Partial to full thickness suture device & method for endoscopic surgeries

• US 5,895,395 A
• Filed: 07/17/1997
• Issued: 04/20/1999
• Est. Priority Date: 07/17/1997
• Status: Expired due to Fees

• Current Assignee: Teresa T. Yeung
• Original Assignee: Teresa T. Yeung
• Inventors: Yeung, Teresa T.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/896,106
• Time in Patent Office: 642 Days
• Field of Search: 606/139, 606/144, 606/148
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0474 Knot pushers

Abstract

This invention relates to devices and methods for making partial thickness or full thickness sutures in tissues endoscopically. The preferred embodiment comprises a suture delivering needle and a suture receiving needle which are in substantially parallel alignment. A shape memory needle with a pre-formed semi-circular shape is used to bridge a gap formed between the suture delivery needle and receiving needle. In preparation for a surgical procedure, the shape memory needle is retracted and partially straightened in the suture delivering needle. After determining the placement of suture, the suture delivering and suture receiving needles are pierced into the repairing tissue. The semi-circular shape memory needle is deployed and resumes the appropriate pre-formed shape while piercing the tissue and extending into the distal opening of the suture receiving needle. A suture is then passed down from the proximal opening of the shape memory needle into the distal opening of the suture receiving needle, then out of the proximal opening of the receiving needle. The shape memory needle is then retracted back into the suture delivering needle, leaving only the suture bridging the distal openings of the delivery needle and receiving needle. The suture device is then withdrawn and the suture is tied to fasten the tissue.

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NUMERAL REFERENCES IN DRAWINGS______________________________________Suture Delivering Needle (SDN) 1SDN Distal Opening 2Gliding Slot 3Trough 4Strain, Stress Relief Window (SRW) 5Endoscopic Scissors 6Shape Memory Needle (SMN) 7SMN Distal Opening 8SMN Proximal Beveled Opening 9Suture Receiving Needle (SRN) 10SRN Distal Opening 11Receiving Slot for SMN 12Penetration Markers 13Body 14Equipment Inlet 15Equipment Outlet 16Operating Lever 17Suture Threading Funnel 18Handle 19Suture Outlet 20Suture 21Filament 22Skin Opening (Cannula not shown) 23Meniscal Tear 24Anterior Cruciate Ligament Tear 25Knot Pusher 26Arthroscope 27______________________________________

Claims

1. A suture device comprising:

(a) a body having a proximal end, a distal end, and plurality of holes in substantially parallel alignment running from said proximal end to said distal end;

(b) a handle located substantially near said proximal end of said body;

(c) a plurality of needles fixed longitudinally through said plurality of holes and extending out of said body, said plurality of needles having proximal openings, distal tips, distal openings, inside bores, and said distal tips spaced apart by gaps;

(d) said plurality of needles possess a first needle and a second needle;

(e) a shape memory needle longitudinally and slidably housed in said first needle, said shape memory needle having an inside bore, a proximal opening, a distal opening, a distal tip, a hook substantially near said distal opening, and a suture threading means connected to said proximal opening;

(f) an operating means to slide said shape memory needle along said first needle;

(g) said shape memory needle having a retracted position, wherein said hook is substantially housed in said first needle;

(h) said shape memory needle having a deployed position, wherein said distal opening of said hook is substantially inserted into said distal opening of said second needle; and

(i) a suture passing from said suture threading means, into said proximal opening and out of said distal opening of said shape memory needle;

then into said distal opening of said second needle and exiting through said proximal opening of said second needle.

2. A suture device as recited in claim 1, wherein said body is curved.

3. A suture device as recited in claim 1, wherein said first needle further comprising:

(a) a strain, stress relief window fitting to said hook;

(b) a gliding slot opened to said distal opening;

(c) a trough carved from said inside bore; and

(d) penetration markers.

4. A suture device as recited in claim 3, wherein said strain, stress relief window opens from said inside bore to outside wall of said first needle.

5. A suture device as recited in claim 3, wherein said strain, stress relief window opens from said inside bore but does not penetrate outside wall of said first needle.

