Vascular suturing device

• US 9,592,038 B2
• Filed: 09/13/2012
• Issued: 03/14/2017
• Est. Priority Date: 08/08/2005
• Status: Active Grant

• Current Assignee: Abbott Laboratories
• Original Assignee: Abbott Laboratories
• Inventors: Pantages, Anthony J., Ellingwood, Brian A., Walberg, Erik K.
• Primary Examiner(s): Anderson, Gregory
• Assistant Examiner(s): LAUER, CHRISTINA C
• Application Number:
  US13/615,523
• Publication Number:
  US 20130066340A1
• Time in Patent Office: 1,643 Days
• US Class Current: 1/1
• 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 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06004 Means for attaching suture to needle tipping A61B17/06195; connecting wire to other metallic objects B21F15/00
• 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 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/06009 having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle
• CPC Class Codes: A61B 2017/06028 by means of a cylindrical longitudinal blind bore machined at the suture-receiving end of the needle, e.g. opposite to needle tip

Abstract

A surgical device of suturing vascular vessels is described, as well as methods for suturing tissue employing the surgical device. In one form the device includes a distal member that contains a suture and needle engaging fitting. A needle is advanced through tissue adjacent the puncture wound and into the needle engaging fitting to draw lengths of suture material which can then be used to close the puncture wound. In another form the device includes a needle advanceable through tissue and into a needle capture element within a distal end of the surgical device to draw lengths of suture material which can then be used to close various puncture wounds. In still another form the device includes at least one needle advanceable to draw lengths of suture material to close various puncture wounds. A foot is pivotal between a non-deployed and a deployed position.

Claims

1. A suturing device for suturing an opening in a vascular vessel, said device comprising:

a proximal member including an elongate body having a needle channel therethrough sized to receive at least one needle and including a needle cartridge slidably mounted thereon configured to contain a plurality of needles, the needle cartridge being biased to automatically and successively align each of the plurality of needles with the needle channel;

a distal member configured to be inserted within a lumen of a vascular vessel, said distal member having a receptacle located therein;

an intermediate member disposed between the proximal member and the distal member, said intermediate member defining a tissue receiving area and having a first opening providing a passageway to the channel and a second opening providing a passageway into the receptacle, the intermediate member including a foot pivotally mounted on a lateral outer surface of the intermediate member and pivotal about pivot axis that extends through the foot and the lateral outer surface; and

a length of suture material comprising a needle engaging fitting positioned in the receptacle to engage a needle entering from the second opening.

2. The device of claim 1 wherein the needle engaging fitting comprises a ferrule having a needle engaging tab.

3. The device of claim 2 wherein the ferrule comprises a cylindrical housing having a plurality of tabs extending radially inward.

4. The device of claim 2 comprising a needle having a recessed engaging surface configured to engage with the needle engaging tabs.

5. The device of claim 1 wherein the length of suture material comprises a first needle engaging fitting on and first end and a second needle engaging fitting on a second end.

6. The device of claim 1 comprising two needle engaging fittings in the receptacle.

7. The device of claim 1 wherein the proximal member contains a single needle channel extending therethrough.

8. The device of claim 1 wherein the intermediate member is curved or angled to define a tissue receiving recess configured to receive a portion of vascular tissue adjacent the opening in the vascular vessel.

9. The device of claim 1 comprising a needle pusher slidably mounted in alignment with the needle channel to advance a needle along the needle channel in a direction toward the first opening in the intermediate member.

10. A method of suturing an opening in a vascular vessel, said method comprising:

inserting a vascular suturing device through the opening in the vascular vessel, said suturing device comprising

a proximal member having a needle channel and a needle therein;

a distal member configured to be inserted into a lumen of the vascular vessel, the distal member having a cavity therein and a length of suture material disposed in the cavity, the length of suture having a fitting disposed on each end thereof, the fittings being positioned side by side within the cavity; and

a connecting member between the proximal and distal members, the connecting member being crooked to offset the channel and the cavity from the opening in the vascular vessel and having a first opening into the needle channel and a second opening into the cavity; and

a foot pivotally mounted on a lateral outer surface of the connecting member and pivotal about pivot axis that extends through the foot and the lateral outer surface;

advancing the needle through the needle channel, sufficient to pierce a portion of tissue adjacent the opening in the vessel and extend into the cavity of the distal member;

capturing the suture within the cavity with the needle; and

retracting the needle carrying a first portion of the suture back through the tissue and the channel.

11. The method of claim 10 comprising repositioning the suturing device within the lumen and advancing the same or a different needle through the channel to the suture within the cavity.

12. The method of claim 10 comprising retracting the same or different needle carrying a second length of suture back through the tissue and the channel to leave a loop of suture within the cavity.

