Surgical suturing apparatus

• US 8,075,572 B2
• Filed: 04/26/2007
• Issued: 12/13/2011
• Est. Priority Date: 04/26/2007
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Stefanchik, David, Griffith, David B.
• Primary Examiner(s): Erezo, Darwin
• Application Number:
  US11/796,035
• Publication Number:
  US 20080269782A1
• Time in Patent Office: 1,692 Days
• Field of Search: 606/139, 606/144, 606/145, 606/148
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0625 the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator A61B17/06109 takes precedence
• 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 2017/0609 having sharp tips at both ends, e.g. shuttle needle alternately retained and released by first and second facing jaws of a suturing instrument MIS suturing instruments A61B17/0469; jaws of MIS forceps A61B2017/2926

Abstract

A surgical suturing apparatus is described. The suturing apparatus has a needle having at least one pointed end, a channel for releasably receiving the needle, a needle positioning assembly having members for moving the needle and an actuation assembly for actuating the needle positioning assembly. The needle includes a first puncturing point at a proximal end thereof and an engagement section adjacent thereto, a distal end, which may have a second puncturing point, and another engagement section adjacent the distal end. A structure, such as an eye or a slot, is provided to secure a length of suture material to the needle. The members for moving the needle include an engagement member for releasably engaging one of the engagement sections of the needle to effect axial movement of the needle within the channel, a ramp member for effecting movement of the needle in the distal direction along the longitudinal axis of the channel and for urging the proximal end of the needle out of the channel, and a snare axially movable within the channel and having a portion releasably housed within the channel. The snare portion is configured for capturing the proximal engagement section of the needle to guide the needle in a proximal direction when the needle is out of the channel and to guide the return of the needle to the channel.

Claims

1. A surgical suturing apparatus comprising:

a channel having a longitudinal axis, a distal end and a proximal end, said channel defining a housing at the distal end thereof having an opening therein;

a needle releasably disposed within said housing, said needle having a distal end, a proximal end, and a proximal puncturing point at the proximal end, said needle being structured for attachment to a length of suture material;

a needle positioning assembly having members movable relative to said channel for effecting a desired number of release and retrieval cycles for releasing said needle from said housing and guiding the return of said needle to said housing; and

an actuation assembly for controlling said members of said needle positioning assembly;

wherein needle positioning assembly comprises (a) an engagement member configured for releasably engaging said needle to effect axial movement of said needle within said channel;

(b) a ramp member movable axially within said channel and configured for operative contact with said needle for effecting movement of said needle to a first stage of progression adjacent said opening of said housing and to a second stage of progression wherein at least said proximal puncturing point is out of said housing; and

(c) a movable snare member having a portion configured for engagement with said needle for guiding said needle when said needle is out of said housing.

2. The surgical suturing apparatus recited in claim 1 wherein said actuation assembly further comprises:

a body portion;

a handle;

a plurality of rods operatively connected to said members of said positioning assembly for controlling movement of said needle.

3. The surgical suturing apparatus recited in claim 1 wherein the channel forms a distal puncturing point at the distal end thereof, and the suturing apparatus further comprises a length of suture material attached to said needle such that the puncture of tissue with said distal puncturing point and movement of said needle through said tissue in a first direction threads said suture material through said tissue in the first direction.

4. The surgical suturing apparatus recited in claim 3 wherein the puncture of tissue with said proximal puncturing point and movement of said needle through said tissue in a second direction threads said suture material through said tissue in the second direction.

5. The surgical suturing apparatus recited in claim 1 wherein said distal end of said needle forms a distal puncturing point and said channel is open at the distal end thereof to expose said distal puncturing point for puncturing tissue in a first direction when said channel is moved in said first direction.

6. The surgical suturing apparatus recited in claim 1 wherein said needle has a first engagement surface adjacent said distal end and a second engagement surface adjacent said proximal puncturing point.

7. The surgical suturing apparatus recited in claim 6 wherein said portion of said snare member further comprises:

a noose for engagement with said second engagement surface of said needle;

an expandable loop proximal to said noose, said loop being biased away from the longitudinal axis of said channel; and

an elongate section proximal to said loop and operatively connected to said actuation assembly, wherein movement of said elongate section in a distal direction positions said noose and loop adjacent said opening of said housing to enable the release of said loop and noose from said channel and movement in a proximal direction when said noose and loop are out of said channel effects the return of said loop and said noose to said channel.

8. The surgical suturing apparatus recited in claim 6 wherein said ramp member comprises:

a rail operatively connected to said actuation assembly at a proximal end of said rail; and

,

a slope at a distal end of said rail for contact with said needle.

9. The surgical suturing apparatus recited in claim 8 wherein said slope, when moved into the second stage of progression, urges said needle from said housing at an angle to position said proximal puncturing point at a desired location for puncturing tissue.

10. The surgical suturing apparatus recited in claim 6 wherein said engagement member comprises an elongate portion operatively connected to said actuation assembly and a pair of tines for engaging said needle at said first engagement surface.

11. The surgical suturing apparatus recited in claim 1 wherein said actuation assembly further comprises:

a body portion;

a handle;

a first push rod housed in said body portion and being operatively connected to said handle and said engagement member for driving axial movement of said engagement member;

a second push rod housed in said body portion and being operatively connected to said handle and said ramp member for driving axial movement of said ramp member to said first stage of progression and for driving movement of said ramp member in said second stage of progression;

a lock mechanism for locking said second push rod against movement of said ramp member to said second stage of progression;

a release mechanism for selectively unlocking said second push rod to trigger movement of said ramp member to said second stage of progression; and

a third push rod housed in said body portion and being operatively connected to said handle and said snare member for driving axial movement of said snare member to a position for release of said portion of said snare from said channel and for return of said portion to said channel.

