Suturing device, system and method

• US 20070060930A1
• Filed: 09/14/2005
• Published: 03/15/2007
• Est. Priority Date: 09/14/2005
• Status: Active Grant

• Current Assignee: Boss Instruments, Ltd., Inc.
• Original Assignee: Rhaphis Medical, Inc.
• Inventors: Belman, Yuri, Hamilton, Henry
• Granted Patent: US 7,588,583 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 17/062 Needle manipulators
• CPC Class Codes: A61B 17/2841 Handles
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like

Abstract

Improved medical suturing devices, systems, and methods may hold a suture needle at a fixed location relative to a handle of the device, allowing the surgeon to grasp and manipulate the handle of the suturing device to insert the needle through tissues in a manner analogous to use of a standard needle gripper. Cycling the handle from a closed position to an open position and back to the closed position may alternate the device between gripping the needle with a first clamp (for example, along a proximal portion of the needle) to gripping the needle with a second clamp (for example, along a distal portion of the needle) and optionally back to gripping with the first clamp, with the needle often staying at a substantially fixed location relative to the suturing device body.

Claims

1. A suturing method comprising:

inserting a distal portion of a suturing needle distally through a tissue by moving a body of a suturing device while a clamp of the suturing device holds the needle at a fixed location relative to the body;

grasping the distal portion of the needle with a second clamp of the suturing device;

releasing the proximal portion of the needle from the first clamp; and

pulling the proximal portion of the needle through the tissue by moving the body while the second clamp holds the needle.

2. The suturing method of claim 1, wherein the second clamp fixedly holds the needle relative to the body while pulling the proximal portion of the needle through the tissue.

3. The suturing method of claim 2, further comprising:

grasping the proximal portion of the needle with the first clamp and then releasing the distal portion of the needle from the second clamp; and

repeating the inserting of the distal portion and pulling of the proximal portion so as to define a plurality of suture stitches.

4. The suturing method of claim 3, wherein the grasping and releasing steps are effected by actuating a handle of the suturing device with a hand of a surgeon.

5. The suturing method of claim 4, wherein the handle moves relative to the body between an open-handed configuration and a closed grasp configuration, and wherein the handle is in the closed grasp configuration during the inserting of the distal portion, and is in the open-handed configuration during the pulling of the proximal portion.

6. The suturing method of claim 1, wherein the suturing device grasps the needle with both the first and second clamps before releasing of the first clamp and before releasing of the second clamp.

7. The suturing method of claim 6, wherein grasping and releasing of the clamps are effected by moving a handle between a first configuration relative to the body and a second configuration relative to the body, movement of the handle from the first configuration to the second configuration and back to the first configuration defining a handle actuation cycle, and wherein the needle alternates at least once between being supported by the first clamp and being supported by the second clamp with each handle actuation cycle.

8. The suturing method of claim 7, further comprising alternating a configuration of an alternatable drive element of a linkage between a first configuration and a second configuration with each handle actuation cycle, the alternatable drive element driving a first linkage portion coupled to the first clamp in the first configuration and driving a second linkage portion coupled to the second clamp in the second configuration.

9. The suturing method of claim 8, wherein the handle actuation cycle rotates a drive wheel, wherein the first and second linkage portions each comprise a driven wheel, wherein the alternatable drive element in the first configuration drivingly couples the drive wheel with the driven wheel of the first linkage portion, and wherein the alternatable drive element in the second configuration drivingly couples the drive wheel with the driven wheel of the second linkage portion.

10. The suturing method of claim 1, wherein the first clamp is displaced laterally from around the needle when the second clamp is inserting the needle, and wherein the second clamp is displaced laterally from around the needle when the first clamp is pulling the needle.

11. The suturing method of claim 10, wherein each clamp is mounted to an associated reciprocatable shaft, and wherein grasping of the needle with each clamp comprises distally extending the associated shaft from a proximal housing of the body, and thereafter closing the clamp around the needle.

12. The suturing method of claim 11, wherein grasping of the needle with each clamp further comprising rotating the clamp about an axis of the shaft between a retracted position and an extended grasping position.

13. The suturing method of claim 11, wherein at least one associated spring inhibits closing of each clamp before the clamp is adjacent the needle.

14. The suturing method of claim 1, further comprising actuating a release input of the suturing device so as to release the needle from the first and second clamps.

