Endoscopic vascular suturing apparatus

• US 5,728,113 A
• Filed: 06/12/1996
• Issued: 03/17/1998
• Est. Priority Date: 10/07/1994
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Sherts, Charles R.
• Primary Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/662,943
• Time in Patent Office: 643 Days
• Field of Search: 606/139, 606/144, 606/145, 606/147, 606/148, 606/151, 606/205-208, 112/169, 112/80.03
• US Class Current: 606/145
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0491 Sewing machines for surgery
• CPC Class Codes: A61B 17/2909 Handles
• CPC Class Codes: A61B 2017/06019 by means of a suture-receiving lateral eyelet machined in the needle
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/0609 having sharp tips at both ends, e.g. shuttle needle alternately retained and released by first and second facing jaws of a suturing instrument
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots

Abstract

An endoscopic apparatus for suturing vascular tissue including a body portion having a first and a second jaw mounted for movement on a distal end thereon and moveable between an open position spaced apart to a closed position wherein the first and second jaws are in close cooperative alignment and a handle member for moving the first and second jaws to move them between the open and closed positions. The apparatus further includes a reciprocating mechanism associated with the first and second jaws and movable between a first position securing a surgical needle within the first jaw and a second position releasing the surgical needle from the first jaw and a cam actuating lever engagable with the reciprocating mechanism such that the cam actuating lever cams the reciprocating mechanism between the first and second positions in response to predetermined movement of the handle member.

Claims

1. An endoscopic apparatus for suturing tissue comprising:

a) an elongated tubular housing;

b) a first jaw and a second jaw mounted for movement on a distal end of the tubular housing and remotely actuable for movement between an open position and a closed position wherein the first and second jaws are in close cooperative alignment;

c) a handle mechanism including a handle member, the handle mechanism associated with the proximal end of the tubular housing, the handle member being actuable to move the first and second jaws between the open and closed positions;

d) a reciprocating mechanism, mounted to the handle mechanism, remote from the first and second jaws and movable between a first position securing a surgical needle within one of the first and second jaws and a second position releasing the surgical needle from the same one of the first and second jaws; and

e) a cam actuating lever engagable with the reciprocating mechanism to cam the reciprocating mechanism between the first and second positions in response to a predetermined movement of the handle member.

2. The apparatus according to claim 1, wherein the cam actuating lever is positioned with respect to the reciprocating mechanism such that the cam actuating lever automatically engages the reciprocating mechanism subsequent to closure of the jaws.

3. The apparatus according to claim 1 wherein, the first and second jaws have respective first and second needle engaging members and the reciprocating mechanism is operatively associated with the first and second needle engaging members for alternatively moving the first and second needle engaging members into and out of engagement with a surgical needle subsequent to closure of the first and second jaws.

4. The apparatus according to claim 3, wherein the reciprocating mechanism includes a toggle wheel rotatably mounted adjacent a proximal portion of the tubular housing with a proximal end of each of the first and second needle engaging members being connected to opposite sides of the toggle wheel such that rotation of the toggle wheel simultaneously retracts one of the first and second needle engaging members and advances the other of the first and second needle engaging members.

5. The apparatus according to claim 4, wherein the cam actuating lever is mounted on the handle member, such that movement of the handle member drives the cam actuating lever into engagement with camming surfaces on the toggle wheel to rotate the toggle wheel upon movement of the first and second jaw handle member into the closed position.

6. The apparatus according to claim 3, wherein the first jaw has a first recess for receipt of a portion of a surgical needle therein, the first needle engaging member movable adjacent the first recess to engage the surgical needle disposed therein.

7. The apparatus according to claim 1, further comprising a lockout member engagable with the reciprocating mechanism and mounted for movement between a locked position blocking movement of the reciprocating mechanism and an unlocked position allowing movement of the reciprocating mechanism.

8. The apparatus according to claim 7, wherein the cam actuating lever includes a release leg, the release leg moving the lockout member from the locked position to the unlocked position upon closure of the handle member.

