Systems, methods, and devices for closing holes in body lumens

• US 9,241,707 B2
• Filed: 05/31/2012
• Issued: 01/26/2016
• Est. Priority Date: 05/31/2012
• Status: Active Grant

• Current Assignee: Abbott Cardiovascular Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Abbott Cardiovascular Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Roorda, Wouter E., Mehl, Douglas H., Garcia, Rizza, Reynolds, Timothy C., Merrill, Dinorah, Ma, Dawn, Milazzo, David J., Fortson, Aaron M.
• Primary Examiner(s): SHI, KATHERINE MENGLIN
• Application Number:
  US13/485,388
• Publication Number:
  US 20130325058A1
• Time in Patent Office: 1,335 Days
• Field of Search: 606/213, 606/214
• US Class Current: 1/1
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/06061 Holders for needles or sutures, e.g. racks, stands hand-held holding instruments A61B17/0483; holders for articles A61B50/20; racks for syringes or for hypodermic or infusion needles A61M5/008
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/00778 Operations on blood vessels A61B2017/22097, A61B2017/320741 take precedence
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments

Abstract

A closure device for closing an opening in tissue is provided. The closure device includes an elongate member through which needles may be deployed. The closure device also includes a foot portion having one or more feet slidably mounted relative thereto. The feet are movable between a deployed position and a delivery position. The feet include cuffs removably mounted therein, with sutures connected between the cuffs. When the feet are in the deployed position and the needles are advanced, the needles securely engage the cuffs and draw the cuffs and suture through the lumen wall so that the opening in the lumen wall can be closed with the sutures.

Claims

1. A device for closing an opening in tissue, comprising:

an elongate member having a proximal end, a distal end, a central passage and a plurality of needle lumens extending from the proximal end toward the distal end;

a plurality of needles disposed within and advancable from the plurality of needle lumens;

a foot housing disposed at the distal end of the elongate member, the foot housing having an outside surface, the foot housing having a first opening and a second opening formed therein; and

a foot disposed entirely within the foot housing and being remote from the outside surface thereof, the foot having a first end that has at least two cuffs removably mounted therein and a second, opposing end that has at least two cuffs removably mounted therein, a length of suture being connected between each cuff in the first end of the foot and each cuff in the second end of the foot, the foot being slidably mounted within the foot housing so as to be slidable relative to the foot housing between a delivery position and a deployed position, the cuffs in the first end of the foot being positioned below and accessible through the second opening in the foot housing when the foot is in the deployed position, and the cuffs in the second end of the foot being positioned outside the foot housing when the foot is in the deployed position.

2. The device as recited in claim 1, wherein the first and second ends of the foot are positioned generally entirely within the foot housing when the foot is in the delivery position.

3. The device as recited in claim 1, wherein the cuffs in the first end of the foot are substantially inaccessible through the second opening in the foot housing when the foot is in the delivery position.

4. The device as recited in claim 1, wherein the cuffs in the first end of the foot are generally aligned with at least one needle lumen of the plurality of needle lumens when the foot is in the deployed position.

5. The device as recited in claim 1, wherein the cuffs in the second end of the foot are generally aligned with at least one needle lumen of the plurality of needle lumens when the foot is in the deployed position.

6. The device as recited in claim 1, further comprising a first actuator operatively associated with the foot to cause the foot to slidably move linearly between the delivery position and the deployed position.

7. The device as recited in claim 6, wherein the first actuator comprises a lever, a deployment cable connected between the lever and the first end of the foot, and a retraction cable connected between the lever and the second end of the foot, wherein movement of the lever in a first direction draws the deployment cable proximally causing the foot to move to the deployed position, and wherein movement of the lever in a second direction draws the retraction cable proximally causing the foot to move to the delivery position.

8. The device as recited in claim 1, further comprising a plunger operatively associated with the plurality of needles, wherein movement of the plunger in a first direction advances the plurality of needles from the plurality of needle lumens and toward the cuffs in the foot when the foot is in the deployed position, and wherein movement of the plunger in a second direction draws the plurality of needles back into the plurality of needle lumens.

9. The device as recited in claim 8, wherein the plunger comprises a detachable housing detachably disposed on a distal end thereof, the plurality of needles being at least partially disposed within the detachable housing.

