Articulating suturing device and method
First Claim
1. A system for suturing a blood vessel, the vessel having a vessel wall, the system comprising:
- a first needle having a proximal end and a distal end suitable for forming a first needle path through the vessel wall;
a flexible filament;
a first fitting attached to the filament, the first fitting securingly engaging the first needle when the first needle advances through the vessel wall so that the first fitting and at least a portion of the filament can be withdrawn proximally along the first needle path by the first needle;
a shaft having a proximal handle and a distal end suitable for insertion into the vessel through the first needle path; and
a foot mounted near the distal end of the shaft, the foot having a first needle receptacle and articulatable from a small profile configuration to a large profile configuration by actuation of the handle,wherein the first fitting is removably mounted adjacent the first needle receptacle, and wherein the first needle is advanceable from the shaft to the first needle receptacle on the articulated foot.
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Accused Products
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 The cuffs lockingly engage the needles and can be withdrawn proximally along the needle paths and through the tissue tract so as to form a loop of suture across the puncture. The articulating foot may be realigned with the shaft and withdrawn proximally through the tissue tract without dilating the tissue tract.
528 Citations
18 Claims
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1. A system for suturing a blood vessel, the vessel having a vessel wall, the system comprising:
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a first needle having a proximal end and a distal end suitable for forming a first needle path through the vessel wall; a flexible filament; a first fitting attached to the filament, the first fitting securingly engaging the first needle when the first needle advances through the vessel wall so that the first fitting and at least a portion of the filament can be withdrawn proximally along the first needle path by the first needle; a shaft having a proximal handle and a distal end suitable for insertion into the vessel through the first needle path; and a foot mounted near the distal end of the shaft, the foot having a first needle receptacle and articulatable from a small profile configuration to a large profile configuration by actuation of the handle, wherein the first fitting is removably mounted adjacent the first needle receptacle, and wherein the first needle is advanceable from the shaft to the first needle receptacle on the articulated foot. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A system for suturing a blood vessel, the vessel having a vessel wall, the system comprising:
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a first needle having a proximal end and a distal end suitable for forming a first needle path through the vessel wall; a flexible filament; a first fitting attached to the filament, the first fitting securingly engaging the first needle when the first needle advances through the vessel wall so that the first fitting and at least a portion of the filament can be withdrawn proximally along the first needle path by the first needle; 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; a foot mounted near the distal end of the shaft, the foot being articulatable from a low profile configuration to a deployed configuration extending laterally from the shaft; and an actuator extending along the shaft distally to the foot, movement of the actuator sliding the foot axially and pivoting the foot from the low profile configuration aligned along the shaft to the deployed configuration extending laterally from the shaft. - View Dependent Claims (11, 12, 13, 14, 15)
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16. A system for suturing a blood vessel, the vessel having a vessel wall, the system comprising:
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a first needle having a proximal end and a distal end suitable for forming a first needle path through the vessel wall; a flexible filament; a first fitting attached to the filament, the first fitting securingly engaging the first needle when the first needle advances through the vessel wall so that the first fitting and at least a portion of the filament can be withdrawn proximally along the first needle path by the first needle; wherein the first needle is flexible, and wherein the first fitting is releasably supported within a receptacle surface oriented to laterally deflect the advancing first needle toward the first fitting. - View Dependent Claims (17, 18)
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Specification