Articulating suturing device and method

• US 8,048,092 B2
• Filed: 12/06/2010
• Issued: 11/01/2011
• 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, Lasser, Amelia
• Primary Examiner(s): WOO, JULIAN W
• Application Number:
  US12/961,239
• Publication Number:
  US 20110077670A1
• Time in Patent Office: 330 Days
• Field of Search: 606/139, 606/144, 606/145, 606/148, 606/150, 606/153, 128/898
• 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 2017/06104 interconnected at their distal ends, e.g. two hollow needles forming a loop for passing a suture
• 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 is inserted through a penetration and actuated extend the foot carrying suturing attachment cuffs. 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 cuffs lockingly engage the needles and can be withdrawn along the needle paths and through the tissue tract 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 vessel through a puncture and a tissue tract, the method comprising:

inserting a suturing device along the tissue tract and into the vessel through the puncture, the suturing device comprising;

a probe suitable for insertion along the tissue tract and into the vessel through the puncture;

at least one penetrator disposed within a portion of said probe, said at least one penetrator cooperating with a length of suture, said at least one penetrator including a detachable tip and said length of suture including a pre-tied knot; and

an actuator cooperating with said at least one penetrator, said actuator being movable within said probe to deploy said at least one penetrator, said detachable tip becoming detached from the rest of said at least one penetrator from within said portion of said suturing device.

2. The method as recited in claim 1, wherein the suturing device further comprises at least one foot movably mounted to the probe.

3. The method as recited in claim 2, wherein said probe further comprises a shaft, said at least one movable foot being movably mounted to said shaft.

4. The method as recited in claim 1, said pre-tied knot being disposed to receive an end of said length of suture.

5. The method as recited in claim 1, wherein said at least one penetrator is disposed proximal to a distal end of said probe.

6. The method as recited in claim 1, wherein said at least one penetrator comprises a hollow needle.

7. A method for suturing a wall of a vessel through a puncture and a tissue tract, the method comprising:

inserting a suturing device along the tissue tract and into the vessel through the puncture, the suturing device comprising;

a probe suitable for insertion along the tissue tract and into the vessel through the puncture;

at least one detachable penetrator disposed within a first portion of said probe, said at least one detachable penetrator including a tip being detachable from the rest of said at least one detachable penetrator within said first portion of said probe;

an actuator cooperating with said at least one detachable penetrator, said actuator being movable within said probe to deploy said at least one detachable penetrator; and

at least one flexible filament cooperating with said at least one detachable penetrator so that at least a portion of said at least one flexible filament passes through the wall of the vessel and is received by a pre-tied knot of said at least one flexible filament, said pre-tied knot being disposed about an outer surface of said suturing device.

8. The method as recited in claim 7, said pre-tied knot being disposed to receive an end of said at least one flexible filament.

9. The method as recited in claim 8, wherein said bight of suture is disposed within a slot formed in an exterior surface of said probe.

10. The method as recited in claim 7, wherein said at least one flexible filament comprises a first length of suture extending from said at least one detachable penetrator.

11. The method as recited in claim 7, wherein said at least one flexible filament comprises:

a first length of suture extending from said at least one detachable penetrator; and

a second length of suture extending from a receptacle supported by said probe, said receptacle receiving said at least one detachable penetrator.

12. A method for suturing a wall of a body lumen through a puncture and a tissue tract, the method comprising:

inserting a suturing device along the tissue tract and into the vessel through the puncture, the suturing device comprising;

a probe suitable for insertion along the tissue tract and into the body lumen through the puncture;

two needles disposed within a portion of said probe;

an actuator cooperating with said two needles, said actuator being movable within said probe to deploy said two needles into the body lumen, a portion of at least one of said two needles being detachable from the rest of at least one of said two needles from within said portion of said probe upon being disposed within the body lumen, wherein deploying said at least one of said two needles carries said length of suture through the wall of the body lumen and into the body lumen, said length of suture including a pre-tied knot disposed about an outer surface of said suturing device.

13. The method as recited in claim 12, wherein the suturing device further comprises at least one foot movably mounted to the probe.

14. The method as recited in claim 13, wherein said probe further comprises a shaft, said at least one movable foot being movably mounted to said shaft.

15. The method as recited in claim 12, wherein said detachable portion of at least one of the two needles comprises a detachable tip, said detachable tip being detachable from the rest of said needle from within a first portion of said probe.

16. The method as recited in claim 12, said pre-tied knot being disposed to receive an end of said length of suture.

17. The method as recited in claim 12, wherein each of said two needles comprises a detachable tip.

18. The method as recited in claim 12, wherein at least one of said two needles comprises a hollow needle.