9. An endoscopic apparatus for suturing tissue comprising:

a) an elongated tubular housing;

b) a first and a second jaw mounted for movement adjacent a distal end of the tubular housing and remotely actuable for movement between an open position and a closed position wherein the first and second jaws are in close cooperative alignment;

c) a handle member operatively associated with the proximal end of the tubular housing and actuable to move the first and second jaws between the open and closed positions;

d) a reciprocating mechanism operatively associated with the handle member remote from the first and second jaws and movable between a first position securing a surgical needle within one of the first and second jaws and a second position releasing the surgical needle from the same one of the first and second jaws;

e) a cam actuating lever engagable with the reciprocating mechanism to cam the reciprocating mechanism between the first and second positions in response to a predetermined movement of the handle member; and

f) a handle portion positioned adjacent a proximal end of the tubular housing, the handle portion including a plate mounted within the handle portion, the plate including camming structure for moving the jaws from the open position to the closed position and subsequently moving the cam actuating lever into camming engagement with the reciprocating mechanism.

10. The apparatus of claim 9, wherein said camming structure includes a cam slot and the handle member includes a cam pin mounted for movement in the cam slot for sequencing movement of the jaws and the reciprocating mechanism.

11. An apparatus for suturing tissue comprising:

a) an elongated tubular housing;

b) a handle mechanism including a pair of handles mounted adjacent a proximal end of the tubular housing;

c) a first jaw extending from the elongated tubular housing and having a first needle receiving recess configured to receive a portion of a surgical needle therein and a first needle engaging member mounted for movement with respect to the first jaw;

d) a second jaw mounted adjacent the housing for movement with respect to the first jaw and having a second needle receiving recess configured to receive a portion of a surgical needle therein, the second jaw having a second needle engaging member mounted for movement with respect to the second jaw;

e) a reciprocating mechanism mounted to the handle mechanism and connected to the first and second needle engaging members, the reciprocating mechanism actuable by the handles for alternately moving the first and second needle engaging members into and out of the first and second needle receiving recesses, the reciprocating mechanism being movable by the handles between a first position advancing the first needle engaging member with respect to the first jaw and a second position advancing the second needle engaging member with respect to the second jaw; and

f) a cam actuating lever operatively associated with the handles, the cam actuating lever automatically camming the reciprocating mechanism between the first and second positions to allow transfer of control of a surgical needle between the first and second jaws upon closure of the handles.

12. The apparatus according to claim 11, wherein the reciprocating mechanism includes a toggle wheel rotatably affixed to the tubular housing and having first and second camming surfaces such that an initial closure of the handles forces the cam actuating lever into engagement with the first camming surface to automatically move the toggle wheel to the first position and a subsequent closure of the handles forces the cam actuating lever into engagement with the second camming surface to automatically move the toggle wheel to the second position.

13. An apparatus for suturing tissue endoscopically comprising:

a) an elongated body portion defining a longitudinal axis;

b) a first needle holding jaw mounted for movement parallel to the longitudinal axis and having a first needle engaging surface;

c) a second needle holding jaw mounted for movement parallel to the longitudinal axis and having a second needle engaging surface; and

d) a securing mechanism, longitudinally movable relative to the elongated body portion and the first and second needle engaging surfaces, for holding a needle in one of the first and second needle holding jaws, the securing mechanism and the first and second needle holding jaws being relatively longitudinally movable wherein the needle is held substantially perpendicular to the longitudinal axis, the needle being transferable between the first and second needle holding jaws.

14. The apparatus according to claim 13, further comprising a control member for sliding the securing mechanism between a first position to secure the surgical needle within the respective jaw and a second position to release the surgical needle from the jaw.

15. The apparatus according to claim 13, wherein the securing mechanism is engageable with the needle.

16. The apparatus according to claim 15, wherein the needle is secured between an edge of the needle securing mechanism and at least one of the first and second needle engaging surfaces.

17. The apparatus according to claim 13, wherein at least one of the first and second jaws has a substantially planar surface.

18. The apparatus according to claim 17, wherein the planar surface is oriented substantially perpendicular to a longitudinal axis of the needle.

