SUTURING DEVICES AND METHODS FOR SUTURING AN ANATOMIC VALVE

• US 20140303654A1
• Filed: 06/23/2014
• Published: 10/09/2014
• Est. Priority Date: 05/09/2008
• Status: Active Grant

• Current Assignee: Scarab Technology Services, LLC
• Original Assignee: Nobles Medical Technologies, Inc
• Inventors: Nobles, Anthony A., Brosch, Benjamin G., Crew, John R.
• Granted Patent: US 9,326,764 B2
• Time in Patent Office: Days
• US Class Current: 606/147
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 2017/047 having at least one proximally pointing needle located at the distal end of the instrument, e.g. for suturing trocar puncture wounds starting from inside the body J-shaped suture needles A61B2017/0608
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end

Abstract

A device for suturing an anatomic valve can comprise an elongate body, a suture catch mechanism and a suture clasp arm. The suture catch mechanism can be operatively coupled to the elongate body for movement between a retracted position and an advanced position. The suture clasp arm can be attached to the elongate body for movement between a retracted position and an extended position. The suture clasp arm can comprise a suture clasp configured to releasably retain a suture portion. In some embodiments, the suture clasp is positioned on the suture clasp arm such that the suture catch mechanism retrieves the suture portion from the suture clasp arm while the arm is at least partially retracted. In some embodiments, the suture clasp arm can be closed about a tissue portion without damaging the tissue portion.

Claims

1. A device for suturing an anatomic valve, comprising:

an elongate body;

a needle operatively coupled to the elongate body for movement between a retracted position and an advanced position;

an arm attached to the elongate body near a distal end of the elongate body for movement between a retracted position and an extended position, the arm comprising a suture mount configured to releasably retain a suture portion, the suture mount being positioned on the arm such that the needle retrieves the suture portion retained in the suture mount when the needle is moved from the retracted position to the advanced position and returned to the retracted position; and

a recess positioned between the elongate body and the arm, the recess being sized and shaped to receive a leaflet of a valve between the elongate body and the arm without damaging the leaflet.

2. The device of claim 1, wherein the recess is sized and shaped to retain the leaflet between the elongate body and the arm when the arm is at least partially retracted without damaging the leaflet.

3. The device of claim 1, wherein the recess is sized and shaped to receive the leaflet between the elongate body and the arm when the arm is in the retracted position without damaging the leaflet.

4. The device of claim 3, wherein the recess is sized and shaped to retain the leaflet between the elongate body and the arm when the arm is in the retracted position without damaging the leaflet.

5. The device of claim 1, wherein the suture mount is positioned on the arm such that the needle retrieves the suture portion retained in the suture mount when the needle is moved from the retracted position to the advanced position and returned to the retracted position while the arm is in a partially retracted position.

6. The device of claim 1, wherein the suture mount is positioned on the arm such that the needle retrieves the suture portion retained in the suture mount when the needle is moved from the retracted position to the advanced position and returned to the retracted position while the arm is in a fully retracted position.

7. The device of claim 1, wherein a tissue-piercing structure of the needle is received within the arm when the arm is at least partially closed and the needle is in the advanced position.

8. The device of claim 7, wherein the tissue-piercing structure of the needle is received within the arm when the arm is in the retracted position and the needle is in the advanced position.

9. The device of claim 1, further comprising at least a second arm and at least a second needle.

10. The device of claim 9, wherein the needles are mounted for simultaneous movement.

11. The device of claim 9, wherein the arms are moveable simultaneously between retracted and extended positions.

12. A method of suturing an anatomic valve, comprising:

positioning a suturing device comprising an elongate body at least partially within an anatomic valve;

deploying a first arm from the elongate body, the first arm releasably holding a first suture portion;

at least partially closing the first arm about a first leaflet of the anatomic valve;

while the first arm is at least partially closed about the first leaflet, advancing a first needle through the first leaflet to engage the first suture portion;

drawing the first suture portion through the first leaflet;

passing a second suture portion through a second leaflet; and

securing together the first and second suture portions.

13. The method of claim 12, wherein, without damaging the first leaflet, the first leaflet is trapped between the first arm and the elongate body when the first arm is at least partially closed.

14. The method of claim 12, wherein, without damaging the first leaflet, the first leaflet is trapped between the first arm and the elongate body when the first arm is fully closed.

15. The method of claim 12, further comprising receiving a tissue-piercing structure of the first needle within the first arm when the first arm is at least partially closed and the first needle is positioned through the first leaflet.

16. The method of claim 15, wherein the tissue-piercing structure is received within the first arm when the first arm is fully closed and the first needle is positioned through the first leaflet.

17. The method of claim 12, wherein passing the second suture portion through the second leaflet comprises:

deploying a second arm from the elongate body, the second arm releasably holding the second suture portion;

at least partially closing the second arm about the second leaflet;

while the second arm is at least partially closed about the second leaflet, advancing a second needle through the second leaflet to engage the second suture portion; and

drawing the second suture portion through the second leaflet.

18. The method of claim 17, wherein the second arm is deployed from an additional suturing device.

19. The method of claim 17, wherein the first arm and the second arm are deployed simultaneously.

20. The method of claim 17, wherein the first needle and the second needle are simultaneously advanced.

21. A method of suturing a heart valve, comprising:

advancing a first elongate member to a heart valve;

extending a first arm from the elongate member around a first heart valve portion, the first arm releasably holding a first suture portion;

advancing a first needle from the elongate member through a first heart valve portion to retrieve a first suture portion from the first arm;

extending a second arm around a second heart valve portion, the second arm releasably holding a second suture portion;

advancing a second needle through a second heart valve portion to retrieve the second suture portion from the second arm; and

securing the first and second suture portions.

22. The method of claim 21, wherein the first heart valve portion is a first leaflet and the second heart valve portion is a second leaflet.

23. The method of claim 21, wherein the second arm is extended from a second elongate member, and the second needle is advanced from the second elongate member.

24. The method of claim 21, further comprising at least partially closing the first arm to retain the first heart valve portion between the first arm and the elongate body.