U.S. patent application number 11/106700 was filed with the patent office on 2005-09-29 for suture device.
Invention is credited to Davenport, James A..
Application Number | 20050216037 11/106700 |
Document ID | / |
Family ID | 34589957 |
Filed Date | 2005-09-29 |
United States Patent
Application |
20050216037 |
Kind Code |
A1 |
Davenport, James A. |
September 29, 2005 |
Suture device
Abstract
The present invention is a suture device generally intended for
use in puncture wounds of a body cavity. The suture device can be
inserted through the tissue layer into the body cavity and extend
needles attached to a common suture line, under endoscopic vision,
for engagement with the internal side of the tissue layer. The
needles are deployed using a straight spring that deforms outwardly
from the shaft of the suture device when a force is applied to the
spring. Because of the inherent characteristics of the spring, it
bends perpendicular to the shaft of the suture device and the
removably attached needle is moved outwardly while staying
generally parallel to the shaft of the suture device. Once the
force is removed on the spring, the spring returns to its original
position close to the body of the shaft.
Inventors: |
Davenport, James A.; (San
Antonio, TX) |
Correspondence
Address: |
Daniel D. Chapman
JACKSON WALKER L.L.P.
Suite 2100
112 E. Pecan Street
San Antonio
TX
78205
US
|
Family ID: |
34589957 |
Appl. No.: |
11/106700 |
Filed: |
May 23, 2005 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11106700 |
May 23, 2005 |
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10353732 |
Jan 29, 2003 |
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6896685 |
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Current U.S.
Class: |
606/144 ;
606/139 |
Current CPC
Class: |
A61B 2017/00663
20130101; A61B 2017/00637 20130101; A61B 2017/0472 20130101; A61B
2017/047 20130101; A61B 17/0057 20130101 |
Class at
Publication: |
606/144 ;
606/139 |
International
Class: |
A61B 017/10; A61B
017/04; A61B 017/12 |
Claims
I claim:
1. A suture device for suturing puncture wounds in a body cavity
wall comprising: a shaft having a spring slot; a spring having an
upper portion, a crimped portion, and a lower portion, said upper
portion moveably positioned in said spring slot; said spring lower
portion attached to said shaft; said spring crimped portion having
a first relaxed position relatively near said shaft, and a second
tensioned position relatively extended from said shaft; a means for
exerting force on said spring upper portion such that said spring
crimped portion moves from said first relaxed position to said
second tensioned position; and a needle receiver attached to said
spring crimped portion.
2. The apparatus of claim 1, further comprising: a crimp member
attached to said shaft between said shaft and said spring crimped
portion such that said crimp member causes a bend in said spring
when said spring is in said first relaxed position.
3. The apparatus of claim 1, further comprising: a first needle
removably attached to said needle receiver.
4. The apparatus of claim 3, further comprising: a suture attached
to said first needle.
5. The apparatus of claim 3, further comprising: a suture having a
first end attached to said first needle, and an excess suture; a
suture chamber in said shaft; and said excess suture removably
contained in said suture chamber.
6. The apparatus of claim 5, further comprising: a suture second
end attached to a second needle.
7. The apparatus of claim 1, wherein said spring returns to said
first relaxed position if no force is exerted on said spring upper
portion.
8. The apparatus of claim 7, wherein said spring is made of metal
or plastic.
9. The apparatus of claim 3, wherein said needle is held
substantially parallel to said shaft both when said spring crimped
portion is in said first relaxed position and when said spring
crimped portion is in said second tensioned position.
10. The apparatus of claim 1, wherein said shaft is cylindrical and
has a diameter that is sized to fit in an aperture of a
cannula.
11. The apparatus of claim 1, wherein said shaft has a diameter
that is sized to fit through a defect caused by a cannula.
12. The apparatus of claim 1, wherein said spring is comprised of
more than one piece.
13. The apparatus of claim 1, wherein said spring has a greater
coefficient of elasticity in an area between an attachment point of
said needle receiver and an attachment point of said spring lower
portion to said lower shaft.
14. The apparatus of claim 1, wherein said spring is crimped at a
desired point in the spring crimped portion for said bend to occur
in said second tensioned position while said spring is in said
first relaxed position.