19. The apparatus according to claim 13, wherein the securing mechanism has a substantially planar surface adjacent the needle.

20. The apparatus according to claim 13, wherein at least one of the first and second jaws has an opening for receipt of the needle.

21. The apparatus according to claim 20, wherein the opening is a bore formed in at least one of the first and second jaws.

22. The apparatus according to claim 20, wherein the opening is a slot fomed in at least one of the first and second jaws.

23. The apparatus according to claim 20, wherein the opening is a notch formed in at least one of the first and second jaws.

24. A method of endoscopically suturing vascular tissue comprising the steps of:

a) providing an endoscopic suturing apparatus having first and second needle holding jaws mounted to the body portion and pivotal relative to each other about a common pivot point, the first and second jaws movable relative to the body portion from a first position spaced apart to a second position in close cooperative alignment;

b) endoscopically accessing a surgical site containing vascular tissue to be sutured;

c) preparing the vascular tissue for suturing by manipulating adjacent portions of the vascular tissue to form a tissue area suitable for suturing;

d) inserting a portion of the body portion of the endoscopic suturing apparatus to the surgical site including the first and second needle holding jaws with a surgical needle and associated length of suture held in the first needle holding jaw;

e) positioning the first and second needle holding jaws and surgical needle in the first position adjacent the formed tissue area;

f) remotely actuating the endoscopic suturing apparatus to close both the first and second jaws about the common pivot point to the second position with the formed tissue area therebetween to drive the surgical needle through the formed tissue area;

g) transferring the surgical needle from the first jaw to the second jaw by actuating a camming mechanism positioned in a proximal end of the endoscopic suturing apparatus;

h) remotely actuating the endoscopic suturing apparatus to open the jaws to the first position; and

i) drawing the length of suture at least partially through the formed tissue area to form a stitch therein.

25. The method of claim 24, wherein the step of endoscopically accessing a surgical site includes inserting a cannula to provide access to vascular tissue by the endoscopic suturing apparatus.

26. The method of claim 25, wherein the step of remotely actuating the apparatus to open the jaws and the step of transferring the surgical needle from the first jaw to the second jaw comprises the step of actuating a handle mechanism.

27. The method of claim 26, wherein the step of actuating the handle mechanism includes the step of camming a reciprocating mechanism positioned in the apparatus to move a needle securing mechanism to secure the needle in the second jaw.

28. The method of claim 27, wherein the step of moving the needle securing mechanism to secure the needle in the second jaw includes the step of simultaneously releasing the needle from the first jaw.

29. A method of endoscopically suturing vascular tissue comprising the steps of:

a) providing an endoscopic suturing apparatus having an elongated body portion and first and second needle holding jaws mounted to the body portion, the first and second jaws relatively movable from a first position spaced apart to a second position in close cooperative alignment;

b) endoscopically accessing a surgical site containing vascular tissue to sutured;

c) preparing the vascular tissue for suturing by manipulating adjacent portions of the vascular tissue to form a tissue area suitable for suturing;

d) inserting a portion of the body portion of the endoscopic suturing apparatus to the surgical site including the first and second needle holding jaws with a surgical needle and associated length of suture held in the first needle holding jaw;

e) positioning the first and second needle holding jaws and surgical needle in the first position adjacent the formed tissue area;

f) remotely actuating the endoscopic suturing apparatus to close both the first and second jaws to the second position with the formed tissue area therebetween to drive the surgical needle through the formed tissue area;

g) transferring the surgical needle from the first jaw to the second jaw by actuating a camming mechanism positioned in a proximal end of the endoscopic suturing apparatus to move securing members extending through the length of the elongated body portion relative to the surgical needle;

h) remotely actuating the endoscopic suturing apparatus to open the jaws to the first position; and

i) drawing the length of suture at least partially through the formed tissue area to form a stitch therein.

30. The method according to claim 29, wherein the step of remotely actuating the endoscopic suturing apparatus to close both the first and second jaws to the second position includes moving both the first jaw and the second jaw relative to the other.