Method and apparatus for suturing

• US 5,860,990 A
• Filed: 08/23/1996
• Issued: 01/19/1999
• Est. Priority Date: 08/24/1995
• Status: Expired due to Term

• Current Assignee: Scarab Technology Services, LLC
• Original Assignee: Nr Medical, Inc.
• Inventors: Nobles, Anthony A., Jech, Charles L.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/702,315
• Time in Patent Office: 879 Days
• Field of Search: 606/144, 606/145, 606/146, 606/143, 606/139
• 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 17/0491 Sewing machines for surgery
• 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 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/2911 rings

Abstract

A suturing device capable of suturing biological tissue including the walls of arterial blood vessels comprises suture clasps for insertion inside the central passage way of an arterial vessel. The device utilizes a suture introducer housing to aid insertion of the suture clasps in the vessel. A suture catch operates to catch a suture held by the suture clasps, remove the suture from the suture clasps, and pull the suture through the arterial wall, so the suture can be completed.

Claims

1. A suturing device for suturing an opening in a vessel wall comprising:

a housing;

an actuator supported within the housing;

at least one suture clasp for holding a suture wherein the suture clasp is operatively coupled to the actuator and comprises a pair of tips each having an outside edge defining an indentation adapted to receive a suture and engage a knot or bead on a suture whereby the suture is held by the suture clasps; and

at least one suture catch supported by the housing and operatively positioned relative to the suture clasp to capture a suture held by the suture clasp.

2. The suturing device according to claim 1 further comprising at least a resilient element attached to each of the tips.

3. A suturing device for suturing an opening in a vessel wall comprising:

a housing;

an actuator supported within the housing;

at least one suture clasp for holding a suture, wherein the suture clasp is operatively coupled to the actuator, and

at least one suture catch supported bv the housing and operatively positioned relative to the suture clasp to capture a suture held by the suture clasp, wherein the suture catch comprises a needle having an angled slot.

4. A suturing device for suturing an opening in a vessel wall comprising:

a housing;

an actuator supported within the housing;

at least one suture clasp for holding a suture wherein the suture clasp is operatively coupled to the actuator;

at least one suture catch supported by the housing and operatively positioned relative to the suture clasp to engage the suture clasp;

a tube having an aperture with the suture clasp deployably disposed therein and an outer surface with a key way; and

a suture catch assembly having at least one suture catch operatively positioned relative to the suture clasp and a key to engage the key way and align the tube with the suture catch assembly.

5. A suturing device for suturing an opening in a vessel wall comprising:

a housing;

an actuator supported within the housing;

at least one suture clasp for holding a suture, wherein the suture clasp is operatively coupled to the actuator and comprises an arm defining an aperture for receiving a suture fitting; and

at least one suture catch supported by the housing and operatively positioned relative to the suture clasp to capture the suture fitting, wherein the suture catch comprises a needle defining a slot having top, a peg inside the slot and extending downwardly from the top, and the peg being movable to receive a suture fitting.

6. A suturing device for suturing an opening in a vessel wall comprising:

a housing;

a plurality of arms attached to the housing extending in a plurality of directions, each arm having a suture clasp for holding at least one suture;

a penetrating mechanism deployably attached to the housing and operatively positioned relative to the suture clasps to penetrate biological tissue with at least one suture;

a suture introducer housing having the arms deployable disposed therein; and

a suture catch assembly having at least one suture catch and an aperture therethrough adapted to receive the introducer housing, the suture catch assembly deployably positioned relative to the suture clasps to capture a suture held by the suture clasps.

7. The suturing device according to claim 6 wherein the penetrating mechanism comprises at least one needle, the suture catch comprises a slot in the needle, and the at least one needle is slidably held by the catch assembly.

8. The suturing device according to claim 7 wherein the suture catch assembly further comprises an activation ring attached to the at least one needle.

9. The suturing device according to claim 8 wherein the activation ring has a stop to control depth of entry of the suture catch.

10. A suturing device for suturing an opening in a vessel wall comprising:

a housing;

a plurality of arms attached to the housing and extending in a plurality of directions, each arm having a suture clasp for holding at least one suture;

a penetrating mechanism deployably attached to the housing and operatively positioned relative to the suture clasps to penetrate biological tissue with at least one suture;

a cylindrical suture introducer housing with an aperture therethrough and wherein the arms have a first retracted position inside the aperture and a second deployed position outside the aperture; and

a spreader located in the aperture of the housing, extending across a diameter line of the housing, and being substantially perpendicular to the longitudinal axis of the tube.

