Method of using needle-point suture passer to retract and reinforce ligaments

• US 5,899,911 A
• Filed: 12/05/1997
• Issued: 05/04/1999
• Est. Priority Date: 08/25/1993
• Status: Expired due to Term

• Current Assignee: Coopersurgical Incorporated (The Cooper Cos., Inc.)
• Original Assignee: Inlet Medical, Inc. (The Cooper Cos., Inc.)
• Inventors: Carter, James E.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): PHAM, THUY D
• Application Number:
  US08/985,695
• Time in Patent Office: 515 Days
• Field of Search: 606/148, 606/139, 606/144, 606/145, 606/151
• US Class Current: 606/148
• 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 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/282 Jaws
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• 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 J-shaped suture needles A61B2017/0608
• CPC Class Codes: A61B 2017/2825 Inserts of different material in jaws
• CPC Class Codes: A61B 2090/0813 Accessories designed for easy sterilising, i.e. re-usable

Abstract

A surgical instrument, guide, and method capable of being used for closure of peritoneum fascia, occlusion of bleeding vessels such as inferior epigastric, and for all uses related to accurately passing suture material through a guide into tissue. A tip of a surgical instrument in a standard suture-/needle-driving position with a sharp tip that opens and closes with the surgeon grasping suture material with the sharp tip is provided. Insertion of the tip/suture through tissue until the tip is seen through the peritoneum by direct vision begins the wound-closing procedure. The suture is released by opening and withdrawing the tip from the guide. The suture is recovered by using the guide to redirect the tip and puncturing the tissue opposite the first point of insertion. The tip grasps the suture and pulls the suture through the guide. The suture is pulled outside the wound, providing for rapid closure of the surgical incision. The guide is insertable within the wound to be closed and guides the surgical instrument at a predetermined angle from the longitudinal axis of the guide for optimum wound closure. The surgical instrument and method may be used to advantageously shorten and strengthen ligaments. For example, by gathering and reinforcing the round ligament that supports a woman'"'"'s uterus with suture materials, surgeons can reposition and stabilize a retroverted uterus.

Claims

1. A method of suturing ligaments within a person'"'"'s body comprising the steps of:

(a) laparoscopically entering the person'"'"'s body with a tool having a sharp tip bearing suture material for suturing ligaments;

(b) inserting said tool into the ligament to be affected along its axial length, and pushing said suture material through the axial length;

(c) pulling said suture material exteriorly from the ligament in a direction generally opposite of said suture material'"'"'s point of entry to the ligament causing the ligament to retract along its length; and

(d) attaching said suture material within the body at a point generally in proximity to said suture'"'"'s original point of entry into the ligament, whereby the ligament retracted along its length is reinforced within the person'"'"'s body.

2. The method of claim 1, wherein inserting said tool into the ligament along its axial length includes its thinnest section.

3. The method of claim 1, wherein inserting said tool into the ligament along its axial length includes near the supporting point of an internal organ.

4. The method of claim 1, wherein attaching said suture material is to an anatomical anchoring point.

5. The method of claim 1, wherein attaching said suture material is to a medical device.

6. The method of claim 5, wherein the medical device is anchored to a bone.

7. The method of claim 1, wherein inserting said tool into the ligament to be affected is the round ligament attached to a woman'"'"'s uterus.

8. A method of suturing ligaments within a person'"'"'s body comprising the steps of:

(a) laparoscopically entering the person'"'"'s body at a first point in the body with a tool having a sharp tip bearing suture material for suturing ligaments;

(b) inserting said tool into the ligament to be affected along its axial length, and pushing said suture material through the axial length;

(c) exiting the ligament at a first point in the ligament and dropping off the suture material;

(d) withdrawing the tool from the ligament;

(e) laparoscopically entering the person'"'"'s body at a second point in the body with the tool;

(f) inserting the tool into the ligament and pushing the tool along the axial length of the ligament;

(g) exiting the ligament at a second point in the ligament and grasping the suture material;

(h) withdrawing the tool from the ligament; and

(i) pulling the suture material exteriorly from the ligament in a direction generally opposite of said suture material'"'"'s point of entry to the ligament causing the ligament to retract along its length; and

(j) attaching said suture material within the body at a point generally in proximity to said suture'"'"'s original point of entry into the ligament, whereby the ligament retracted along its length is reinforced within the person'"'"'s body.

9. The method of claim 8, wherein inserting said tool into the ligament along its axial length includes its thinnest section.

10. The method of claim 8, wherein inserting said tool into the ligament along its axial length includes near the supporting point of an internal organ.

11. The method of claim 8, wherein attaching said suture material is to an anatomical anchoring point.

12. The method of claim 8, wherein attaching said suture material is to a medical device.

13. The method of claim 12, wherein the medical device is anchored to a bone.

14. A method of investing suture within ligaments in a person'"'"'s body comprising the steps of:

(a) entering the person'"'"'s body with suture materials for suturing ligaments;

(b) inserting the suture material into the ligament to be affected along its axial length, and pushing said suture material through the axial length;

(c) pulling said suture material exteriorly from the ligament in a direction generally opposite of said suture material'"'"'s point of entry to the ligament causing the ligament to retract along its length; and

(d) attaching said suture material within the body at a point generally in proximity to said suture'"'"'s original point of entry into the ligament, whereby the ligament retracted along its length is reinforced within the person'"'"'s body.

15. The method of claim 14, wherein entering the person'"'"'s body is laparoscopically with a tool having a sharp tip bearing the suture material.

16. The method of claim 15, wherein inserting the suture material is with the tool.

17. A method of suturing ligaments within a person'"'"'s body comprising the steps of:

(a) entering the person'"'"'s body at a first point in the body with suturing material for suturing ligaments;

(b) inserting the suture material into the ligament to be affected along its axial length, and pushing said suture material through the axial length;

(c) exiting the ligament at a first point in the ligament and dropping off the suture material;

(d) entering the person'"'"'s body at a second point in the body with the tool;

(e) exiting the ligament at a second point in the ligament and grasping the suture material;

(f) pulling the suture material through the axial length of the ligament;

(g) pulling the suture material exteriorly from the ligament in a direction generally opposite of said suture material'"'"'s point of entry to the ligament causing the ligament to retract along its length; and

(h) attaching said suture material within the body at a point generally in proximity to said suture'"'"'s original point of entry into the ligament, whereby the ligament retracted along its length is reinforced within the person'"'"'s body.

18. The method of claim 17, wherein entering the person'"'"'s body is laparoscopically with a tool having a sharp tip bearing the suture material.

19. The method of claim 18, wherein inserting the suture material is with the tool.