CA2265832A1 - Automatic needle-passer suturing instrument - Google Patents

Automatic needle-passer suturing instrument Download PDF

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Publication number
CA2265832A1
CA2265832A1 CA002265832A CA2265832A CA2265832A1 CA 2265832 A1 CA2265832 A1 CA 2265832A1 CA 002265832 A CA002265832 A CA 002265832A CA 2265832 A CA2265832 A CA 2265832A CA 2265832 A1 CA2265832 A1 CA 2265832A1
Authority
CA
Canada
Prior art keywords
needle
end effector
stitching
tubular member
end effectors
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002265832A
Other languages
French (fr)
Inventor
Juergen Andrew Kortenbach
Robert Sixto Jr.
Michael Sean Mcbrayer
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Boston Scientific Miami Corp
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of CA2265832A1 publication Critical patent/CA2265832A1/en
Abandoned legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A61B17/0625—Needle manipulators the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0491—Sewing machines for surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/0609—Needles, e.g. needle tip configurations having sharp tips at both ends, e.g. shuttle needle alternately retained and released by first and second facing jaws of a suturing instrument

Abstract

An automatic suturing instrument (10) generally includes a proximal actuation ha ndle assembly (12), a flexible tubular member (14), a control wire (18), and an end effector assembly (20). The control wire extends through the tubular member and the end effector assembly is coupled to the distal end of each of the tubular member and the control wire, while the handle (22) is coupled to the proximal end of each of the tubular member and the control wire. Actuation of the handle moves the co ntrol wire relative to the tubular member and thereby moves the end effector assembly (20) from an open to a closed position. The end effector assembly generally includes two end effectors (34a, 34b), a needle (36) engaged by one of the end effectors (but which can be engaged by either end effector alternately), and a suture material. The end effector assembly further includes a needle passing mechanism that automatically alternates which end effector engages the needle each time the end effectors are moved into a closed position.

Description

CA 02265832 1999-03-09W0 98/ 1 1829 PCT/U S9 7/ 16809AUTOMATIC NEEDLE-PASSER SUTURING INSTRUMENTBACKGROUND OF THE INVENTION1. Field of the InventionThis invention relates broadly to surgical suturinginstruments. More particularly, this invention relates tolaparoscopic automatic needle-passer suturing instruments.2. State of the ArtLaparoscopic suturing instruments are used for placingstitches in soft tissue. Typically, a small incision is formedin the abdominal cavity of a patient via the use of a trocarwhich is used to puncture the skin and fascia of the patient.The laparoscopic suturing instrument can then be passed throughthe trocar tube which is left in place in the incision.A prior art laparoscopic suturing instrument is sold underthe Autosuture Endostitch trademark by United States SurgicalCorp., Norwalk, CT. The Endostitch includes a proximal handle, arigid tubular member and a control wire extending therethrough, astitching end effector assembly, a toggling switching lever forengaging and disengaging a needle in the end effector assembly,arrow alignment indicia for aligning the toggle switch, and aneedle reloading button set. The control wire extends throughthe tubular member and the end effector assembly is coupled tothe distal end of each of the tubular member and the controlwire, while the handle is coupled to the proximal end of each ofthe tubular member and the control wire. The end effectorassembly generally includes two stitching end effectors and aneedle. The end effectors are rotatable relative to each other.The needle is engaged in one of the end effectors, but can beengaged by either end effector, and is provided with a suturematerial. Actuation of the handle moves the control wirerelative to the tubular member and thereby moves the endeffectors from an open to a closed position._W,_______y___~_____‘_W,_,___,,,,, , , .,, i-..,.....,.....~..-,.....................M......,....,,., . . . 