible driver member being slidably disposed in said curved pathway section of said internal driver pathway.

26. A suturing instrument as defined in claim 25 wherein said flexible driver member further comprises an alloy of nickel and titanium.

27. A suturing instrument as defined in claim 25 further comprising a rolling bearing member positioned adjacent said curved pathway section of said internal driver pathway and said channel intersection such that said flexible driver member contacts said rolling bearing member.

28. A suturing instrument comprising:

an elongate body member having a longitudinal axis;

a curved needle carrier channel having a guide track formed therein, said curved needle carrier channel located within said elongate body member at a distal end thereof, said curved needle carrier channel located substantially in a plane which is substantially parallel to said elongate body member longitudinal axis, said curved needle carrier channel forming a needle exit port in a side wall of said elongate body member; and

a curved needle carrier movably positioned in said curved needle carrier channel, said curved needle carrier having a guide wing which engages said guide track formed in said curved needle carrier channel thereby guiding and stabilizing said curved needle carrier within said curved needle carrier channel.

29. A suturing instrument as defined in claim 28 further comprising an internal driver pathway extending from a proximate end portion of said elongate body member to a distal end portion of said elongate body member, where said internal driver pathway comprises a curved pathway section near said distal end portion of said elongate body member, said curved pathway section having a distal end curvature.

30. A suturing instrument as defined in claim 29 further comprising a channel intersection at a location where a projection of a centerline of said distal end curvature of said curved pathway section from said distal end of said curved pathway section into said curved needle carrier channel is substantially tangent to a centerline of said curved needle carrier channel.

31. A suturing instrument as defined in claim 30 further comprising a flexible driver member coupled to said curved needle carrier, said flexible driver member being slidably disposed in said curved pathway section of said internal driver pathway.

32. A suturing instrument as defined in claim 31 wherein said flexible driver member further comprises an alloy of nickel and titanium.

33. A suturing instrument as defined in claim 31 further comprising a rolling bearing member positioned adjacent said internal driver pathway and said channel intersection such that said flexible driver member contacts said rolling bearing member.

34. A suturing instrument as defined in claim 28 wherein said curved needle carrier guide wing further comprises a plurality of pins.

35. A suturing instrument comprising:

an elongate body member;

a curved tubular channel positioned in a distal end

portion of said body member, wherein said curved tubular channel further comprises;

a length defined by a proximate end and a distal end; and

a bearing groove formed along at least a portion of said curved tubular channel length; and

a curved suture carrier movably positioned in said curved tubular channel, said curved suture carrier having a bearing wing which engages said bearing groove formed in said curved tubular channel thereby guiding and stabilizing said curved suture carrier movably positioned within said curved tubular channel.

36. A suturing instrument as defined in claim 35 further comprising an internal driver pathway extending from a proximate end portion of said elongate body member to a distal end portion of said elongate body member, wherein said internal driver pathway comprises a curved pathway section near said distal end portion of said elongate body member, said curved pathway section having a distal end curvature.

37. A suturing instrument as defined in claim 36 further comprising a channel intersection at a location where a projection of a centerline of said distal end curvature of said curved pathway section from said distal end of said curved pathway section into said curved tubular channel is substantially tangent to a centerline of said curved tubular channel.

38. A suturing instrument as defined in claim 37 further comprising a flexible driver member coupled to said curved suture carrier, said flexible driver member being slidably disposed in said curved pathway section of said internal driver pathway.

39. A suturing instrument as defined in claim 38 wherein said flexible driver member further comprises an alloy of nickel and titanium.

40. A suturing instrument as defined in claim 38 further comprising a rolling bearing member positioned adjacent said internal driver pathway and said channel intersection such that said flexible driver member contacts said rolling bearing member.

41. A suturing instrument as defined in claim 35 wherein said curved suture carrier bearing wing further comprises a plurality of pins.

42. A suturing instrument comprising:

an elongate body member having a longitudinal axis;

a curved suture carrier channel having a guide track formed therein, said curved suture carrier channel located within said elongate body member at a distal end thereof, said curved suture carrier channel located substantially in a plane which is substantially parallel to said elongate body member longitudinal axis, said curved suture carrier channel forming an exit port in a side wall of said elongate body member; and

a curved suture carrier movably positioned in said curved suture carrier channel, said curved suture carrier having a guide wing which engages said guide track formed in said curved suture carrier channel thereby guiding and stabilizing said curved suture carrier within said curved suture carrier channel.

43. A suturing instrument as defined in claim 42 further comprising an internal driver pathway extending from a proximate end portion of said elongate body member to a distal end portion of said elongate body member, wherein said internal driver pathway comprises a curved pathway section near said distal end portion of said elongate body member, said curved pathway section having a distal end curvature.

44. A suturing instrument as defined in claim 43 further comprising a channel intersection at a location where a projection of a centerline of said distal end curvature of said curved pathway section from said distal end of said curved pathway section into said curved suture carrier channel is substantially tangent to a centerline of said curved suture carrier channel.

45. A suturing instrument as defined in claim 44 further comprising a flexible driver member coupled to said curved suture carrier, said flexible driver member being slidably disposed in said curved pathway section of said internal driver pathway.

46. A suturing instrument as defined in claim 45 wherein said flexible driver member further comprises an alloy of nickel and titanium.

47. A suturing instrument as defined in claim 45 further comprising a rolling bearing member positioned adjacent said internal driver pathway and said channel intersection such that said flexible driver member contacts said rolling bearing member.

48. A suturing instrument as defined in claim 42 wherein said curved suture carrier guide wing further comprises a plurality of pins.