13. The method of claim 10, the length of suture further comprising a second portion, the method further comprising securing the first and second portions of the suture together to promote hemostasis.

14. The method of claim 13 wherein said securing comprises tying the first and second portions of suture together.

15. The method of claim 13 wherein said securing comprises clamping the first and second portions of suture together with a suture clamp.

16. A method of suturing vascular tissue adjacent an opening in a vascular vessel, said method comprising:

inserting a suturing device through the opening in the vascular vessel, said suturing device comprising

a proximal member having a needle channel and a needle therein, said needle carrying a length of suture material;

a distal member configured to be inserted into a lumen of the vascular vessel, the distal member having a receptacle comprising a needle capture element and sized to receive at least one needle therein;

an intermediate member disposed between the proximal member and the distal member, the intermediate member defining a tissue receiving area and configured to provide a linear needle pathway between the channel and the receptacle; and

a foot pivotally mounted on a lateral outer surface of the intermediate member and pivotal about pivot axis that extends through the foot and the lateral outer surface;

advancing the needle distally along the needle channel to pierce the vascular tissue and draw a portion of the length of suture material through the vascular tissue; and

engaging the needle with the needle capture element in the receptacle.

17. The method of claim 16 wherein engaging the needle with said capture element comprises piercing the needle capture element with at least a tip of the needle.

18. The method of claim 16 wherein the needle capture element comprises at least one projection and said engaging comprises contacting the needle with the at least one projection.

19. The method of claim 18 wherein the said engaging comprises inserting the needle between the at least one projection and an internal wall of the receptacle.

20. The method of claim 16 wherein the needle capture element comprises a plurality of projections extending into the receptacle and said engaging comprises inserting the needle between two or more of the plurality of projections.

21. The method of claim 16 comprising sequentially advancing two or more needle along the needle channel and into the receptacle.

22. The method of claim 16 comprising withdrawing the suturing device from the opening in the vascular vessel with the needle retained within the receptacle.

23. The method of claim 22 comprising pulling suture material distally through vascular tissue adjacent the opening.

24. The method of claim 23 comprising pulling suture material proximally out the opening.

25. The method of claim 24 comprising pulling two lengths of suture material proximally out the opening.

26. The method of claim 25 comprising securing the two lengths of suture material together.

27. The method of claim 26 wherein said securing comprises tying the two lengths of suture material together.

28. The method of claim 26 wherein said securing comprises using a suture securing device to secure the two lengths of suture material together.

29. The method of claim 26 comprising using a knot pusher to secure the two lengths of suture material together.

30. A method of suturing an opening in a vascular vessel, said method comprising:

inserting a suturing device through the opening in the vascular vessel, said suturing device comprising

a proximal member having a needle channel therein;

a distal member configured to be inserted into a lumen of the vascular vessel, the distal member having a receptacle therein sized to receive at least one needle therein;

an intermediate member disposed between the proximal and distal members, the intermediate member having a first opening providing a passageway to the needle channel and a second opening providing a second passageway into the receptacle and wherein the intermediate member is crooked to offset the needle channel and the receptacle from the opening in the vascular vessel; and

a foot pivotally mounted on a lateral outer surface of the intermediate member and pivotal about pivot axis that extends through the foot and the lateral outer surface;

deploying the foot to contact vascular tissue adjacent the opening; and

advancing a first needle carrying a first length of suture material through the needle channel to pierce a portion of vascular tissue at a first suture site adjacent the opening in the vascular vessel and into the receptacle in the distal member.

31. The method of claim 30 comprising repositioning the suturing device to a second suturing site.

32. The method of claim 31 comprising retracting the foot to a first position prior to repositioning the suturing device.

33. The method of claim 32 comprising securing the first length of suture material to the second length of suture material.

34. The method of claim 31 comprising advancing a second needle carrying a second length of suture material through the needle channel to pierce tissue at the second suture site.

35. The method of claim 34 comprising withdrawing the suturing device from the vascular vessel.

36. The method of claim 30 wherein the step of advancing said first needle draws the first length of suture material distally through a portion of vascular tissue adjacent the opening in the vascular vessel.

37. The method of claim 36 wherein said withdrawing comprises drawing the first length of suture material and a second lengths of suture material through the opening in a proximal direction.

38. The method of claim 30 wherein said deploying comprises pivoting the foot from a first position adjacent the tissue receiving area to a second position distal to the tissue receiving area.

39. The method of claim 30 wherein said deploying comprises deploying the foot after said inserting step.

40. The method of claim 39 wherein said securing comprises tying the first length of suture material and the second lengths of suture material together.

41. The method of claim 39 wherein said securing comprises clamping the first length of suture material and the second lengths of suture material together with a suture securing device.

42. The method of claim 41 wherein the first length of suture material and the second length of suture material are two ends of a single length of suture material.