12. The surgical suturing apparatus recited in claim 11 wherein movement of said third push rod in a distal direction positions said portion of said snare member within an opening in said housing to effect the release of said portion of said snare member for engagement with said needle, and movement of said third push rod in a proximal direction when said portion engages said needle effects (i) the proximal travel of said needle when said needle is out of said housing to pull said needle through tissue in said proximal direction and (ii) the return of said portion of said snare member and said needle to said channel.

13. The surgical suturing apparatus recited in claim 12 wherein said actuation assembly further comprises a trigger for moving said snare portion distally to said opening in said housing.

14. The surgical suturing apparatus recited in claim 11 wherein said lock mechanism comprises a pin extending outwardly from said second push rod, and a locking plate having a notch therein for stopping said pin against movement in a distal direction beyond said notch.

15. The surgical suturing apparatus recited in claim 14 wherein said release mechanism comprises a lever for lifting said locking plate to release said pin from said notch.

16. The surgical suturing apparatus recited in claim 1 further comprising at least one suture tag, each having passages therethrough for attachment to the suture material, said suture tags being configured for attachment at one or both ends of the length of suture for securing the suture to said tissue.

17. The surgical suturing apparatus recited in claim 16 wherein the suture tag comprises an outer tapered cylinder and an inner tapered cylinder within said outer cylinder, each said cylinder having at least one passage therethrough for passage of the suture material.

18. A surgical suturing apparatus comprising:

a channel having a longitudinal axis, a distal end and a proximal end, said channel defining a housing at the distal end thereof having an opening therein;

a needle releasably disposed within said housing, said needle having a first end and a first puncturing point at a second end, said needle being structured for attachment to a length of suture material;

a needle positioning assembly having members movable relative to said channel for effecting a desired number of release and retrieval cycles for releasing said needle from said housing and guiding the return of said needle to said housing, wherein needle positioning assembly comprises;

an engagement member configured for releasably engaging said needle to effect axial movement of said needle within said channel;

a ramp member movable axially within said channel and configured for operative contact with said needle for effecting movement of said needle to a first stage of progression adjacent said opening of said housing and to a second stage of progression wherein at least said first puncturing point is out of said housing; and

a movable snare member having a portion configured for engagement with said needle for guiding said needle when said needle is out of said housing; and

an actuation assembly for controlling said members of said needle positioning assembly.

19. The surgical suturing apparatus recited in claim 18 wherein said needle has a first engagement surface adjacent said first end and a second engagement surface adjacent said first puncturing point.

20. The surgical suturing apparatus recited in claim 19 wherein said portion of said snare member further comprises:

a noose for engagement with said second engagement surface of said needle;

an expandable loop proximal to said noose, said loop being biased away from the longitudinal axis of said channel; and

an elongate section proximal to said loop and operatively connected to said actuation assembly, wherein movement of said elongate section in a distal direction positions said noose and loop adjacent said opening of said housing to enable the release of said loop and noose from said channel and movement in a proximal direction when said noose and loop are out of said channel effects the return of said loop and said noose to said channel.

21. The surgical suturing apparatus recited in claim 19 wherein said ramp member comprises:

a rail operatively connected to said actuation assembly at a proximal end of said rail; and

,

a slope at a distal end of said rail for contact with said needle.

22. The surgical suturing apparatus recited in claim 21 wherein said slope, when moved into the second stage of progression, urges said needle from said housing at an angle to position said first puncturing point at a desired location for puncturing tissue.

23. The surgical suturing apparatus recited in claim 19 wherein said engagement member comprises an elongate portion operatively connected to said actuation assembly and a pair of tines for engaging said needle at said first engagement surface.

24. The surgical suturing apparatus recited in claim 18 wherein said actuation assembly further comprises:

a body portion;

a handle;

a first push rod housed in said body portion and being operatively connected to said handle and said engagement member for driving axial movement of said engagement member;

a second push rod housed in said body portion and being operatively connected to said handle and said ramp member for driving axial movement of said ramp member to said first stage of progression and for driving movement of said ramp member in said second stage of progression;

a lock mechanism for locking said second push rod against movement of said ramp member to said second stage of progression;

a release mechanism for selectively unlocking said second push rod to trigger movement of said ramp member to said second stage of progression; and

a third push rod housed in said body portion and being operatively connected to said handle and said snare member for driving axial movement of said snare member to a position for release of said portion of said snare from said channel and for return of said portion to said channel.

25. The surgical suturing apparatus recited in claim 24 wherein movement of said third push rod in a distal direction positions said portion of said snare member within an opening in said housing to effect the release of said portion of said snare member for engagement with said needle, and movement of said third push rod in a proximal direction when said portion engages said needle effects (i) the proximal travel of said needle when said needle is out of said housing to pull said needle through tissue in said proximal direction and (ii) the return of said portion of said snare member and said needle to said channel.

26. The surgical suturing apparatus recited in claim 25 wherein said actuation assembly further comprises a trigger for moving said snare portion distally to said opening in said housing.

27. The surgical suturing apparatus recited in claim 24 wherein said lock mechanism comprises a pin extending outwardly from said second push rod, and a locking plate having a notch therein for stopping said pin against movement in a distal direction beyond said notch.

28. The surgical suturing apparatus recited in claim 27 wherein said release mechanism comprises a lever for lifting said locking plate to release said pin from said notch.