15. The suturing method of claim 1, wherein the needle comprises an off-the-shelf needle sold primarily for standard open or laparoscopic surgery.

16. A suturing device for use with a suturing needle, the device comprising:

a body having a proximal end and a distal end;

a first clamp near the distal end of the body;

a second clamp near the distal end of the body;

a linkage effecting movement of the first and second clamps between a grasping configuration and a displaced configuration, each clamp grasping the needle at an associated grasping location in the grasping configuration and laterally displaced from the needle in the displaced configuration, the grasping locations fixed relative to the body.

17. The suturing device of claim 16, further comprising a handle disposed at the proximal end of the body and coupled to the first and second clamps by the linkage so that actuation of the handle alternates between:

the first clamp in the grasping configuration and the second clamp in the displaced configuration, and

the second clamp in the grasping configuration and the first clamp in the displaced configuration.

18. The suturing device of claim 17, wherein the handle is configured for grasping by a hand of a surgeon and is actuatable between a closed hand configuration and an open hand configuration, movement of the handle from the closed-hand configuration to the open-hand configuration and back to the closed-hand configuration defining a handle actuation cycle, and wherein support for the needle alternates at least once between the first clamp and the second clamp during each handle actuation cycle, and wherein the surgeon can insert the needle into tissue by closing his hand on the handle and manipulating the handle while the needle is grasped by one of the clamps.

19. The suturing device of claim 18, wherein each clamp opens after the other clamp has closed during the handle actuation cycle so that the clamps maintain the needle at a substantially fixed location relative to the body.

20. The suturing device of claim 17, wherein the linkage comprises an alternatable drive element, the alternatable drive element moving between a first configuration and a second configuration with each handle actuation cycle, the alternatable drive element driving a first linkage coupled to the first clamp in the first configuration and driving a second linkage coupled to the second clamp in the second configuration.

21. The suturing device of claim 20, wherein the handle actuation cycle rotates a drive wheel, wherein the first and second linkages each comprise a driven wheel, wherein the alternatable drive element in the first configuration drivingly couples the drive wheel with the driven wheel of the first linkage, and wherein the alternatable drive element in the second configuration drivingly couples the drive wheel with the driven wheel of the second linkage.

22. The suturing device of claim 16, wherein during actuation the linkage displaces the first clamp laterally from around the needle after the second clamp grasps the needle, and wherein during actuation the linkage displaces the second laterally from around the needle after the first clamp grasps the needle.

23. The suturing device of claim 22, wherein each clamp has a reciprocatable shaft extending proximally from the clamp to the body, wherein the linkage reciprocates the shafts relative to the body during the actuation cycle so as to move each clamp distally, and wherein the linkage thereafter closes the distally extended clamp around the needle.

24. The suturing device of claim 23, wherein the linkage rotates each clamp about an axis of the shaft between a retracted position and an extended grasping position.

25. The suturing device of claim 23, wherein at least one associated spring inhibits closing of each clamp before the clamp is adjacent the needle.

26. The suturing device of claim 16, further comprising a release input coupled to the linkage so as to release the needle from the first and second clamps.

27. The suturing device of claim 16, further comprising the needle, wherein the needle comprises an off-the-shelf needle sold primarily for standard open or laparoscopic surgery.

28. The suturing device of claim 16, wherein the clamping locations of the first and second clamps are axially offset along a length of the needle and angularly offset so as to accommodate axial curvature of the needle.

29. The suturing device of claim 16, further comprising a proximal handle coupled to the body so as to actuate along a handle actuation plane, wherein the first and second clamps are oriented to support the needle so that an axis of the needle traverses the handle actuation plane

30. The suturing device of claim 16, wherein the suturing device is composed of chemically sterilizable materials.

31. A suturing device for use with a suturing needle, the device comprising:

a body having a proximal end and a distal end;

a handle disposed near the proximal end of the body, the handle actuatable from a first configuration to a second configuration and back to the first configuration so as to define an actuation cycle;

a first clamp and a second clamp disposed near the distal end of the body, the first and second clamps coupled to the handle so that;

a first portion of the actuation cycle, initiated while the first clamp is grasping the needle, effects grasping of the needle with the second clamp and release of the needle from the first clamp; and

a second portion of the actuation cycle, initiated while the second clamp is grasping the needle, effects grasping of the needle with the first clamp and release of the needle from the second clamp.