4 »- — - 1-CA 02265832 1999-03-09W0 98/ 11829 _ PCT/US97/ 16809The practitioner actuates the handle to open the endeffector assembly and carefully guides the end effectors aroundthe tissue to be sutured. When the end effectors are in thecorrect position, the practitioner manipulates the handle toclose the end effectors on the tissue to be sutured. As the endeffectors close, the needle passes into and through the tissueand contacts the second end effector on the other side of thetissue. The practitioner is then required to toggle theswitching lever to lock the needle in one end effector and tounlock the needle from the other end effector. The practitionerthen operates the handle to open the end effectors and transferthe needle from one side of the tissue to the other side of thetissue. Consequently, the suture is pulled through the tissue.The process is repeated for as many sutures as the practitionerdesires. The suture is then tied and cut by another instrumentand the instruments are removed from the surgical site.As suggested above, the Autosuturem Endostitch instrumentrequires a complex operation to pass the needle from one endeffector to the other. Failure to toggle the switch will resultin the needle not being passed from one end effector to theother. Furthermore, care must be made to not toggle the switchduring a suturing procedure, as the needle may be dislodged fromthe instrument or the needle may be prevented from engaging withthe other end effector. Another shortcoming of the AutosutureEndostitch instrument is that two-handed operation is required inunloading the needle from the Autosuturem Endostitch instrument.One hand must align the toggle levers with arrow indicia on thehousing of the instrument while simultaneously squeezing thehandles. The other hand must simultaneously depress reloadingbuttons on both the front and back of the instrument. Thisoperation will cause the reloading buttons to advance position.Then the handle can be released and the needle can be removed.Moreover, the mechanism of the Autosuture“ device incorporates acomplex array of wires running through the entire length of therigid tubular member.CA 02265832 1999-03-09W0 98/1 1829 PCT/US97/ 16809The suturing process poses several challenges to the designand manufacture of a surgical suturing instrument. Presently,the manner in which the needle is passed from one end effector tothe other and pulled through the tissue, and the manner in whichthe needle is unloaded from and reloaded in the instrument areinefficient and cumbersome with the instruments of the prior art.In addition, the complex array of wires utilized in the mechanismof the prior art instruments is not conducive to an instrumenthaving a flexible design.SUMARY OF THE INVENTIONIt is therefore an object of the invention to provide asuturing instrument which is easy to use by the practitioner.It is also an object of the invention to provide a suturinginstrument which is flexible.It is a further object of the invention to provide asuturing instrument which automatically switches engagement of aneedle between two end effectors.It is another object of the invention to provide a suturinginstrument which assists in passing a needle through tissue atthe suturing site.It is yet another object of the invention to provide asuturing instrument having an easily replaceable needle.In accord with these objects which will be discussed indetail below, an automatic endoscopic suturing instrument isprovided. The instrument generally includes a proximal actuationhandle assembly, a flexible tubular member, a control wire, andan end effector assembly. The control wire extends through thetubular member and the end effector assembly is coupled to thedistal end of each of the tubular member and the control wire,while the handle is coupled to the proximal end of each of thetubular member and the control wire. Actuation of the handleCA 02265832 1999-03-09W0 98/ 11829 PCT/US97/168094moves the control wire relative to the tubular member and therebymoves the end effector assembly from an open to a closedposition. The end effector assembly generally includes two endeffectors, a needle engaged by one of the end effectors at a time(but which can be engaged by either end effector alternately),and a suture material. The end effector assembly furtherincludes a needle passing mechanism that automatically alternateswhich end effector engages the needle each time the end effectorsare moved into a closed position, and two blades which extendthrough the end effectors which may, if desired, bias the endthe two bladesalso cooperate with the needle passing mechanism to lock theeffectors toward an open position. In addition,needle in one of the end effectors. When a blade is locking theneedle that blade extends out of the distal end of the end 9effector holding the needle. The needle may be released fromthat end effector by simply tapping the distal end of the endeffector on a hard surface to depress the blade extending out ofthe distal end of the end effector or alternatively pressing theblade with a human finger. A new needle with suture may then beinserted in and engaged by an end effector.With the above embodiment it will be appreciated that theautomatic suturing instrument of the invention is easilyoperable, requiring no additional effort to alternate engagementof the needle by the