11. The suturing device according to claim 10 wherein the spreader comprises a substantially triangular bar.

12. The suturing device according to claim 10 wherein the spreader comprises a cam pin.

13. A suturing device for suturing an opening in a vessel wall comprising:

a housing;

a plurality of arms attached to the housing and extending in a plurality of directions each arm having a suture clasp for holding at least one suture;

a penetrating mechanism deployably attached to the housing and operatively positioned relative to the suture clasps to penetrate biological tissue with at least one suture; and

means for aligning the arms and the penetrating mechanism, and wherein the arms comprise an upper lever arm and a lower pivot arm with the suture clasp thereon.

14. The suturing device according to claim 13 wherein the aligning means comprises a key and a key way.

15. The suturing device according to claim 14 wherein the arm actuator assembly comprises three substantially identical sectors.

16. The suturing device according to claim 14 further comprising:

a suture catch assembly having an activation ring; and

wherein the arm actuator assembly comprises an actuation post having a height corresponding to a depressed height of the activation ring such that the actuation post is depressed simultaneously with the activation ring.

17. A suturing device for suturing an opening in a vessel wall comprising:

a housing;

a plurality of arms attached to the housing and extending in a plurality of directions each arm having a suture clasp for holding at least one suture;

a penetrating mechanism deployably attached to the housing operatively positioned relative to the suture clasps to penetrate biological tissue with at least one suture;

a suture introducer housing having the arms deployably housed therein;

an actuating rod having a proximal end and having a distal end attached to the arms; and

an arm actuator assembly attached to the proximal end of the actuating rod for deploying the arms.

18. A suturing device for suturing an opening in a vessel wall comprising:

a housing;

a plurality of arms attached to the housing and extending in a plurality of directions, each arm having a suture clasp for holding at least one suture;

a penetrating mechanism deployably attached to the housing and operatively positioned relative to the suture clasps to penetrate biological tissue with at least one suture;

an actuating rod having a proximal end and a distal end attached to the arms; and

a detachable arm deployment handle removably attached to the proximal end of the actuating rod.

19. A method of suturing a vessel comprising:

holding a suture with at least one suture clasp;

introducing at least a portion of the suture clasp and ends of the suture into an internal passage way of a vessel through an opening in a wall of the vessel;

piercing the vessel wall with a suture catch;

catching the suture with the suture catch;

penetrating a vessel wall with the suture, the step of penetrating comprising retracting the suture catch from the vessel wall; and

tying the suture.

20. A method of suturing a vessel comprising:

holding a suture with at least one suture clasp;

introducing at least a portion of the suture clasp and ends of the suture into an internal passage way of a vessel through an opening in a wall of the vessel;

penetrating a vessel wall with the suture;

introducing a suture introducer housing into an opening in a vessel wall;

introducing the suture into the internal passage way of the vessel through the housing;

positioning the suture beyond an outer diameter of the housing; and

tying the suture;

wherein penetrating the vessel walls with the suture comprises penetrating the vessel wall outside the outer diameter of the housing.

21. The method according to claim 20 further comprising removing the housing from the opening, and thereafter, tying the suture.

22. The method according to claim 20 wherein positioning the suture comprises positioning the suture with portions of the suture on opposite sides of the opening and the suture extending in a direction transverse to the flow of blood.

23. A method of suturing a vessel comprising:

holding a suture with at least one suture clasp;

introducing at least a portion of the suture clasp and ends of the suture into an internal passage way of a vessel through an opening in a vessel;

penetrating a vessel wall with the suture;

introducing a suture introducer housing through an introducer in the passage way of a vessel;

introducing the suture into the internal passage way of the vessel through the housing;

deploying the suture clasps beyond the outer diameter of the tube; and

tying the suture.

24. The method according to claim 23 further comprising:

removing the introducer;

placing a suture catch assembly having an aperture and a suture catch over the outside of the housing;

piercing the vessel wall with the suture catch;

catching the suture; and

wherein penetrating the vessel wall with the suture comprises retracting the suture catch from the vessel wall with the suture caught therein.

25. The method according to claim 24 further comprising:

pushing the suture catch assembly over the housing up to the vessel wall.

26. The method according to claim 23 further comprising placing a suture catch assembly having an aperture, a longitudinal slit, and a suture catch over the outside of the introducer.

27. A method of suturing a vessel comprising:

holding a suture with at least one suture clasp;

introducing at least a portion of the suture clasp and ends of the suture into an internal passage way of a vessel through an opening in a vessel;

penetrating a vessel wall with the suture;

orienting the suture perpendicular to the direction of blood flow in the vessel; and

tying the suture.

28. A method of suturing a vessel comprising:

holding a suture with at least one suture clasp, wherein the suture clasps are positioned on the end of suture arms and further comprising attaching an arm deployment handle to actuating rod;

introducing at least a portion of the suture clasp and ends of the suture into an internal passage way of a vessel through an opening in a vessel;

penetrating a vessel wall with the suture; and

tying the suture.