15. A suture device for suturing puncture wounds in a body cavity
wall comprising: a shaft having a spring slot; a spring having an
upper portion, a crimped portion, and a lower portion, said upper
portion moveably positioned in said spring slot; said spring lower
portion attached to said shaft; said spring crimped portion having
a first relaxed position relatively near said shaft, and a second
tensioned position relatively extended from said shaft; a means for
exerting force on said spring upper portion such that said spring
crimped portion moves from said first relaxed position to said
second tensioned position; a needle receiver attached to said
spring crimped portion; and a crimp member attached to said shaft
between said shaft and said spring crimped portion such that said
crimp member causes a bend in said spring when said spring is in
said first relaxed position.
16. The apparatus of claim 15, wherein said spring returns to said
first relaxed position if no force is exerted on said spring upper
portion.
17. The apparatus of claim 15, further comprising: a suture having
a first end attached to a first needle, said first needle removably
attached to said needle receiver wherein said needle is held
substantially parallel to said shaft both when said spring crimped
portion is in said first relaxed position and when said spring
crimped portion is in said second tensioned position.
18. The apparatus of claim 15, further comprising: a suture chamber
in said shaft; and a portion of said suture removably contained in
said suture chamber.
19. The apparatus of claim 15, further comprising: a suture second
end attached to a second needle.
20. The apparatus of claim 15, wherein said spring is made of metal
or plastic.
21. The apparatus of claim 15, wherein said shaft is cylindrical
and has a diameter that is sized to fit in an aperture of a
cannula.
22. The apparatus of claim 15, wherein said shaft has a diameter
that is sized to fit through a defect caused by a cannula.
23. The apparatus of claim 15, wherein said spring is comprised of
more than one piece.
24. The apparatus of claim 15, wherein said spring has a greater
coefficient of elasticity in an area between an attachment point of
said needle receiver and an attachment point of said spring lower
portion to said lower shaft.
25. The apparatus of claim 15, wherein said spring is crimped at a
desired point in the spring crimped portion for said bend to occur
in said second tensioned position while said spring is in said
first relaxed position.
26. A suture device for suturing puncture wounds in a body cavity
wall comprising: a shaft having a spring slot; a spring having an
upper portion, a crimped portion, and a lower portion, said upper
portion moveably positioned in said spring slot; said spring lower
portion attached to said shaft; said spring crimped portion having
a first relaxed position relatively near said shaft, and a second
tensioned position relatively extended from said shaft; a means for
exerting force on said spring upper portion such that said spring
crimped portion moves from said first relaxed position to said
second tensioned position; a needle receiver attached to said
spring crimped portion; a crimp member attached to said shaft
between said shaft and said spring crimped portion such that said
crimp member causes a bend in said spring when said spring is in
said first relaxed position; and a suture having a first end
attached to a first needle, said first needle removably attached to
said needle receiver wherein said needle is held substantially
parallel to said shaft both when said spring crimped portion is in
said first relaxed position and when said spring crimped portion is
in said second tensioned position.
27. The apparatus of claim 26, wherein said shaft has a diameter
that is sized to fit through a defect caused by a cannula.
28. The apparatus of claim 26, wherein said spring is comprised of
more than one piece.
29. The apparatus of claim 26, wherein said spring has a greater
coefficient of elasticity in an area between an attachment point of
said needle receiver and an attachment point of said spring lower
portion to said lower shaft.
30. The apparatus of claim 26, wherein said spring is crimped at a
desired point in the spring crimped portion for said bend to occur
in said second tensioned position while said spring is in said
first relaxed position.
31. A suture device for suturing puncture wounds in a body cavity
wall comprising: a means for extending a needle, said needle having
a first end and a second end, wherein said needle is removably
attached to said means for extending, wherein said means for
extending moves said needle from a first position to a second
position, and wherein a line running from said needle first end to
said needle second end when said needle is in said first position
is substantially parallel a line running from said needle first end
to said needle second end when said needle is in said second
position; and a means for activating said means for extending to
move said needle from said first position to said second position,
said means for activating in operative engagement with said means
for extending.
32. The apparatus of claim 31, further comprising: a shaft having a
proximal end and a distal end with a longitudinal axis extending
between said proximal end and said distal end; said means for
extending attached to said distal end of said shaft; and said means
for activating attached to said proximal end of said shaft.