end effectors beyond actuating the handle toopen and close the end effectors. In addition, the manner ofremoving a needle and inserting a new needle with suture into theend effector is greatly simplified.Additional objects and advantages of the invention willbecome apparent to those skilled in the art upon reference to thedetailed description taken in conjunction with the providedfigures.CA 02265832 1999-03-09W0 98/1 1829 PCT/US97/ 16809BRIEF DESCRIPTION OF THE DRAWINGSFigure 1 is a broken transparent partial side elevation View0of an automatic suturing instrument according to the invention;Figure 2 is an enlarged broken cutaway perspective view ofthe distal end of the suturing instrument of Figure 1;Figure 3 is an enlarged broken side view schematic of thedistal end of the suturing instrument of Figure 1;Figure 4 is an enlarged broken bottom view schematic of thedistal end of the suturing instrument of Figure 1;Figure 5 is an enlarged broken side elevational view of thedistal end of an end effector of the suturing instrument ofFigure 1;Figures 6A and 6B are enlarged broken partial top views ofthe distal end of an end effector of the suturing instrument ofFigure 1;Figure 7 is a view similar to Figure 5 of a secondembodiment of a suturing instrument according to the invention;Figures 8A and 8B are views similar to Figures 6A and 6B ofthe second embodiment of a suturing instrument according to theinvention;Figure 9 is a view similar to Figure 5 of a third embodimentof a suturing instrument according to the invention; andFigures 10A and 10B are views similar to Figures 6A and 6Bof the third embodiment of a suturing instrument according to theinvention.CA 02265832 1999-03-09W0 98/ 1 1829 PCT/U S97/ 16809DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTSTurning now to Figure 1, an automatic endoscopic suturinginstrument 10 is shown. The suturing instrument includes aproximal actuation handle assembly 12, a tubular member 14 havinga lumen 16, a control wire 18 (or push rod) extending through thelumen, and an end effector assembly 20. The proximal actuationhandle assembly 12 includes a fixed handle portion 22 and a lever24 pivotally coupled to the fixed handle portion by a pivot pin26. The tubular member is preferably a flexible coil, but mayalso be a rigid tube. The proximal end of the tubular member 14is fixedly coupled to the handle portion 22. The lumen 16 of thetubular member 14 is sized to permit the control wire 18 tofreely move axially but preferably to allow only a small amountof radial movement. The distal end of the tubular member isprovided with a clevis 28. The control wire 18 is coupled at itsproximal end 23 to the lever 24 by an axle 30 in a known mannerand is provided at its distal end 32 with a coupling structure21. As will be described in more detail below, the couplingstructure 21 includes a mounting block 35, a post 37, and abracket 39 which support various parts of the end effectorassembly 20.Turning to Figures 2, 3, and 4, the end effector assembly 20generally includes two end effectors 34a, 34b, an elongate needle36 (shown only with respect to Figure 3) locked in one of the endeffectors 34b but lockable by either, and a needle transferassembly 38. The two end effectors 34a, 34b each have a mountingbore 39a, 39b and are rotatably mounted at the mounting bore onan axle 40 between the arms of the clevis 28. Each end effector34a, 34b also includes a proximal tang 41a, 41b which is coupledby a link 47a, 47b to diagonally opposed sides of the mountingblock 35 of the coupling structure 21. Each end effector 34a,34b further includes a distal needle receiving hole 44a, 44b, anda longitudinal blade receiving channel 46a, 46b which intersectsthe needle receiving hole and preferably extends through thedistal end of the end effectors. When the end effectors are in aclosed position, the needle receiving holes are mutually aligned.CA 02265832 1999-03-09W0 98I11829 _ PCT /US97/16809Blades 48a, 48b, preferably resilient and made of springsteel or Nitinol, extend through the blade receiving channel 46a,46b. Each blade 48a, 48b is preferably provided with a bend 49a,49b located where the blade enters the blade receiving channeland angled away from the longitudinal axis of the tubular member14. If desired, the blades may be of a strength and angled suchthat the end effectors are biased toward an open position.Referring to Figure 5 (shown with the needle 36 and withrespect to one end effector 34b) and Figures 6A and 6B (shownwithout the needle 36 and with respect to one end effector 34b),the distal end of each blade 48b defines a keyhole 50b forreceiving the needle 36. .The keyhole 50b has a narrow lockportion 52b and a wider release portion 54b. A circumferentialgroove 62a, 62b is provided at each end of the needle 36 forengagement by the blade at