Articulating suturing device and method

• US 7,842,047 B2
• Filed: 02/27/2006
• Issued: 11/30/2010
• Est. Priority Date: 03/04/1999
• Status: Expired due to Fees

• Current Assignee: Abbott Laboratories Incorporated
• Original Assignee: Abbott Laboratories Incorporated
• Inventors: Modesitt, D. Bruce, Franco, Justina A., Gross, T. Daniel
• Primary Examiner(s): Woo; Julian W
• Application Number:
  US11/363,005
• Publication Number:
  US 20060142785A1
• Time in Patent Office: 1,737 Days
• Field of Search: 606/139, 606/144, 606/148, 606228-230, 606231-233, 289/1.2, 289/1.5, 264/235.6, 206/63.3, 206/63.5, 206/438
• 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 17/0483 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 17/0625 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 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00641 for closing fistulae, e.g. anorectal fistulae
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/00672 Locating means therefor, e.g. bleed back lumen
• 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 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft

Abstract

Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot near a distal end of a shaft is inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot carries suturing attachment cuffs, and needles are advanced from the shaft through the vessel wall outside of the penetration and into engagement with the needle cuffs after the foot has been drawn proximally up against the endothelial surface of the blood vessel. The cross-section of the shaft within the tissue tract can be minimized by laterally deflecting the needles as they leave the shaft, while tapered depressions within the foot can guide the advancing needles into engagement with the cuffs. The cuffs lockingly engage the needles and can be withdrawn proximally along the needle paths and through the tissue tract so as to form a loop of suture across the puncture. The articulating foot may be realigned with the shaft and withdrawn proximally through the tissue tract without dilating the tissue tract.

Claims

1. A method for suturing a puncture in tissue, the method, comprising:

providing a monofilament suture having a first end, a pre-tied knot spaced from the first end, and a second end;

providing a shaft carrying the pre-tied knot and positioning a portion of the shaft through the puncture;

advancing the first end of the suture through the tissue and maintaining the second end of the suture outside of the tissue, the pre-tied knot encircling and being supported by a needle prior to the first end advancing through the tissue;

advancing the first end of the suture with the needle through the pre-tied knot following advancing the first end and the needle through the tissue; and

tensioning the suture across the puncture.

2. The method of claim 1 wherein the pre-tied knot of the suture includes at least one loop, and wherein providing the monofilament suture having a first end and a pre-tied knot spaced from the first end comprises forming the pre-tied knot with at least one loop, and heating the at least one loop to set the pre-tied knot.

3. The method of claim 2 wherein heating the formed pre-tied knot to set the pre-tied knot comprises heating the formed pre-tied knot at a temperature from about 190°

Fahrenheit to about 280°

Fahrenheit.

4. The method of claim 1 wherein the shaft has a needle guide, and wherein the method further comprises advancing a needle from the needle guide to form a needle path through the vessel wall, wherein advancing the first end of the suture through the tissue includes advancing the first end of the suture along the needle path.

5. The method of claim 4 wherein the shaft has a proximal and a distal end and includes a pivotable foot that carries the first end of the suture, wherein the method further comprises deploying the foot adjacent the tissue wall so that the foot extends laterally from a fixed point above the distal end of the shaft, and wherein advancing the needle from the needle guide to form a needle path includes advancing the needle to the foot to connect with the first end of the suture.