Instrument for closing trocar puncture wounds

• US 5,470,338 A
• Filed: 10/08/1993
• Issued: 11/28/1995
• Est. Priority Date: 10/08/1993
• Status: Expired due to Term

• Current Assignee: Neil D. Gershon
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Whitfield, Kenneth H., Castro, Michael, Scott, Ian M.
• Primary Examiner(s): Bellegrino, Stephen C.
• Assistant Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/134,144
• Time in Patent Office: 781 Days
• Field of Search: 606/139, 606/144, 606/145, 606/146, 606/147, 606/148, 606/151, 606/208, 112/169, 112/80.03
• US Class Current: 606/144
• 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 17/0469 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 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• 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 2017/047 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 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end

Abstract

A novel surgical instrument for applying sutures through body tissue including an elongated body having a proximal end portion and a distal end portion, at least one needle carrier member operatively mounted in the distal end portion and movable between at least a retracted position and a deployed position, a needle releasably retained in the at least one needle carrier member, a predetermined length of suture material having one end affixed to the needle, and a suture material tensioning member disposed within the elongated body for maintaining the suture material in tension during movement of the at least one needle carrier member from the retracted position to the deployed position the suture material. The instrument may also include a retaining mechanism adapted to retain the at least one needle carrier in the partially deployed position, and a needle skewing mechanism operatively associated with an actuator member to change the alignment thereof relative to the retaining member. A deployment indicator may be provided to indicate to an operator of the instrument When the at least one needle carrier member is in the second position.

Claims

1. A surgical instrument for applying sutures through body tissue, which comprises:

(a) an elongated body having a proximal end portion and a distal end portion;

(b) at least one needle carrier member operatively mounted in said distal end portion and movable between at least a retracted position and a deployed position;

(c) a needle having a tapered end and being releasably retained in said at least one needle carrier member such that when said at least one needle carrier member is in said retracted position said tapered end is prevented from contacting tissue;

(d) a predetermined length of suture material having one end affixed to said needle; and

(e) a suture material tensioning member movably disposed within said elongated body for maintaining said suture material in tension during movement of said at least one needle carrier member from said retracted position to said deployed position.

2. A surgical instrument recited in claim 1, wherein said suture material tensioning member is a spring.

3. A surgical instrument recited in claim 1, wherein said suture material tensioning member is a constant force spring such that upon deployment of said suture material the amount of force necessary to move said spring remains uniform.

4. A surgical instrument recited in claim 1, further comprising a retaining mechanism operatively associated with said at least one needle carrier member and configured and dimensioned to retain said at least one needle carrier member in a partially deployed position located between said retracted position and said deployed position.

5. A surgical instrument recited in claim 1, further comprising a needle retaining mechanism disposed in said elongated body and configured and dimensioned to retain said needle therein when said at least one needle carrier mechanism is moved to said deployed position.

6. A surgical instrument according to claim 1, further comprising a deployment indicator configured and dimensioned to provide an indication to an operator of said instrument when said at least one needle carrier member is in said deployed position.

7. A surgical instrument for applying sutures through body tissue, which comprises:

(a) an elongated body having a proximal end portion and a distal end portion;

(b) at least one needle carrier member operatively mounted in said distal end portion and movable between at least a retracted position and a deployed position;

(c) a needle releasably retained in said at least one needle carrier;

(d) a predetermined length of suture material having one end affixed to said needle;

(e) a suture material tensioning member disposed within said elongated body for maintaining said suture material in tension during movement of said at least one needle carrier member from said retracted position to said deployed position; and

(f) an actuator member operatively associated with said at least one needle carrier member, said actuator member being movable between at least a first position and a second position to move said at least one needle carrier from said retracted position to said deployed position and a needle skewing mechanism operatively associated with said actuator member such that upon movement of said actuator member from said first position to said second position said needle skewing mechanism contacts a tapered portion of said needle to change the alignment thereof relative to said retaining member.

8. A surgical instrument for applying sutures through body tissue, which comprises:

(a) an elongated body having a proximal portion and a distal portion,

(b) at least one needle carrier member operatively mounted in said distal end portion and movable between at least an initial position, a partially deployed position and a fully deployed position;

(c) a needle releasably retained at a predetermined position with respect to said at least one needle carrier as said needle carrier moves from the initial position to the fully deployed position;

(d) an actuator member engaging said at least one needle carrier member, said actuator member being movable between at least a first position and a second position to move said at least one needle carrier from said initial position to said fully deployed position;

(e) a predetermined length of suture material having one end thereof affixed to said needle; and

(f) a needle carrier retaining mechanism operatively associated with said at least one needle carrier member, said needle carrier retaining mechanism being configured and dimensioned to retain said at least one needle carrier in said partially deployed position.