the lock 52b, and a central eye 64 isprovided for receiving a suture material. When the blade 48b issituated in the channel 46b such that the release 54b of thekeyhole 50b intersects the needle receiving hole 44b, the needleis in a needle-release position and the needle may freely enteror exit the needle receiving hole 44b. When the needle 36 isinserted in the needle receiving hole 44b, distal movement of theblade 48b moves the locking portion 52b of the keyhole intoengagement with the circumferential groove 62b of the needle suchthat the blade moves into a needle-lock position. When the blade48b is in the needle-lock position, the distal end of the bladepreferably extends through the distal end of the channel 46b.Referring back to Figures 2, 3, and 4, a rocking lever 45 isprovided which is coupled by a pivot 72 to one arm of the clevis28 with a cylindrical spacer 78. The lever 45 includes a centraltooth 70 which extends distally and first and second arms 74a,74b on either side of the pivot 72. The first and second armsare each provided with a coupling bore 76a, 76b which isrotatably coupled to a respective tang 77a, 77b at the proximalend of a respective one of the blades 48a, 48b. A rigid switchpin 82, preferably having an L-shaped distal end 83, is fixedlycoupled to the bracket 39 of the mounting rod 21. A resilientCA 02265832 1999-03-09W0 98/ 11829 PCT/US97/16809washer 81, or a coil spring, is situated on the mounting rod 21,interposed between the bracket 39 and the mounting block 35. Aspring 86 is positioned between the washer 81 and the bracket 39.The spring 86 biases the switch pin 82 to a center positionparallel to the longitudinal axis of the tubular member 14.It will be appreciated that movement of the lever 24relative to the handle portion 22 moves the control wire 18relative to the tubular member 14,the end effectors 34a, 34b.as the control wire 18 is moved proximally relative to theand thereby opens and closesIt will be further appreciated thattubular member, the switch pin 86 is moved proximally from aThe distal end 83 of the switch pin 82 willride on one side of the tooth 70,distal position.engage the first arm, androtate the lever such that the first and second arms and the twoblades are moved into reciprocal positions. The resilient washer81 is provided with enough resiliency to permit the switch pin torotate the lever after the end effectors have closed. When theswitch pin is moved distally and again proximally it will ridedown the other side of the tooth and thereby again causeof the arms and, the blades. Eachof the blades will alternate which blade isin a needle~lock position and which blade is in a needle-releasereciprocal movement likewise,reciprocal movementeffectorsposition. If the blades are designed to bias the endinto an open position, the blades will thereby assist in pullingthe needle through tissue. Regardless, one actuation cycle ofthe proximal actuation handle assembly will close the endeffectors on an area of tissue, transfer the needle from one endeffector to the other, and open the end effectors so that thesuture material is pulled through the tissue. Multiple stitchesmay be made by moving the distal end of the end effectors furtheralong the tissue and repeating the process.It will be further appreciated that the needle may bemanually released by tapping on a hard surface the distal end ofthe end effector in which the needle is engaged, thereby forcingproximally the portion of the blade which extends through thedistal end of the end effector and unlocking the needle. The..-—.-....1» 1» ~CA 02265832 1999-03-09W0 98/118253 PCT/US97/168099needle will then be disengaged from the blade and the needle canbe extricated. If the needle cannot be freely extricated fromthe needle receiving hole 44a, 44b (for example, if there is nosuture to pull on or if a piece of tissue becomes lodged with theneedle), a small pin (not shown) may be placed through theexterior side of the needle receiving hole and the needle may bepushed out of the interior side of the needle receiving hole.It also will be appreciated that by locating substantiallyall of the needle passing mechanism at the end effector assemblyand by having only a control wire extending through the tubularmember, a flexible automatic needle passing suturing instrumentcan be provided. This is in contrast to the instruments of theprior art which have their operating mechanisms in both theproximal and distal portions of the instruments.Turning now to Figures 7, 8A and 8B, a second embodiment,substantially similar to the first embodiment (with similar partshaving numbers incremented by 100), is shown. Each of two endeffectors (shown without the needle and with respect to one endeffector l34b) includes a longitudinal blade channel 146b,laterally offset from the longitudinal axis of