Articulating suturing device and method

• US 8,137,364 B2
• Filed: 09/11/2003
• Issued: 03/20/2012
• Est. Priority Date: 09/11/2003
• Status: Active Grant

• Current Assignee: Abbott Laboratories Incorporated
• Original Assignee: Abbott Laboratories Incorporated
• Inventors: Zung, Michael, Jackson, Jasper
• Primary Examiner(s): Jackson, Gary
• Assistant Examiner(s): MENDOZA, MICHAEL G
• Application Number:
  US10/660,288
• Publication Number:
  US 20050059982A1
• Time in Patent Office: 3,113 Days
• Field of Search: 606/146, 606/144, 606/139, 606/145, 606/147, 606/148, 606/138
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• 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 2017/00672 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 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. The suture may be provided with a bight between first and second ends, the bight including one or more loops prearranged to define a pre-tied knot when one or more ends of the suture passed therethrough. A suture cutting blade may be positioned on the device such that when the needle is withdrawn from the device, the suture can be drawn across the blade to sever the suture.

Claims

1. A suturing device comprising:

a housing, the housing having a proximal end, a distal end, a hollow body, an opening disposed toward the distal end and into the housing, and a blade guard partially extending over the opening from a proximal end toward a distal end of the opening and terminating proximal the distal end of the opening;

a needle actuation handle disposed at the proximal end of the housing;

a movable handle;

a shaft at least partially disposed within a portion of the housing and extending distally from the distal end of the housing;

a needle movable within a needle lumen associated with the shaft and that extends toward a proximal end of the housing, the needle being attached to a length of suture, the needle having a tapered tip, the tapered tip being initially oriented toward the distal end of the housing; and

a stationary suture cutting blade positioned on the housing and protruding through the opening and the hollow body, the stationary suture cutting blade being disposed beneath the blade guard, the stationary suture cutting blade extending distally toward the distal end of the housing and having a cutting edge facing toward the distal end of the housing, the suture cutting blade being configured to sever the suture drawn across the stationary suture cutting blade.

2. The suturing device of claim 1, wherein the moveable handle and the blade are positioned near the distal end of the housing.

3. The suturing device of claim 2, wherein the needle and the suture are withdrawn from the proximal end of the housing.

4. The suturing device of claim 1, wherein the moveable handle and the blade are positioned near the proximal end of the housing.

5. The suturing device of claim 1, wherein the movable handle is configured to deploy a foot transverse to the shaft.

6. The suturing device of claim 1, wherein the needle has a distal end and the suture is attached to the distal end of the needle.

7. A suturing device comprising:

a housing, the housing having a proximal end, a distal end, and a hollow body having an opening disposed toward the distal end and into the housing, and a blade guard partially extending over the opening from a proximal end toward a distal end of the opening and terminating proximal the distal end of the opening;

an elongate stationary suture cutting blade positioned on the housing and protruding through the opening and the hollow body, the stationary suture cutting blade being disposed beneath and recessed below the blade guard, the stationary suture cutting blade extending distally toward the distal end of the housing and having a cutting edge facing toward the distal end of the housing;

an elongate shaft at least partially disposed within the housing and extending distally from the distal end of the housing, the elongate shaft having a distal end region;

a removable needle actuation handle disposed at the proximal end of the housing and removably from within the proximal opening of the housing;

a needle extending from the needle actuation handle, through the housing and further through a needle lumen associated with the shaft that extends toward the proximal end of the housing, the needle having a tapered tip, the tapered tip being initially oriented toward the distal end of the housing; and

a suture carried by the device, wherein a portion of the suture is positioned near the distal end region of the shaft such that the needle pulls the suture proximally to position the suture through tissue, the needle actuation handle being removable from within the proximal opening of the housing to position the suture adjacent the suture cutting blade to separate the needle from the suture.

8. The suturing device of claim 7, wherein the blade is positioned near the distal end of the inner surface of the opening of the housing.

9. The suturing device of claim 8, wherein the needle pulls the suture through the proximal end of the housing.

10. The suturing device of claim 7, wherein the needle and the suture are withdrawn from the proximal end of the housing.

11. The suturing device of claim 7, wherein the blade is positioned near the proximal end of the inner surface of the opening of the housing.

12. The suturing device of claim 7, wherein the removable needle actuation handle is configured to deploy a foot transverse to the shaft.

13. A suturing device comprising:

a housing, the housing defining an interior space and having a proximal end, a distal end, an opening disposed toward the distal end and into the housing, and a blade guard partially extending over the opening from a proximal end toward a distal end of the opening and terminating proximal the distal end of the opening, the housing includes a finger grip;

a needle actuation handle disposed at the proximal end of the housing;

a shaft at least partially disposed within a portion of the housing and extending distally from the distal end of the housing;

a needle movable within a needle lumen associated with the shaft and that extends toward a proximal end of the housing, the needle being attached to a length of suture, the needle having a tapered tip, the tapered tip being initially oriented toward the distal end of the housing; and

a stationary suture cutting blade positioned on the housing and protruding through the opening and the interior space, the stationary suture cutting blade being recessed within and beneath the blade guard, the stationary suture cutting blade having a V-shaped cutting edge having one cutting edge orientated relative to another cutting edge in a V-shaped orientation, the cutting edges being configured to sever the suture drawn across the stationary suture cutting blade.

14. The suturing device of claim 13, wherein the blade is mounted on an end of the finger grip.

15. The suturing device of claim 13, wherein the finger grip and the blade are positioned near the proximal end of the housing.

16. The suturing device of claim 15, wherein the needle and the suture are withdrawn from the proximal end of the housing.

17. The suturing device of claim 13, wherein the needle has a distal end and the suture is attached to the distal end of the needle.

18. The suturing device of claim 13, wherein the needle actuation handle is configured to deploy a foot transverse to the shaft.