33. The apparatus of claim 32, further comprising: a needle recess
in the surface of said shaft, wherein said first position is within
said needle recess and said second position is outside of said
needle recess.
34. The apparatus of claim 33, further comprising: said means for
extending comprising: a spring having an upper portion, a crimped
portion, and a lower portion; said upper portion moveably attached
to said shaft; said spring lower portion attached to said shaft;
said needle removably attached to said crimped portion; and wherein
said spring holds said needle in said first position if no force is
exerted on said spring upper portion; and wherein said means for
activating exerts force on said spring upper portion such that said
spring crimped portion moves said needle from said first position
to said second position.
35. The apparatus of claim 34, further comprising: a suture chamber
in said shaft; and a suture having a first end attached to said
needle, and the majority of the remainder of said suture removably
positioned inside said suture chamber.
36. The apparatus of claim 34, wherein said shaft is cylindrical
and has a diameter that is sized to fit in an aperture of a
cannula.
37. The apparatus of claim 34, wherein said shaft has a diameter
that is sized to fit through a defect caused by a cannula.
38. The apparatus of claim 34, wherein said spring is comprised of
more than one piece.
39. The apparatus of claim 34, wherein said spring has a greater
coefficient of elasticity in an area between an attachment point of
said needle receiver and an attachment point of said spring lower
portion to said lower shaft.
40. The apparatus of claim 34, wherein said spring is crimped at a
desired point in the spring crimped portion for said bend to occur
in said second tensioned position while said spring is in said
first relaxed position.
Description
[0001] This application is a Continuation and claims priority from
and incorporates by reference patent application Ser. No.
10/353/732 filed Jan. 29, 2003.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] Applicant's invention relates to a device for suturing
together the tissue walls of body cavities that have received
puncture type wounds. More particularly, it relates to a suture
device that can be inserted into the body cavity through the
puncture wound, extend needles connected by a suture line and draw
them through the tissue walls in order to close the puncture
wound.
[0004] 2. Background Information
[0005] Conventional instruments for closing puncture wounds
generally provide for a device with a shaft that can be extended
into the body cavity through the puncture wound, and then deploy
needles for pulling up through the tissue walls. However, the means
for deploying the needles are often cumbersome, or the needles are
deployed at an angle that is not parallel to the shaft of the
suture device. These characteristics mean that either it may be
difficult to extend or retract the needle, or the needle may not be
pulled perpendicularly through the tissue layer.
[0006] The need for a device that allows the needle to be engaged
with the tissue layer from inside of the body cavity arises in the
case of puncture wounds. These wounds may be accidental, as in the
case of trauma, or intentional, as in the case of a surgical
procedure. Although not exclusive, one of the most common occasions
that calls for this type of device is during an endoscopic surgical
procedure. As a general statement regarding these procedures, an
incision is made creating an opening for access by the surgeon to
the patient's abdominal or chest cavities. In some surgical
procedures, a trocar and cannula may be used so that the access
opening is created, but the body cavity remains relatively airtight
and gas can be pumped into the body cavity expanding the body wall
and making organs more accessible. In these situations, it is
desirable to suture close the incisions starting from the inside of
the body. To this end, several devices have been developed.
[0007] The general criteria for these devices is the need for a
shaft that may be extended through the incision into the body
cavity with the needles and suture line attached to the insertion
end of the shaft. Additionally, in order to be able to smoothly
insert the shaft and needles, the needles must be shielded from
catching on the body tissue as the shaft is inserted through the
incision. This necessitates that such devices incorporate
mechanisms to extend and retract the needles from the shaft.
Conventional devices use various means to deploy the needles. For
example, there are instances where the needles are curved and are
extended from a pivot point at the base of the needle. Other
inventions incorporate various types of gearing and sliding members
to effect the deployment of the needles. Unfortunately,
conventional deployment mechanisms can be cumbersome and not as
efficient as necessary in surgical procedures that require
precision. Additionally, surgeons want to be able to accurately
insert the needle in the tissue layer and have the needle pierce
the insertion point and the fascia layer parallel to the wound or
incision edge. This requires that the needle be positioned along a
known axis and the most intuitive is parallel to the shaft of the
instrument.