10. The device as recited in claim 9, wherein the detachable housing comprises a first half and a second half that are selectively detachable from one another when the detachable housing is detached from the plunger.

11. The device as recited in claim 1, wherein the plurality of needles comprise at least one needle having a shaft and a plurality of needle tips extending from a distal end of the shaft.

12. The device as recited in claim 11, wherein the plurality of needle tips are generally aligned with and parallel to one another.

13. The needle as recited in claim 11, wherein the plurality of needle tips are generally parallel to and offset from one another.

23. The device as recited in claim 1, wherein the suture extends from the cuffs in the first end of the foot out the second opening formed in the foot housing and back into the foot housing through the first opening in the foot housing to the cuffs in the second end of the foot.

24. The device as recited in claim 1, wherein the cuffs are disposed distal the first opening when the foot is in the delivery position.

14. A device for closing an opening in tissue, comprising:

an elongate member having a proximal end, a distal end, a central passage and a plurality of needle lumens extending from the proximal end toward the distal end;

a plurality of needles disposed within and advancable from the plurality of needle lumens;

a foot housing disposed at the distal end of the elongate member, the foot housing defining a first opening and a second opening therein; and

a foot slidably mounted within the foot housing, the foot having a first end that has at least two cuffs removably mounted therein and a second, opposing end that has at least two cuffs removably mounted therein, a length of suture being connected between each cuff in the first end of the foot and each cuff in the second end of the foot, the foot being slidable relative to the foot housing between a delivery position and a deployed position, the cuffs in the first end of the foot being positioned below and accessible through the second opening in the foot housing when the foot is in the deployed position, and the cuffs in the second end of the foot being positioned outside the foot housing when the foot is in the deployed position; and

a plunger operatively associated with the plurality of needles, the plunger comprises a detachable housing detachably disposed on a distal end thereof, the detachable housing comprises a first half and a second half that are selectively detachable from one another when the detachable housing is detached from the plunger, the plurality of needles being at least partially disposed within the detachable housing such that movement of the plunger in a first direction advances the plurality of needles from the plurality of needle lumens and toward the cuffs in the foot when the foot is in the deployed position and movement of the plunger in a second direction draws the plurality of needles back into the plurality of needle lumens,

wherein a first set of needles from the plurality of needles are at least partially disposed in the first half of the detachable housing, and a second set of needles from the plurality of needles are at least partially disposed in the second half of the detachable housing.

15. A device for closing an opening in tissue, comprising:

an elongate member having a proximal end, a distal end, a central passage and a plurality of needle lumens extending from the proximal end toward the distal end;

a plurality of needles disposed within and advancable from the plurality of needle lumens;

a foot housing disposed at the distal end of the elongate member, the foot housing having an outside surface, the foot housing having a first opening and a second opening formed therein; and

a foot disposed entirely within the foot housing and being remote from the outside surface of the foot housing, the foot having a first end that has at least two cuffs removably mounted therein and a second, opposing end that has at least two cuffs removably mounted therein, a length of suture being connected between at least two cuffs, the foot being slidably mounted within the foot housing so as to linearly slide relative to the foot housing between a delivery position and a deployed position, the cuffs in the first end of the foot being positioned below and accessible through the second opening in the foot housing when the foot is in the deployed position, and the cuffs in the second end of the foot being positioned outside the foot housing when the foot is in the deployed position.

16. The device as recited in claim 15, wherein the first and second ends of the foot are positioned generally entirely within the foot housing when the foot is in the delivery position.

17. The device as recited in claim 16, wherein the cuffs in the first end of the foot are substantially inaccessible through the second opening in the foot housing when the foot is in the delivery position.

18. The device as recited in claim 17, wherein the cuffs in the first end of the foot are generally aligned with at least one needle lumen of the plurality of needle lumens when the foot is in the deployed position.

19. The device as recited in claim 18, wherein the cuffs in the second end of the foot are generally aligned with at least one needle lumen of the plurality of needle lumens when the foot is in the deployed position.

20. The device as recited in claim 19, wherein the plurality of needles comprise at least one needle having a shaft and a plurality of needle tips extending from a distal end of the shaft.

21. The device as recited in claim 20, wherein the plurality of needle tips are generally aligned with and parallel to one another.

22. The needle as recited in claim 20, wherein the plurality of needle tips are generally parallel to and offset from one another.