Apparatus and method for minimally invasive suturing

• US 20060069396A1
• Filed: 09/20/2005
• Published: 03/30/2006
• Est. Priority Date: 09/20/2004
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Suturtek Incorporated
• Inventors: DiFrancesco, Francis J., Meade, John C., Griffiths, Jerry R.
• Granted Patent: US 7,862,572 B2
• Time in Patent Office: Days
• US Class Current: 606/144
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• 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 2017/06028 by means of a cylindrical longitudinal blind bore machined at the suture-receiving end of the needle, e.g. opposite to needle tip
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2943 Toothed members, e.g. rack and pinion

Abstract

An apparatus and method for minimally invasive suturing is disclosed. A suturing device for minimally invasive suturing includes an elongated barrel having a proximal end, a distal end, and a longitudinal axis therebetween; a suture head assembly extending from the distal end of the elongated barrel; a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the elongated barrel, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle; and an actuator extending from the proximal end of the elongated barrel to actuate a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Claims

1. A suturing device for minimally invasive suturing comprising:

an elongated barrel having a proximal end, a distal end, and a longitudinal axis therebetween;

a suture head assembly extending from the distal end of the elongated barrel;

a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the elongated barrel, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle; and

an actuator extending from the proximal end of the elongated barrel to actuate a drive mechanism having a needle driver for engaging and rotating the suturing needle.

2. The suturing device of claim 1 wherein the suture head assembly is fabricated as a single piece.

3. The suturing device of claim 1 further comprising a cartridge holder assembly at a distal end of the suture head assembly, the cartridge holder assembly comprising:

a latch for retaining a cartridge that is releasable engaged at the distal end of the suture head assembly, the cartridge includes a protective housing and the suturing needle;

a shoulder screw for locking the latch over the cartridge;

a lever that engages the latch and is rotated to attach and release the cartridge;

at least one anti-rotate spring on the cartridge holder assembly that engages the suturing needle and prevents the suturing needle from moving backwards in the cartridge; and

at least one groove along the distal edge of the cartridge holder assembly that releasably engages the cartridge having the suturing needle.

4. The suturing device of claim 3 wherein the cartridge further comprises:

an aperture in a sidewall of the protective housing;

a curved track whereby the suturing needle follows a curved path along the track during rotation of the suturing needle; and

at least one extension that engages at least one groove along the distal edge of a cartridge holder assembly that releasably engages the cartridge having the suturing needle.

5. The suturing device of claim 1 further comprising:

an articulation rod capable of laterally articulating the suture head assembly to left and right of center; and

a locking lever for locking the suture head assembly in position.

6. The suturing device of claim 1 wherein the suture head assembly is laterally articulated to the left of center or the right of center.

7. The suturing device of claim 1 wherein the suturing needle covers an arc greater than about 180°

and less than about 330°

having an aperture located adjacent to the blunt end for engaging a suturing material.

8. The suturing device of claim 1 wherein the suturing needle comprises an aperture between the pointed end and blunt end.

9. The suturing device of claim 1 wherein the needle driver rides in a track formed by a C-brace and the suture head assembly preventing the needle driver from over-rotating and locking the suturing needle.

10. The suturing device of claim 1 further comprising:

an upper drive rod and a lower drive rod connected to linkages of the actuator;

a plurality of cables connecting the upper and lower drive rods to a gear train in the suture head assembly;

an actuator arm attached to the gear train; and

a needle driver located at a distal end of the actuator arm,

wherein the actuator arm follows an arc causing the needle driver to engage and rotate the suturing needle about the axis.

11. The suturing device of claim 1 wherein the suture head assembly is fabricated as multiple pieces.

12. The suturing device of claim 1 further comprising:

a latch for locking a needle holder assembly in place over the suturing needle, the needle holder assembly providing a protective housing for the suturing needle; and

a shoulder screw for locking the latch over the needle holder assembly.

13. The suturing device of claim 12 further comprising:

an aperture in the sidewall of the protective housing;

a curved track whereby the suturing needle follows a curved path along the track during rotation of the suturing needle; and

at least one extension that engages the latch and helps hold the latch in place.

14. The suturing device of claim 13 wherein the curved track further comprises:

an outside slot that provides clearance for the needle driver; and

an inner slot that provides clearance for a tip of the needle driver.

15. The suturing device of claim 1 wherein the drive mechanism further comprises:

a plurality of cables connecting the actuator to a plurality of pulleys in the suture head assembly;

an actuator arm attached to the plurality of pulleys; and

a needle driver located at a distal end of the actuator arm,

wherein the actuator arm follows an arc causing the needle driver to engage and rotate the suturing needle about the axis.

16. The suturing device of claim 12 wherein the suturing needle is held in a path of rotation by a combination of the latch and the needle holder assembly.

17. The suturing device of claim 1 for use in a minimally invasive surgery.

18. A method for minimally invasive suturing comprising:

(a) engaging a cartridge to a suture head assembly at a distal end of a suturing device, the cartridge having a protective housing and a suturing needle with a pointed end and a blunt end;

(b) introducing the distal end of the suturing device into a body cavity;

(c) positioning an opening in the cartridge to span a tissue;

(d) activating an actuator coupled to a drive mechanism that engages the suturing needle to cause rotational movement of the suturing needle about an axis approximately perpendicular to a longitudinal axis of the suturing device and advance the suturing needle through the tissue;

(e) pulling a suturing material attached to the suturing needle through the tissue forming a stitch; and

repeating steps (c) through (e) to cause a plurality of stitches to be placed through the tissue.

19. A method for suturing tissue during minimally invasive surgery comprising:

(a) engaging a suturing needle with a pointed end and a blunt end to a suture head assembly at a distal end of a suturing device, whereby the suturing needle follows a curved path along a track during rotation of the suturing needle, and a latch that provides a protective housing for the suturing needle; and

(b) introducing the distal end of the suturing device into a body cavity;

(c) positioning an opening in the needle holder assembly to span a tissue;

(d) activating an actuator coupled to a drive mechanism that engages the suturing needle to cause rotational movement of the suturing needle about an axis approximately perpendicular to a longitudinal axis of the suturing device and advance the suturing needle through the tissue;

(e) pulling a suturing material attached to the suturing needle through the tissue; and

repeating steps (c) through (e) to cause a plurality of stitches to be placed through the tissue.

20. A method for minimally invasive suturing comprising:

inserting a distal end of a suturing device having a suturing needle with a pointed end into a body;

positioning the suturing needle to span a plurality of separated tissue segments;

activating an actuator a first time causing the pointed end of the suturing needle to extend beyond a protective housing of a cartridge to engage the plurality of separated tissue segments; and

activating the actuator a second time to cause the suturing needle to complete a revolution and pull a suture extending from the suturing needle through the plurality of separated tissue segments.