6. A suture device as recited in claim 1, wherein said second needle further comprising:

(a) a receiving slot opened to said distal opening of said second needle;

(b) said proximal opening opened to outside of said proximal end of said body; and

(c) penetration markers.

7. A suture device as recited in claim 1, wherein said shape memory needle further comprising:

(a) a sharp distal tip and a proximal beveled opening; and

(b) said hook located substantially near said sharp distal tip.

8. A suture device as recited in claim 7, wherein said shape memory needle is comprised of any material having the characteristics of being shapable under a non-operating condition and resiliently retaining the shape after substantially straightened in an operating condition.

9. A suture device as recited in claim 1, wherein said suture threading means is a funnel.

10. A suture device as recited in claim 1, wherein said operating means is a lever.

11. A suture device as recited in claim 1, wherein said suture further comprises a flexible and pushable filament.

12. A suture device as recited in claim 1, wherein said suture further comprises a substance.

13. A suture device as recited in claim 1, wherein said suture is a wire.

14. A suture device as recited in claim 1, wherein said suture is a cable.

15. A suture device as recited in claim 1, wherein said plurality of needles are curved.

16. A suture device as recited in claim 1, wherein said plurality of entries and outlets are equipment inlets and outlets.

17. A method of endoscopically suturing tissue using said suture device as recited in claim 1 comprises the steps of:

(a) placing a cannula substantially close to a site of surgical operation;

(b) setting said shape memory needle in said retracted position;

(c) inserting an endoscope into an equipment inlet and extending out an equipment outlet;

(d) inserting said suture device with said endoscope into said cannula;

(e) guiding by said endoscope, piercing tissue to be sutured with at least one, preferring both said first and second needles;

(f) threading said suture through said suture threading means into said proximal opening of said shape memory needle;

(g) passing said suture longitudinally along said inside bore to said distal opening of said shape memory needle;

(h) deploying said hook of said shape memory needle into a receiving slot of said second needle;

(i) continue passing said suture through said receiving slot into said inner bore of second needle;

(j) retrieving said suture from said proximal opening of said second needle outside said suture device;

(k) retracting said hook, leaving said suture between said distal openings of said first needle and said second needle;

(l) withdrawing said endoscope from said equipment inlet;

(m) withdrawing said suture device from said site of surgical operation, leaving said suture in said tissue;

(n) tying and delivering slip knot to said tissue;

(o) cutting off excess suture; and

(p) repeating all of the steps a plurality of times until said tissue is fastened.

18. A method of endoscopically suturing tissue using said suture device as recited in claim 1 comprises the steps of:

(a) placing a cannula substantially close to a site of surgical operation;

(b) setting said shape memory needle in said retracted position;

(c) inserting an endoscope into an equipment inlet and extending out an equipment outlet;

(d) inserting said suture device with said endoscope into said cannula;

(e) guiding by said endoscope, piercing tissue to be sutured with at least one, preferring both said first and second needles;

(f) deploying said hook of said shape memory needle into a receiving slot of said second needle;

(g) retrieving said endoscope from said equipment inlet;

(h) threading said suture through said suture threading means into said proximal opening of said shape memory needle;

(i) passing said suture longitudinally along said inside bore of said shape memory needle into a receiving slot of said second needle, and continue passing said suture along said inside bore of said second needle;

(j) retrieving said suture from said proximal opening of said second needle outside said suture device;

(k) retracting said hook, leaving said suture between said distal openings of said first needle and said second needle;

(l) withdrawing said suture device from said site of surgical operation, leaving said suture in said tissue;

(m) tying and delivering slip knot to said tissue;

(n) cutting off excess suture; and

(o) repeating all of the steps a plurality of times until said tissue is fastened.

19. A method of endoscopically suturing tissue in claim 18 and claim 17, wherein said shape memory needle is deployed outside said tissue, a full-thickness suturing is formed.

20. A method of endoscopically suturing tissue in claim 17 and claim 18, wherein said shape memory needle is deployed within said tissue, a partial-thickness suturing is formed.

21. A method of endoscopically suturing tissue in claim 18 and claim 17, wherein said suture further comprises a flexible and pushable filament.