ARTICULATING SUTURING DEVICE

• US 20160242749A1
• Filed: 04/29/2016
• Published: 08/25/2016
• Est. Priority Date: 12/21/2012
• Status: Active Grant

• Current Assignee: Abbott Cardiovascular Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Abbott Cardiovascular Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Voss, Laveille Kao
• Granted Patent: US 10,537,312 B2
• Time in Patent Office: 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 17/04 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 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061

Abstract

An apparatus for closing an opening in a body tissue. The apparatus includes a shaft, a plurality of arms, and an expander. The arms each extend between a proximal end and a distal end. The distal end of each arm is hingedly attached to or integrally formed with the shaft. The arms are laterally spaced apart from each other. The arms are movable between a retracted configuration, in which the arms are each aligned along the shaft, and a deployed configuration, in which the proximal end of each arm pivots respectively about the distal end of the arm so as to extend laterally away from the shaft. The expander is positioned within the shaft, and movement of the expander causes the arms to move between the retracted and deployed configurations. Methods of using the apparatus are also included.

Claims

1. A method for closing an opening extending through a tissue wall, the method comprising:

inserting a distal end of a tissue locator distally through the opening, the tissue locator comprising a first arm and a second arm each extending between a proximal end and a distal end, the first and second arms each being aligned along a shaft of the tissue locator in a retracted configuration, the tissue locator being inserted far enough through the opening that the first and second arms are positioned distal of the tissue wall, first and second ends of a flexible filament respectively being removably coupled with the first and second arms;

pivoting the proximal end of each of the first and second arms of the tissue locator about the distal end of the respective arm to move the proximal ends of the first and second arms from the retracted configuration to a deployed configuration in which the proximal ends of the first and second arms extend laterally away from the shaft;

advancing a first penetrator and a second penetrator distally through the tissue wall such that the first and second penetrators respectively couple with the first and second ends of the flexible filament; and

withdrawing the first and second penetrators proximally through the tissue wall, thereby causing the first and second ends of the filament to uncouple from the first and second arms, the first end of the flexible filament remaining coupled with the first penetrator such that the first end of the filament withdraws proximally through the tissue wall with the first penetrator.

2. The method recited in claim 1, wherein the distal ends of the first and second arms remain aligned along a shaft of the tissue locator in the deployed configuration.

3. The method recited in claim 1, wherein the distal ends of the first and second arms are integrally formed with the shaft of the tissue locator.

4. The method recited in claim 1, wherein the distal ends of the arms are hingedly attached to the shaft of the tissue locator.

5. The method recited in claim 1, wherein the distal ends of the arms flex outward when the proximal ends of the arms move to the deployed configuration.

6. The method recited in claim 1, wherein the second end of the flexible filament remains coupled with the second penetrator such that the second end of the filament withdraws proximally through the tissue wall with the second penetrator.

7. The method recited in claim 1, wherein the proximal ends of the first and second arms extend in opposite lateral directions when the arms are in the deployed configuration.

8. The method recited in claim 1, wherein pivoting the proximal ends of the arms comprises moving an arm expander axially along the shaft so as to cause a laterally outward force to occur on the arms.

9. The method recited in claim 8, wherein moving the arm expander axially comprises moving the arm expander proximally to cause the laterally outward force to occur on the arms.

10. The method recited in claim 8, wherein moving the arm expander axially comprises moving the arm expander distally to cause the laterally outward force to occur on the arms.

11. The method recited in claim 1, wherein the tissue locator further comprises a third arm and a fourth arm each extending between a proximal end and a distal end, first and second ends of a second flexible filament respectively being removably coupled with the third and fourth arms, and wherein the third and fourth arms are also each aligned along the shaft of the tissue locator in the retracted configuration and the third and fourth arms are positioned distal of the tissue wall when the tissue locator is inserted through the opening, and wherein the method further comprises:

pivoting the proximal end of each of the third and fourth arms of the tissue locator about the distal end of the respective arm to move the proximal ends of the third and fourth arms from the retracted configuration to a deployed configuration in which the proximal ends of the third and fourth arms extend laterally away from the shaft;

advancing a third penetrator and a fourth penetrator distally through the tissue wall such that the third and fourth penetrators respectively couple with the first and second ends of the second flexible filament; and

withdrawing the third and fourth penetrators proximally through the tissue wall, thereby causing the first and second ends of the second filament to uncouple from the third and fourth arms, the first end of the second flexible filament remaining coupled with the third penetrator such that the first end of the second filament withdraws proximally through the tissue wall with the third penetrator.

12. The method recited in claim 11, wherein the second end of the second flexible filament remains coupled with the fourth penetrator such that the second end of the second filament withdraws proximally through the tissue wall with the fourth penetrator.

13. The method recited in claim 11, wherein the proximal ends of the third and fourth arms extend in opposite lateral directions from each other and in lateral directions different than the lateral directions of the proximal ends of the first and second arms when the third and fourth arms are in the deployed configuration.

14. The method recited in claim 11, wherein moving an arm expander axially along the shaft also causes a laterally outward force to occur on the third and fourth arms to pivot the third and fourth arms laterally outward.

15. A method for closing an opening extending through a tissue wall, the method comprising:

inserting a distal end of a tissue locator distally through the opening, the tissue locator comprising a plurality of arms, each being aligned along a shaft of the tissue locator in a retracted configuration, the tissue locator being inserted far enough through the opening that the plurality of arms are positioned distal of the tissue wall, at least one flexible filament or web being removably coupled with the plurality of arms;

moving the plurality of arms from the retracted configuration to a deployed configuration in which the plurality of arms extend laterally away from the shaft;

for each arm, advancing a penetrator distally through the tissue wall to couple with the at least one flexible filament or web associated with the arm, the penetrators being movable independent of each other; and

withdrawing the penetrators proximally through the tissue wall, thereby causing the at least one flexible filament or web to uncouple from the plurality of arms and withdraw proximally through the tissue wall with the penetrators.

16. The method recited in claim 15, wherein each penetrator is advanced at different times from each other.

17. The method recited in claim 15, wherein each penetrator has a separate penetrator actuator associated therewith, and each penetrator is advanced and withdrawn by manually manipulating the associated penetrator actuator.

18. A method for closing an opening extending through a tissue wall, the method comprising:

inserting a distal end of a tissue locator distally through the opening, the tissue locator comprising a plurality of arms, each being aligned along a shaft of the tissue locator in a retracted configuration, the tissue locator being inserted far enough through the opening that the plurality of arms are positioned distal of the tissue wall;

advancing a plurality of penetrators distally to attempt to penetrate through the tissue wall, each penetrator being associated with a different one of the arms, one or more penetrators not penetrating through the tissue wall;

removably coupling separate ends of a filament net with the plurality of arms, one or more of the plurality of arms associated with the nonpenetrating penetrators not being coupled with the filament net;

moving the plurality of arms from the retracted configuration to a deployed configuration in which the plurality of arms extend laterally away from the shaft;

for each arm associated with penetrating penetrators, advancing a penetrator distally to penetrate through the tissue wall, the penetrators penetrating through the wall to couple with the end of the filament net associated with the corresponding arm; and

withdrawing the penetrators proximally, thereby causing the ends of the filament net to uncouple from the plurality of arms and withdraw proximally through the tissue wall with the penetrators.