Devices, systems, and methods for providing surgical access and facilitating closure of surgical access openings

• US 9,700,303 B2
• Filed: 07/29/2014
• Issued: 07/11/2017
• Est. Priority Date: 08/02/2013
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Prior, Scott J., Malkowski, Jaroslaw T., Hendershot, III, John D., Tebbe, Gregory F., Horton, Kenneth W.
• Primary Examiner(s): SHI, KATHERINE MENGLIN
• Application Number:
  US14/445,259
• Publication Number:
  US 20150038994A1
• Time in Patent Office: 1,078 Days
• Field of Search: 606139-148
• 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 17/0482 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 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 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 2017/00907 for light
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• CPC Class Codes: A61B 2017/3441 with distal sealing means
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3454 Details of tips
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2090/036 abutting on tissue or skin
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61B 2090/701 for flexible tubular instruments, e.g. endoscopes
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/70 : Cleaning devices specially adapted for surgical instruments
• CPC Class Codes: A61M 13/00 : Insufflators for therapeutic or disinfectant purposes , i.e. devices for blowing a gas, powder or vapour into the body hand-held units in which gas flow is produced by muscular energy at the moment of use B05B11/062
• CPC Class Codes: A61M 19/00 : Local anaesthesia syringes therefor A61M5/00; Hypothermia A61M5/42 takes precedence; cooling blood in a bypass of the arterial system A61M1/36
• CPC Class Codes: A61M 5/329 : characterised by features of the needle shaft

Abstract

A suture passer includes a handle, an elongated sleeve defining a distal end, an inner shaft slidably disposed within the elongated sleeve, and an end effector assembly disposed at a distal end of the inner shaft. The end effector assembly includes first and second arms, at least one which is movable relative to the other between a spaced-apart position and an approximated position for retaining a portion of a suture therebetween. The inner shaft and elongated sleeve are relatively movable between a first condition, wherein the first and second arms are disposed in the approximated position and the distal end of the elongated sleeve is exposed, a second condition, wherein the first and second arms are disposed in the approximated position and the distal end of the elongated sleeve is shielded, and a third condition, wherein the first and second arms are disposed in the spaced-apart position.

Claims

1. A suture passer, comprising:

a handle;

an elongated sleeve extending distally from the handle and defining a sharpened distal tip;

an inner member extending through the elongated sleeve;

an end effector assembly disposed at a distal end of the inner member, the end effector assembly including first and second arms, at least one of the arms movable relative to the other between a spaced-apart position and an approximated position, wherein, in the approximated position, the first and second arms are configured to retain a portion of a suture therebetween, the inner member movable relative to the elongated sleeve and the handle to thereby move the end effector assembly between;

a proximal position, wherein the first and second arms are disposed in the approximated position, the end effector assembly is disposed within the elongated sleeve, and the sharpened distal tip of the elongated sleeve is exposed;

an intermediate position, wherein the first and second arms are disposed in the approximated position and the end effector assembly extends at least partially from the distal end of the elongated sleeve to shield the sharpened distal tip; and

a distal position, wherein the first and second arms are disposed in the spaced-apart position and the end effector assembly extends further from the sharpened distal tip of the elongated sleeve;

a first biasing member disposed within the handle, the first biasing member having a distal end and a proximal end, the proximal end of the first biasing member being secured to the inner member, the first biasing member configured to maintain a continuous first bias on the inner member to thereby bias the end effector assembly relative to the elongated sleeve from the distal position towards the intermediate position;

a second biasing member disposed within the handle, the second biasing member operatively coupled to the inner member and configured to bias the inner member to thereby bias the end effector assembly relative to the elongated sleeve from the proximal position towards the intermediate position;

a locking component operably coupled to the inner member, the locking component configured to engage a cooperative locking structure within the handle to releasably lock the inner member relative to the handle and the elongated sleeve, wherein the locking component includes at least one spring leg having an engagement member, and wherein the cooperative locking structure within the handle includes a slot defined in the handle, wherein when the locking component engages the cooperative locking structure, the engagement member of the at least one spring leg is disposed within the slot defined in the handle to lock the inner member relative to the handle and the elongated sleeve; and

a release mechanism including at least one release member mounted to the handle, the at least one release member movable to engage the locking component to cause release of the locking component from the locking structure to release the inner member relative to the handle and the elongated sleeve.

2. The suture passer according to claim 1, wherein one of the first and second arms is a spring arm, the spring arm biased towards the spaced-apart position relative to the other arm.

3. The suture passer according to claim 2, wherein the other of the first and second arms is a receiver shaft, the receiver shaft configured to at least partially receive the spring arm therein when the first and second arms are disposed in the approximated position.

4. The suture passer according to claim 3, wherein the receiver shaft defines a cut-out configured to retain a portion of a suture therein.

5. The suture passer according to claim 1, further including an actuator operatively associated with the inner member, the actuator selectively actuatable for moving the end effector assembly from the intermediate position to the distal position against the bias of the first biasing member.

6. The suture passer according to claim 1, wherein the locking component is configured to automatically lock the inner member when the end effector assembly is in the intermediate position.

7. The suture passer according to claim 1, wherein the locking component is configured to selectively engage the cooperative locking structure when the inner member is translated to a position relative to the housing such that the engagement member of the at least one spring leg is aligned with the slot of the cooperative locking structure defined in the handle.

8. The suture passer according to claim 1, wherein the at least one release member is slidably disposed within the slot of the cooperative locking structure defined in the handle, the at least one release member configured to slidably extend into the slot of the handle to drive the engagement member of the at least one spring leg from the slot of the handle to release the locking component from the locking structure and unlock the inner member relative to the handle and the elongated sleeve.