9. A surgical instrument as recited in claim 8, wherein said needle carrier retaining mechanism includes a latch member mounted on said elongated body and a post member operatively associated with said at least one needle carrier member and movable in relation to said latch member, whereby upon movement of said at least one needle carrier member to said partially deployed position said post member engages said latch member and is releasably retained therein such that said at least one needle carrier member is releasably retained in said partially deployed position.

10. A surgical instrument as recited in claim 8, further comprising an actuator member operatively associated with said at least one needle carrier member and said needle carrier retaining mechanism, said actuator member being movable between at least a first position and a second position to move said at least one needle carrier member into said initial position, said partially deployed position and said fully deployed position.

11. A surgical instrument as recited in claim 10, wherein said actuator member is biased toward said first position.

12. A surgical instrument as recited in claim 10, wherein said needle carrier retaining mechanism includes a latch member operatively associated with said elongated body and a post member mounted on said actuator member and operatively associated with said latch member.

13. A surgical instrument as recited in claim 12, wherein said latch member is mounted on a pivot arm.

14. A surgical instrument as recited in claim 13, wherein said pivot arm is biased to maintain said latch member in a predetermined orientation.

15. A surgical instrument as recited in claim 14, wherein said latch member is configured and dimensioned such that upon movement of said actuator member from said first position toward said second position, said post member releasably engages said latch member whereby said actuator member is releasably held at a predetermined distance between said first and second positions.

16. A surgical instrument as recited in claim 15, wherein upon further movement of said actuator member toward said second position said post member disengages said latch member.

17. A surgical instrument as recited in claim 16, wherein said actuator member is biased toward said first position, whereby upon release of said actuator member when said actuator member is in said second position, said at least one need carrier member returns to said initial position.

18. A surgical instrument as recited in claim 8, further comprising a needle retaining mechanism disposed in said elongated body and configured and dimensioned to retain said needle therein when said at least one needle carrier member is in said deployed position.

19. A surgical instrument as recited in claim 18, further comprising a needle skewing mechanism disposed adjacent said needle retaining mechanism movable from a first position to a second position to change the alignment of said needle relative to said retaining member.

20. A surgical instrument for applying sutures through body tissue, which comprises:

(a) an elongated body having a proximal portion and a distal portion;

(b) at least one needle carrier member operatively associated with said distal portion and movable between at least an initial position and a deployed position;

(c) an actuator member operatively associated with said at least one needle carrier member, said actuator member being movable between at least a first position and a second position to move said at least one needle carrier from said initial position to said deployed position;

(d) a needle releasably retained in said at least one needle carrier member;

(e) a needle retaining member disposed in said elongated body and adapted to retain said needle therein when said at least one needle carrier member is in said deployed position; and

(f) a needle skewing mechanism operatively associated with said actuator member for changing the alignment of the needle relative to said retaining member.

21. A surgical instrument as recited in claim 20, wherein upon movement of said actuator member from said first position to said second positions said needle skewing mechanism contacts a tapered portion of said needle.

22. A surgical instrument as recited in claim 21, wherein said needle skewing mechanism includes at least one arm member moveable between at least an initial position and a final position, said arm member being operatively associated with said actuator member, whereby upon movement of said actuator member from said first position to said second position said arm member is moved from said initial position to said final position.

23. A surgical instrument as recited in claim 22, wherein said needle skewing mechanism further includes a camming pin which is mounted on said actuator member such that said camming pin contacts Said arm member when said actuator member is moved from said first position to said second position.

24. A surgical instrument as recited in claim 22, wherein said needle skewing mechanism further includes a camming pin mounted on said actuator member and a slot formed in said arm member such that said camming pin travels in said slot when said actuator member is moved from said first position to said second position.

25. A surgical instrument as recited in claim 20, further comprising a deployment indicator operatively associated with said distal elongated body distal portion and configured and dimensioned to provide an indication to an operator of said instrument when said at least one needle carrier member is in said second position.

26. A surgical instrument for applying sutures through body tissue, which comprises:

(a) an elongated body having a proximal portion and a distal portion;

(b) at least one needle carrier member operatively associated with said distal portion of said body portion, said at least one needle carrier member movable between at least a first position and a second position;

(c) a needle member having a tapered end and being releasably retained in said at least one needle carrier member such that when said at least one needle carrier member is in said first position said tapered end is prevented from contacting tissue; and

(d) an illuminating indicator configured and dimensioned to provide an indication to an operator of said instrument when said at least one needle carrier member is in said second position.

27. A surgical instrument as recited in claim 26, wherein said indicator is a deployment indicator and includes an illuminating member which illuminates when said at least one needle carrier member is moved to said second position.

28. A surgical instrument as recited in claim 27, wherein said illuminating member is a light bulb connected in a series circuit with a power source, said circuit being closed when said at least one needle carrier member is in said second position.