the end effector,and a distal needle receiving hole l44b such that when the endeffectors 134a, l34b are in a closed position the needlereceiving holes 144a, l44b are mutually aligned. Each of twoblades l48b has a notched cutout l50b and extends through thechannel 146b of each end effector. When a blade is positionedwithin the channel l46b such that the notched cutout l50bintersects the needle receiving hole 144b, that blade is in aneedle-release position. If that blade is moved proximally theblade will partly obstruct the needle receiving hole and be in aneedle-lock position. A needle 136 has a notch 162a, l62b ateach of two ends and a central eye 164 for receiving a suturematerial. When the needle 136 is received within the needlereceiving hole and the blade l48b is moved distally extendinginto the notch l62a, 162b, the blade engages the needle. Whenthe blade is moved proximally within the channel and the notchedCA 02265832 1999-03-09W0 98/11829 PCT /US97/ 1680910cutout l50b again intersects the needle receiving hole l44b andthe needle is released.Turning now to Figures 9, 10A and 10B, a third embodiment,substantially similar to the first embodiment (with similar partshaving numbers incremented by 200), is shown. Each of two endeffectors (shown without the needle and with respect to one endeffector 234b) includes a central longitudinal blade channel246b, symmetrical along the longitudinal axis of the endeffector, and a distal needle receiving hole 244b such that whenthe end effectors are in a closed position the needle receivingholes of each end effectors are mutually aligned. Each of twoblades 248b includes two notched cutouts 250b, 251b wherein onenotched cutout 250b is deep and the other notched cutout 251b isshallow. When a blade is positioned within the channel 246b suchthat the deeper notched cutout 250b intersects the needlereceiving hole 244b, that blade is in a needle-release position.When the blade is positioned within the channel 246b such thatthe shallow notched cutout 251b is aligned with the needlereceiving hole 244b, the passageway of the needle receiving holeis obstructed. A needle 236 has a notch 262a, 262b at each oftwo ends and a central eye 264 for receiving a suture material.When the needle 236 is received within the needle receiving holeand the blade 248b is moved distally, the blade lateral of theshallow notch 251b extends into the notch 262b and engages theneedle. The needle is released when the blade is movedproximally within the channel and the deeper notched cutout 250bagain intersects the needle receiving hole 244b.There have been described and illustrated herein severalembodiments of a endoscopic suturing instrument. Whileparticular embodiments of the invention have been described, itis not intended that the invention be limited thereto, as it isintended that the invention be as broad in scope as the art willallow and that the specification be read likewise. Thus, whileone particular proximal actuation handle assembly has beendisclosed, it will be appreciated that other proximal actuationhandle assemblies could likewise be used for the instrument. ForCA 02265832 1999-03-09W0 98/11829 PCT/US97/168091 lekample, and not by way of limitation, a handle rotatablerelative to the end effectors could be used as disclosed in co-owned U.S. Serial. No. 08/284,793 which is hereby incorporated byreference herein. Furthermore, while it has been disclosed thatthe instrument has a preferably flexible tubular member (e.g., acoil) and control wire, it will be appreciated that using methodsknown in the art an instrument having a rigid tubular memberand/or a push rod could likewise be designed. In addition, whileparticular types of couplings have been disclosed for the variousparts of the instrument, it will be understood that other methodsknown in the art for coupling the parts can be used. Also, whilea notched or grooved needle is preferred, it will be recognizedthat other configurations of the needle which provide means forengagement can also be used. In addition, other blade keyhole ornotch configurations can also be used. Furthermore, while theswitch pin is disclosed as having an L—shaped distal end, it willbe appreciated that another bend in the pin, for example a U-shape at the distal end, can also be used. Moreover, while theblades have been disclosed as potentially having the ability tobias the end effectors into'an open position and thereby assistin pulling the needle through the tissue, it will also beappreciated that in the alternative the handle could be biasedwith a spring or other means such that the end effectors arebiased into an open position. It will therefore be appreciatedby those skilled in the art that yet other modifications could bemade to the provided invention without deviating from its spiritand scope as so claimed.

