Device for closing an opening in tissue and method of closing a tissue opening using the device

• US 5,984,948 A
• Filed: 05/21/1998
• Issued: 11/16/1999
• Est. Priority Date: 04/14/1997
• Status: Expired due to Fees

• Current Assignee: Harrith M. Hasson
• Original Assignee: Harrith M. Hasson
• Inventors: Hasson, Harrith M.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US09/082,932
• Time in Patent Office: 544 Days
• Field of Search: 606/213, 606/144, 606/148, 606/139
• US Class Current: 606/213
• 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 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 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/0474 Knot pushers

Abstract

A device for facilitating the performance of a medical procedure in a cavity bounded by a tissue. The device has a body with a first opening therethrough to define a first passageway for a medical instrument to be directed from externally of the cavity through an opening in the tissue to the cavity, and an exposed surface that can be placed against the tissue around the opening therethrough with the device in an operative state relative to the tissue. A second opening through the body defines a second passageway through which a tying instrument can be directed from externally of the tissue through the body and into the cavity bounded by the tissue. A first repositionable element is movable between first and second positions relative to the body. In the first position, the first repositionable element allows a suturing thread to be placed into and removed from a holding position. In the second position, the first repositionable element captively maintains a suturing thread in the holding position.

Claims

1. A device for facilitating the performance of a medical procedure in a cavity bounded by a tissue, said device comprising:

a body having a first opening therethrough to define a first passageway for a medical instrument to be directed from externally of the cavity through an opening in the tissue to the cavity and an exposed surface that can be placed against the tissue around the opening therethrough with the device in an operative state relative to the tissue,

there being a second opening through the body to define a second passageway through which a tying instrument can be directed from externally of the tissue through the body and into the cavity bounded by the tissue; and

a first repositionable element that is movable between first and second positions relative to the body,

the first repositionable element in the first position allowing a suturing thread to be placed into and removed from a holding position,

the first repositionable element in the second position situated to captively maintain a suturing thread in the holding position.

2. The device for facilitating the performance of a medical procedure according to claim 1 wherein the first repositionable element is threaded and pivotable about an axis in changing between the first and second positions.

3. The device for facilitating the performance of a medical procedure according to claim 2 wherein the body has a first cantilevered arm defining a first surface, the first repositionable element has a second surface, the first and second surfaces are spaced from each other a first distance with the first repositionable element in the first position and the first and second surfaces are at least one of a) abutted to each other and b) spaced from each other a second distance that is less than the first distance with the first repositionable element in the second position.

4. The device for facilitating the performance of a medical procedure according to claim 3 wherein the body has a second cantilevered arm and a second repositionable element that cooperate with each other in the same manner as the first cantilevered arm and first repositionable element cooperate with each other.

5. The device for facilitating the performance of a medical procedure according to claim 4 wherein the first passageway has a central axis and the first and second cantilevered arms project diametrically oppositely away from the central axis of the first passageway.

6. The device for facilitating the performance of a medical procedure according to claim 1 further comprising a releasable locking mechanism for releasably fixing a medical instrument directed through the first opening relative to the body.

7. The device for facilitating the performance of a medical procedure according to claim 6 wherein the releasable locking mechanism comprises a ring member which extends at least partially around the first opening and bounds at least a part of the first opening.

8. The device for facilitating the performance of a medical procedure according to claim 7 wherein the ring member has an effective diameter, the releasable locking mechanism comprises a repositionable actuator that is movable between third and fourth positions, the ring member has a first effective diameter with the actuator in the third position and a second effective diameter that is less than the first effective diameter with the actuator in the fourth position, the ring member with the second effective diameter capable of closely embracing a medical instrument directed through the first opening.

9. The device for facilitating the performance of a medical procedure according to claim 8 wherein the repositionable actuator is threaded and is pivotable about an axis in changing between the third and fourth positions.

10. The device for facilitating the performance of a medical procedure according to claim 8 wherein with the ring member in the third position, the ring member extends through less than 360°

around the first opening.

11. The device for facilitating the performance of a medical procedure according to claim 1 in combination with a medical instrument directed into the first opening in the body.

12. The device for facilitating the performance of a medical procedure according to claim 11 wherein there is a third opening through the body to define a third passageway through which a tying instrument can be directed from externally of the tissue through the body and into the cavity bounded by the tissue.

13. The device for facilitating the performance of a medical procedure according to claim 1 in combination with a suturing thread directed through tissue bounding a cavity and held captively in the holding position by the first repositionable element.

14. The device for facilitating the performance of a medical procedure according to claim 1 further comprising a resilient sealing material and the second opening is formed through the resilient sealing material so that the resilient sealing material is directly exposed at the second opening.

15. The device for facilitating the performance of a medical procedure according to claim 1 wherein the body has a first surface, the first repositionable element has a second surface, the second surface on the first repositionable element captively maintains a suturing thread in the holding position with the repositionable element in the second position, and the exposed surface of the body and the first surface are formed together as a unitary structure.

16. In combination:

a) a device for facilitating the performance of a medical procedure in a cavity bounded by a tissue, said device comprising;

a body having a first opening therethrough to define a first passageway and an exposed surface that can be placed against the tissue around the opening therethrough with the device in an operative state relative to the tissue, a second opening;

b) a medial instrument for performing a procedure within the cavity and directed from externally of the cavity through the first passageway into the cavity; and

c) a suturing thread extendable through the tissue the body and the second opening and held to the body to at least one of i) stabilize the body relative to the tissue and ii) facilitate tying of the suturing thread.

17. The combination according to claim 16 wherein the suturing thread is releasably held to the body.

18. The combination according to claim 16 further comprising a releasable locking mechanism for releasably fixing the medical instrument directed through the first opening relative to the body.

19. The combination according to claim 18 wherein the releasable locking mechanism comprises a ring member that extends at least partially around the first opening and bounds at least a part of the first opening.

20. The combination according to claim 19 wherein the ring member has an effective diameter, the releasable locking mechanism comprises a repositionable actuator that is movable between third and fourth positions, the ring member has a first effective diameter with the actuator in the third position and a second effective diameter that is less than the first effective diameter with the actuator in the fourth position, the ring member with the second effective diameter closely embracing the medical instrument directed through the first opening.

21. The combination according to claim 18 wherein the body has a first surface, the releasable locking mechanism comprises an element with a second surface that captively maintains the suturing thread against the first surface and the exposed surface of the body and the first surface are formed together as a unitary structure.