Device and method for suturing of internal puncture sites

• US 7,390,328 B2
• Filed: 12/19/2003
• Issued: 06/24/2008
• Est. Priority Date: 12/19/2003
• Status: Active Grant

• Current Assignee: Abbott Laboratories Incorporated
• Original Assignee: Abbott Laboratories Incorporated
• Inventors: Modesitt, D. Bruce
• Primary Examiner(s): Hayes; Michael J.
• Assistant Examiner(s): Nguyen; Victor
• Application Number:
  US10/742,406
• Publication Number:
  US 20050149065A1
• Time in Patent Office: 1,649 Days
• Field of Search: 606/139, 606/144, 606/145, 606/147, 606/148, 606/151, 606/213, 606/222, 606/224, 128/898
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00641 for closing fistulae, e.g. anorectal fistulae
• 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 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61F 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2210/0019 operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation

Abstract

A method of closing a puncture in a blood vessel wall, including: positioning a suture placement device in a tissue tract and into a puncture in the blood vessel wall, the placement device having a length of suture with a first end, a second end and a bight between the first and second ends with the bight being prearranged on the device to define a pre-tied knot when the first end of the suture passes through the bight; advancing the first end of the length of suture in a distal direction from the device through a first penetration in the blood vessel wall adjacent to the puncture; guiding the suture length from the first penetration across a proximal side of the puncture to a second penetration adjacent to the puncture opposite the first penetration; and advancing the suture length in a proximal direction through the second penetration, through the device, and through the bight so that the two ends of the suture length are accessible external to the tissue tract for securing the suture across the puncture to close the puncture.

Claims

1. A method of closing a puncture in a blood vessel wall, the method comprising:

positioning a suture placement device through the puncture in the blood vessel wall, the placement device having a length of suture with a first end, a second end and a bight between the first and second ends with the bight being prearranged on the device to define a pre-tied knot when the first end of the suture passes through the bight;

advancing the first end of the length of suture in a distal direction from the device through a first penetration in the blood vessel wall adjacent to the puncture;

guiding the suture length from the first penetration across a proximal side of the puncture to a second penetration adjacent to the puncture opposite the first penetration; and

advancing the suture length in a proximal direction through the second penetration, through the device, and through the bight so that the two ends of the suture length are accessible for securing the suture across the puncture to close the puncture.

2. The method of claim 1, wherein advancing a length of suture in a distal direction comprises pushing a needle which carries the suture through the first penetration.

3. The method of claim 2, wherein guiding the suture length comprises elastically bending the needle as it tracks within the blood vessel to the second penetration.

4. The method of claim 3, wherein advancing the suture length in a proximal direction comprises pushing the needle so that a needle tip passes proximally out through the vessel wall adjacent the puncture.

5. A method for suturing a puncture site in a wall of a blood vessel, said method comprising:

providing a suturing device having a pair of axially advanceable penetrating elements and a length of suture having a first end, a second end and a bight between the first and second ends, the bight being prearranged on the suturing device to define a pre-tied knot when the first end of the suture passes through the bight;

advancing the penetrating elements to form two penetrations in the blood vessel wall on opposite sides of the puncture site;

advancing the first end of the suture distally through the suture device, distally through one of the two penetrations into a lumen of the blood vessel, proximally through the other of the two penetrations, proximally through the suturing device, and through the bight; and

securing the pre-tied knot to close the puncture site.

6. The method of claim 5, wherein the penetrating elements are needle guides.

7. The method of claim 6, wherein advancing the suture comprises pushing the suture distally through a lumen of a first needle guide tube and pulling the suture proximally through a second needle guide tube.

8. The method of claim 7, wherein advancing the suture comprises providing a needle having the suture attached thereto and pushing the needle distally through the lumen of the first needle guide tube and pulling the needle proximally through the second needle guide tube.

9. A method of suturing a puncture site in a wall of a blood vessel, said method comprising:

providing a length of suture having a first end, a second end and a bight between the first and second ends, the bight being prearranged and adapted to receive the first end therethrough to define a pre-tied knot when the first end of the suture passes through the bight;

pushing the suture distally through a tissue tract over the puncture site through a penetration on one side of the puncture site into a lumen of the blood vessel;

pulling the suture proximally through a second penetration on another side of the puncture site and proximally through the tissue tract;

passing the suture through the bight; and

securing the pre-tied knot to close the puncture site.

10. The method of claim 9, wherein the bight is prearranged around a needle in the device.

11. The method of claim 9, wherein the length of suture is advanced in a distal direction by pushing a needle which carries the length of suture through the first penetration.

12. The method of claim 11, wherein the length of suture is guided by elastically bending the needle as it tracks within the blood vessel to the second penetration.