Claims (22)

We Claim:
1. A suturing instrument for use in conjunction with a needle, comprising:
a) a flexible tubular member having a distal end;
b) an actuation means extending through said tubular member, said actuation means having a handle means and one of a control wire and a push rod, said handle means being coupled to said one of said control wire and said push rod for moving said one of said control wire and said push rod relative to said tubular member;
c) first and second stitching end effectors coupled to said tubular member, at least one of said first end second stitching end effectors adapted to move relative to the other, said first and second stitching end effectors having a releasable needle gripping means for releasably gripping the needle; and d) an automatic needle switching means coupled to said needle gripping means and activated by said actuation means, wherein said first and second stitching end effectors are adapted to be movable from a first position to a second position to a third position to a fourth position and back to said first position, and in said first position said first and second stitching end effectors are in an open position and said first end effector is adapted to grip the needle, in said second position said first and second stitching end effectors are in a closed position and said first end effector is adapted to automatically release the needle and said second end effector is adapted to automatically grip the needle, in said third position said first and second stitching end effectors are in said open position and said second end effector is adapted to grip the needle, and in said fourth position said first and second stitching end effectors are in said closed position and said first end effector is adapted to automatically grip the needle and said second end effector is adapted to automatically release the needle.
2. A suturing instrument according to claim 1, wherein:
said tubular member is a coil.
3. A suturing instrument for use in conjunction with a needle, comprising:
a) a tubular member having a distal end;
b) an actuation means extending through said tubular member;
c) first and second stitching end effectors coupled to said tubular member, said first end second stitching end effectors adapted to move from an open position to a closed position, said first and second stitching end effectors defining first and second longitudinal channels, respectively, and further defining first and second distal needle receiving means, respectively, for receiving the needle;
d) first and second blades received in said first and second channels, respectively, said first and second blades defining first and second needle gripping means for aligning with said first and second needle receiving means and gripping the needle;
and e) an automatic needle switching means coupled to said first and second blades and activated by said actuation means, said needle switching means for reciprocally moving said first and second blades axially within said first and second channels, wherein when the needle is gripped in one of said first and second needle gripping means, actuation of said actuation means moves said first and second end effectors into said closed position and further activate said automatic needle switching means to move said first and second blades relative to each other and grip the needle in the other of said first and second needle gripping means.
4. A suturing instrument according to claim 3, wherein:
said actuation means comprises a handle means and one of a control wire and a push rod, said handle means being coupled to said one of said control wire and said push rod for moving said one of said control wire and said push rod relative to said tubular member.
5. A suturing instrument according to claim 4, wherein:
said tubular member is flexible.
6. A suturing instrument according to claim 5, wherein:
said tubular member is a coil.
7. A suturing instrument according to claim 3, further comprising:
f) a needle received in one of said first and second needle receiving means and gripped by one of said first and second needle gripping means.
8. A suturing instrument according to claim 3, wherein:
said first and second blades are biased such that said first and second end effectors are biased in said open position.
9. A suturing instrument according to claim 3, wherein:
said first and second needle gripping means are keyholes defined by said first and second blades.
10. A suturing instrument according to claim 3, wherein:
said first end effector is provided with a distal end and when the needle is gripped in said first needle gripping means, said first blade extends beyond said distal end.
11. A suturing instrument according to claim 4, wherein:
said one of said control wire and said push rod has a distal end and said needle switching means includes i) a switch pin coupled to said distal end of said one of said control wire and said push rod, and ii) a lever defining a distally-extending tooth and two arms, said lever pivotally coupled to said distal end of said tubular member and said two arms pivotally coupled to said first and second blades, respectively.
12. A suturing instrument according to claim 11, wherein:
said needle switching means further includes iii) a spring biasing said switch pin parallel to said tubular member.
