Apparatus for vascular hole closure

• US 6,042,601 A
• Filed: 03/18/1998
• Issued: 03/28/2000
• Est. Priority Date: 03/18/1998
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Smith, Robert C.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US09/044,048
• Time in Patent Office: 741 Days
• Field of Search: 606/139, 606/144, 606/148, 606/232
• US Class Current: 606/232
• 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 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61B 2017/2901 Details of shaft

Abstract

An apparatus for facilitating wound closure of an opening in tissue includes a handle portion dimensioned to be gripped by the hand of a user, an elongate body portion connected to the handle portion and extending distally therefrom, a jaw mechanism including a stationary jaw affixed to the distal end portion of the elongate body portion and a movable jaw movably mounted to the distal end portion of the elongate body portion and movable between an initial closed position and a deployed open position, a suture assembly including a length of suture supported by the jaw mechanism, and being at least partially positionable within the opening in the tissue, first and second suture engaging members respectively operatively associated with the stationary jaw and the movable jaw, a deployment mechanism operable to move the movable jaw between the initial position and the deployed position, and an actuator mechanism operatively associated with the first and second suture engaging members and configured to move the first and second suture engaging members from a first position remote from the free ends of the suture to a second position wherein the first and second suture engaging members engage respective free ends of the suture. A method for facilitating closure of an opening in a tissue, e.g., a blood vessel wall is also disclosed.

Claims

1. An apparatus for facilitating wound closure of an opening in tissue, which comprises:

a) a handle portion dimensioned to be gripped by the hand of a user;

b) an elongate body portion connected to the handle portion and extending distally therefrom, the elongate body portion defining a longitudinal axis and having proximal and distal end portions;

c) a jaw mechanism including a stationary jaw affixed to the distal end portion of the elongate body portion and a movable jaw movably mounted to the distal end portion of the elongate body portion and movable between an initial closed position and a deployed open position;

d) a suture assembly including a length of suture supported by the jaw mechanism, the suture assembly at least partially positionable within the opening in the tissue;

e) first and second suture engaging members operatively associated with the stationary jaw and the movable jaw, respectively, the first and second suture engaging members engagable with end portions of the suture;

f) a deployment mechanism operable to move the movable jaw between the initial position and the deployed position; and

g) an actuator mechanism operatively associated with the first and second suture engaging members, the actuator mechanism configured to move the first and second suture engaging members from a first position remote from the free ends of the suture to a second position wherein the first and second suture engaging members engage respective end portions of the suture.

2. The apparatus according to claim 1, wherein a lockout mechanism is operatively associated with the deployment mechanism and operatively engageable with the actuator mechanism to prevent actuation of the actuator mechanism, the lockout mechanism being movable to a release position disengaged from the actuator mechanism upon movement of the jaw mechanism to the deployed position to thereby permit actuation of the actuator mechanism.

3. The apparatus according to claim 1, wherein the deployment mechanism includes a latch member engagable with one of the handle and the elongate body portion to maintain the movable jaw in the deployed position.

4. The apparatus according to claim 3, wherein the latch member is adapted to release the one of the handle and the elongate body portion upon movement of the first and second suture engaging members to the second position.

5. The apparatus according to claim 4, wherein the actuator mechanism includes camming structure operatively engagable with the latch member such that the camming structure disengages the latch member from the one of the handle and the elongate body portion upon movement of the first and second suture engaging members to the second position.

6. The apparatus according to claim 4 including a deployment biasing member to normally bias the deployment mechanism to a position corresponding to the initial position of the movable jaw.

7. The apparatus according to claim 1, wherein the suture assembly includes a ferrule attached to each suture end portion, a first ferrule being mounted to the stationary jaw, a second ferrule being mounted to the movable jaw.

8. The apparatus according to claim 7, wherein the first and second suture engaging members have pointed end portions to penetrate tissue.

9. The apparatus according to claim 8, wherein the pointed end portions of the first and second suture engaging members are correspondingly dimensioned to be received within the ferrules of respective suture end portions such that the suture engaging members securely frictionally engage the ferrules, whereby upon proximal movement of the suture engaging members the suture end portions are pulled through the blood vessel wall.

10. The apparatus according to claim 1 including a suture guide tube mounted to the stationary jaw, the suture guide tube accommodating a portion of the length of suture and being dimensioned to be received within the lumen of the blood vessel.

11. An apparatus for facilitating closure of an opening in tissue, which comprises:

a handle;

an elongate body extending distally from the handle, and having proximal and distal end portions, and defining a longitudinal axis;

a jaw assembly mounted to the distal end of the elongate member and having a stationary jaw and a movable jaw, the movable jaw movable between an initial position adjacent the stationary jaw such that the stationary jaw and the movable jaw are configured to fit through an opening in tissue to a deployed position wherein the movable jaw is spaced apart from the stationary jaw, the stationary jaw and the movable jaw each defining a recess for receipt of an edge of tissue forming the opening in the tissue;

a suture assembly mounted to the jaw assembly, the suture assembly including a length of suture having first and second suture end portions; and

first and second suture engaging members movably mounted within the stationary and the movable jaw such that the first suture engaging member is movable to traverse the recess in the stationary jaw to engage the first suture end portion and the second suture engaging member is movable to traverse the recess in the movable jaw to engage the second suture end portion.

12. The apparatus according to claim 11, wherein the first and second suture engaging members include needled end portions, the needled end portions configured to penetrate the tissue edges positioned in the recesses when the suture engaging members are moved from a first position remote from the recesses to a second position traversing the recesses.

13. The apparatus according to claim 12, wherein the suture end portions include ferrules configured for frictional engagement with the needled end portions of the first and second suture engaging members as the engaging members are moved from the first position to the second position.

14. The apparatus according to claim 11, further comprising a lockout member, the lockout member preventing movement of the suture engaging members until the movable jaw is moved to the deployed position.

15. The apparatus according to claim 11 including a deployment member mounted to the handle and in operative engagement with the jaw assembly to move the movable jaw between the initial position and the deployed position.

16. The apparatus according to claim 14 including an actuator member mounted to the handle and in operative engagement with the first and second suture engaging members for causing movement thereof.

17. A method for facilitating closure of an opening in a tissue, comprising the steps of:

introducing an elongate body of a surgical apparatus through an opening in a tissue section such that a distal and portion of the surgical apparatus is disposed within a space behind the opening in the tissue section, the distal end portion including a stationary jaw and a movable jaw, the stationary and movable jaws supporting free ends of a length of suture thereon;

moving a distal end of the movable jaw away from a distal end of the stationary jaw;

advancing first and second suture engaging members operatively associated with the elongate body through opposed sides of the opening in the tissue section;

engaging the first and second suture engaging members with respective free ends of the length of suture;

retracting the first and second suture engaging members such that the free ends of the length of suture engaged by the first and second suture engaging members are drawn through the opposed edges of tissue and an intermediate portion of the length of suture extends across the opening; and

securing the free end portions of the length of suture to facilitate closure of the opening.