Articulating suture device and method

• US 7,842,048 B2
• Filed: 08/18/2006
• Issued: 11/30/2010
• Est. Priority Date: 08/18/2006
• Status: Expired due to Fees

• Current Assignee: Abbott Laboratories Incorporated
• Original Assignee: Abbott Laboratories Incorporated
• Inventors: Ma, Dawn
• Primary Examiner(s): Woo; Julian W
• Application Number:
  US11/465,527
• Publication Number:
  US 20080045979A1
• Time in Patent Office: 1,565 Days
• Field of Search: 606/139, 606/144, 606/145, 606/148
• 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 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 2017/047 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 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures

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 of the device can be inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot can carry suturing attachment cuffs with one end of the cuff adapted to receive a needle, while the other end receives suture. A portion of the foot and/or lumen of the shaft can receive a portion of the suture and can include friction reducing structure that aid with movement of the sutured during removal of the cuffs from within the penetration.

Claims

1. A system for suturing a blood vessel, the vessel having a vessel wall, the system comprising;

a shaft suitable for insertion along the tissue tract and into the vessel through a puncture, shaft comprising at least one lumen including at least one friction reducing structure, the at least one friction reducing structure comprises at least one recessed portion and at least one raised portion disposed an interior surface of the lumen;

a needle having a proximal end and a distal end suitable for forming a needle path through the vessel wall, the needle having a recessed engagement surface adjacent the distal end;

a flexible filament disposed within the lumen; and

a fitting attached to the filament and releasably supported by a foot mounted near a distal end of the shaft.

2. The system of claim 1, wherein the needle is flexible, and wherein the fitting is releasably supported within a receptacle surface oriented to laterally deflect the advancing needle toward the fitting.

3. The system of claim 2, further comprising a slot disposed along the receptacle surface, wherein the filament is releasably disposed in the slot, the slot configured to avoid engagement of the needle with the suture.

4. The system of claim 3, wherein the slot comprises at least one friction reducing structure.

5. The system of claim 1, wherein the at least one recessed portion and the at least one raised portion are disposed in the interior surface of the lumen in an alternating fashion.

6. A system for suturing a puncture of a blood vessel within a tissue tract, the vessel having a vessel wall and defining an axis, the system comprising:

a shaft having a proximal handle and a distal end suitable for insertion along the tissue tract and into the vessel through the puncture, the distal end comprising at least one lumen with at least one friction reducing structure formed therein, the at least one friction reducing structure comprises a plurality of recessed portions and a plurality of raised portions disposed an interior surface of the lumen;

a foot mounted near the distal end of the shaft, the foot having a plurality of needle receptacles extendable laterally from the shaft;

a flexible filament extending between the needle receptacles of the foot, at least a portion of the flexible filament being disposed with that at least one lumen;

a plurality of needles advanceable distally and laterally from the shaft, through the vessel wall outside the puncture, and to the needle receptacles of the foot.

7. The system of claim 6, further comprising a plurality of fittings disposed adjacent the receptacles of the foot, the fittings securingly engaging the needles so that the needles, fittings, and at least a portion of the filament can be withdrawn through the vessel wall along at least one of the needle paths formed by the needles without threading the filament into the needles, the at least one friction reducing structure reducing the frictional contact between the filament and the lumen as the filament is withdrawn through the vessel wall.

8. The system of claim 6, wherein the foot comprises an elongate body defining an axis, the foot articulatable from a small profile configuration to a large profile configuration by actuating the proximal handle so that the foot slides axially and pivots laterally within the vessel.

9. The system of claim 6, wherein the plurality of recessed portions and the plurality of raised portions are disposed in the interior surface of the lumen in an alternating fashion.

10. The system of claim 6, wherein the flexible filament is a suture.

11. The system of claim 10, wherein the suture is a monofilament suture.

12. A device for suturing an opening in a tissue, the device comprising:

a shaft having a proximal end and a distal end and defining an axis therebetween, the shaft having a size and configuration suitable for insertion through the opening in the tissue;

an elongate foot movably mounted to the shaft;

an actuator extending along the shaft distally to the foot, movement of the actuator sliding the foot axially and pivoting the foot from a low profile configuration aligned along the shaft to a deployed configuration extending laterally from the shaft;

a suture supported by the foot;

a suture supporting structure having a lumen with at least one friction reducing portion, the at least one friction reducing portion comprises a plurality of recessed portions and a plurality of raised portions disposed an interior surface of the lumen, the suture supporting structure receiving at least a portion of the suture within the lumen; and

a needle advanceable from the shaft through the tissue and to the deployed foot.

13. The device as recited in claim 12, wherein the suture supporting structure comprises a tubular structure disposed within the shaft.

14. The device of claim 13, wherein a first length of suture extends between a first fitting at the first end of the probe to a second fitting at the second end of the probe, and wherein a second length of suture extends from a third fitting at the first end of the probe to a forth fitting at the second end of the probe, and wherein each fitting securingly engages an associated needle to draw ends of the first and second length of suture through the vessel wall and form a plurality of loops across the puncture.

15. The device of claim 13, wherein the plurality of recessed portions and the plurality of raised portions are disposed in the interior surface of the lumen in an alternating fashion.

16. The device of claim 13, wherein the suture is a monofilament suture.

17. The device as recited in claim 12, wherein the suture supporting structure is integrally formed within the shaft.

18. The device of claim 12, wherein the foot has a first end and a second end, and wherein a plurality of needles are extendable from the shaft to the ends of the foot.