13. A suturing instrument, comprising:
a) a needle having a first and second sharp ends;
b) a tubular member having a distal end;
c) an actuation means extending through said tubular member, said actuation means having a handle means and one of a control wire and a push rod, said handle means being coupled to said one of said control wire and said push rod for moving said one of said control wire and said push rod relative to said tubular member;
d) first and second stitching end effectors coupled to said tubular member, at least one of said first end second stitching end effectors adapted to move relative to the other, said first and second stitching end effectors having a releasable needle gripping means for releasably gripping said needle; and e) an automatic needle switching means coupled to said needle gripping means and activated by said actuation means, wherein said first and second stitching end effectors are adapted to be movable from a first position to a second position to a third position to a fourth position and back to said first position, and in said first position said first and second stitching end effectors are in an open position and said first end effector is adapted to grip said needle, in said second position said first and second stitching end effectors are in a closed position and said first end effector is adapted to automatically release said needle and said second end effector is adapted to automatically grip said needle, in said third position said first and second stitching end effectors are in said open position and said second end effector is adapted to grip said needle, and in said fourth position said first and second stitching end effectors are in said closed position and said first end effector is adapted to automatically grip the needle and said second end effector is adapted to automatically release the needle.
14. A suturing instrument for use in conjunction with a needle, comprising:
a) a tubular member having a distal end;
b) an actuation means extending through said tubular member, said actuation means having a handle means and one of a control wire and a push rod, said handle means being coupled to said one of said control wire and said push rod for moving said one of said control wire and said push rod relative to said tubular member;
c) first and second stitching end effectors coupled to said tubular member, at least one of said first end second stitching end effectors adapted to move relative to the other, said first and second stitching end effectors having a releasable needle gripping means for releasably gripping said needle, said needle gripping means having first and second sliding members each defining a keyhole, and said first stitching end effector defining a first channel in which said first sliding member is received and said second end effector defining a second channel in which said second sliding member is received; and d) an automatic needle switching means coupled to said needle gripping means and activated by said actuation means, wherein said first and second stitching end effectors are adapted to be movable from a first position to a second position to a third position to a fourth position and back to said first position, and in said first position said first and second stitching end effectors are in an open position and said first end effector is adapted to grip said needle, in said second position said first and second stitching end effectors are in a closed position and said first end effector is adapted to automatically release said needle and said second end effector is adapted to automatically grip said needle, in said third position said first and second stitching end effectors are in said open position and said second end effector is adapted to grip said needle, and in said fourth position said first and second stitching end effectors are in said closed position and said first end effector is adapted to automatically grip the needle and said second end effector is adapted to automatically release the needle.
15. A suturing instrument for use in conjunction with a needle, comprising:
a) a tubular member having a distal end;
b) an actuation means extending through said tubular member, said actuation means having a handle means and one of a control wire and a push rod, said handle means being coupled to said one of said control wire and said push rod for moving said one of said control wire and said push rod relative to said tubular member;
c) first and second stitching end effectors coupled to said tubular member, at least one of said first end second stitching end effectors adapted to move relative to the other, said first and second stitching end effectors having a releasable needle gripping means for releasably gripping said needle, said needle gripping means having first and second sliding members each defining at least one notch, and said first stitching end effector defining a first channel in which said first sliding member is received and said second end effector defining a second channel in which said second sliding member is received; and d) an automatic needle switching means coupled to said needle gripping means and activated by said actuation means, wherein said first and second stitching end effectors are adapted to be movable from a first position to a second position to a third position to a fourth position and back to said first position, and in said first position said first and second stitching end effectors are in an open position and said first end effector is adapted to grip said needle, in said second position said first and second stitching end effectors are in a closed position and said first end effector is adapted to automatically release said needle and said second end effector is adapted to automatically grip said needle, in said third position said first and second stitching end effectors are in said open position and said second end effector is adapted to grip said needle, and in said fourth position said first and second stitching end effectors are in said closed position and said first end effector is adapted to automatically grip the needle and said second end effector is adapted to automatically release the needle.
16. A suturing instrument for use in conjunction with a needle, comprising:
a) a tubular member having a distal end;
b) an actuation means extending through said tubular member, said actuation means having a handle means and one of a control wire and a push rod, said handle means being coupled to said one of said control wire and said push rod for moving said one of said control wire and said push rod relative to said tubular member;
c) first and second stitching end effectors coupled to said tubular member, at least one of said first end second stitching end effectors adapted to move relative to the other, said first and second stitching end effectors having a releasable needle gripping means for releasably gripping said needle, said needle gripping means having first and second resilient sliding members, and said first stitching end effector defining a first channel in which said first sliding member is received and said second end effector defining a second channel in which said second sliding member is received; and d) an automatic needle switching means coupled to said needle gripping means and activated by said actuation means, wherein said first and second stitching end effectors are adapted to be movable from a first position to a second position to a third position to a fourth position and back to said first position, and in said first position said first and second stitching end effectors are in an open position and said first end effector is adapted to grip said needle, in said second position said first and second stitching end effectors are in a closed position and said first end effector is adapted to automatically release said needle and said second end effector is adapted to automatically grip said needle, in said third position said first and second stitching end effectors are in said open position and said second end effector is adapted to grip said needle, and in said fourth position said first and second stitching end effectors are in said closed position and said first end effector is adapted to automatically grip the needle and said second end effector is adapted to automatically release the needle.
17. A suturing instrument for use in conjunction with a needle, comprising:
a) a tubular member having a distal end;
b) an actuation means extending through said tubular member, said actuation means having a handle means and one of a control wire and a push rod, said handle means being coupled to said one of said control wire and said push rod for moving said one of said control wire and said push rod relative to said tubular member, said one of said control wire and said push rod having a distal end;
c) first and second stitching end effectors coupled to said tubular member, at least one of said first end second stitching end effectors adapted to move relative to the other, said first and second stitching end effectors having a releasable needle gripping means for releasably gripping said needle, said needle gripping means having first and second sliding members, and said first stitching end effector defining a first channel in which said first sliding member is received and said second end effector defining a second channel in which said second sliding member is received; and d) an automatic needle switching means coupled to said needle gripping means and activated by said actuation means, said needle switching means including, i) a switch pin coupled to said distal end of said one of said control wire and said push rod, and ii) a lever defining a distally-extending tooth and two arms, said lever pivotally coupled to said distal end of said tubular member and said two arms pivotally coupled to said first and second sliding members, respectively, wherein said first and second stitching end effectors are adapted to be movable from a first position to a second position to a third position to a fourth position and back to said first position, and in said first position said first and second stitching end effectors are in an open position and said first end effector is adapted to grip said needle, in said second position said first and second stitching end effectors are in a closed position and said first end effector is adapted to automatically release said needle and said second end effector is adapted to automatically grip said needle, in said third position said first and second stitching end effectors are in said open position and said second end effector is adapted to grip said needle, and in said fourth position said first and second stitching end effectors are in said closed position and said first end effector is adapted to automatically grip the needle and said second end effector is adapted to automatically release the needle.
18. A suturing instrument according to claim 15, wherein:
when said first and second end effectors are in said first position, said first sliding member extends beyond said first channel.
19. A suturing instrument according to claim 16 wherein:
said first and second sliding members are provided with a bend such that said first and second end effectors are biased into said open position.
20. The suturing instrument according to claim 15, wherein:
said one of said control wire and said push rod has a distal end and said needle switching means includes i) a switch pin coupled to said distal end of said one of said control wire and said push rod, and ii) a lever defining a distally-extending tooth and two arms, said lever pivotally coupled to said distal end of said tubular member and said two arms pivotally coupled to said first and second sliding members, respectively.
21. The suturing instrument according to claim 17, wherein:
said needle switching means further includes iii) a spring biasing said switch pin parallel to said tubular member.
22. A suturing instrument according to claim 15, further comprising:
e) a first link and a second link, said first link adapted to couple said first end effector to said one of said control wire and said push rod and said second link adapted to couple said second end effector to said one of said control wire and said push rod.
CA002265832A 1996-09-23 1997-09-23 Automatic needle-passer suturing instrument Abandoned CA2265832A1 (en)

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US08/718,019 1996-09-23
US08/718,019 US5814054A (en) 1996-09-23 1996-09-23 Automatic needle-passer suturing instrument
PCT/US1997/016809 WO1998011829A1 (en) 1996-09-23 1997-09-23 Automatic needle-passer suturing instrument

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CA2265832A1 true CA2265832A1 (en) 1998-03-26

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EP (1) EP0942686A4 (en)
JP (1) JP2001500765A (en)
CA (1) CA2265832A1 (en)
WO (1) WO1998011829A1 (en)

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JP2001500765A (en) 2001-01-23
WO1998011829A1 (en) 1998-03-26

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