[0008] Thus, there is a need for a device for suturing closed
puncture wounds and body cavities that will quickly and precisely
extend and retract a needle and suture, and, while doing so, keep
the needle parallel to the shaft of the instrument.
SUMMARY OF THE INVENTION
[0009] The present invention is a suturing device that quickly and
easily extends and retracts suturing needles from the shaft.
[0010] The present invention also provides a means by which the
needles are kept generally parallel to the shaft of the
instrument.
[0011] The present invention further provides:
[0012] a. a shaft for inserting the needles and suture into the
puncture wound;
[0013] b. needle recesses into which the needles can be retracted
in order to more easily pass the shaft tip into and through the
body wall;
[0014] c. a chamber for holding excess suture line;
[0015] d. a spring that bends at a predetermined point when force
is applied at the end having elastic characteristics;
[0016] e. an activator to apply force to the spring;
[0017] f. a crimp member may be included to help cause deformation
of the spring at a predetermined point; and
[0018] g. the diameter of the shaft may be sized to fit through a
cannula.
[0019] In order to solve the difficulties presented in attempting
to obtain these features, a suture device has been developed which
incorporates a spring as a means for extending the needle from the
needle recess outwardly from the shaft.
[0020] Specifically, the present invention provides for a spring
with elastic characteristics that will deform and bend outwardly
from the shaft when pressure is applied to the spring upper
portion. Because of the characteristics of the spring and the
design of the present invention, the spring deforms at a
predetermined point along its length. The needle and suture are
attached to the spring by means of a needle receiver. The elastic
properties of the spring cause it to deform and move outwardly from
the shaft to a second tensioned position when force is applied to
the spring upper portion in a direction along the length of the
spring. Those same elastic characteristics cause the spring to
return to its first relaxed position, and to remain at that first
position, when the force is removed from the spring upper portion.
Because the needle receiver is attached to the spring crimped
portion at the point where the apex of the bend in the spring
occurs, the tensioning of the spring causes the extension of the
needle receiver, along with the needle, from the first position to
the second position. Relaxing the spring moves the needle receiver
back to the first position, and if the needle was not deployed, it
withdraws the needle back into the needle recess as well.
[0021] In order to efficiently use the present invention's
deployment means, the needle receiver should be attached to the
spring at or near the point where the apex of the bend in the
spring occurs when it is in the second position. Additionally, the
bend should occur at or near the same point along the spring each
time the spring is urged to the second position. In order to
accomplish this, several varying means may be employed. A
consistent point of bend, or apex, is encouraged by the manner of
the engagement of the spring to the shaft. In one embodiment, the
spring lower portion is attached to the lower shaft and the spring
upper portion slides within the spring slot. Thus, the only portion
of the spring that can bend is the remaining crimped portion, and
the bend tends to occur at the same point along this portion. In
alternative embodiments, the spring may have a pre-existing bend or
crimp at the desired point of the apex. In another alternative
embodiment, a crimp member may be attached to the shaft to distort
the spring outwardly from the shaft at the desired apex. It is
anticipated that the above, or other, means of creating the apex at
a consistent, desired point may be employed in the present
invention. Additionally, combinations of the various means of
creating the apex at a consistent, desired point may be
employed.
[0022] Although the spring may be a single piece, it is anticipated
that the spring may also be constructed of two or more separate
pieces cooperatively engaged to perform the described function.
Other embodiments of the spring may also be incorporated into the
suture device, such as using a spring that has a greater
coefficient of elasticity in an area between the attachment point
of the needle receiver and the attachment point of the spring lower
portion to the lower shaft. This would result in the stiffening of
the spring lower portion to more effectively withstand the pressure
of pressing the needle through the tissue while in the second
position, and would resist further bending and distortion of the
spring, and ease insertion of the needle.
[0023] This deployment means provides the surgeon with an
easy-to-use suturing device that deploys the needle quickly and
efficiently. Furthermore, the needle is deployed and passed into
the tissue under endoscopic vision to assure accurate placement in
the tissue to receive the suture and also avoid other organs and
tissue, such as the bowels, to prevent damage to them.
Additionally, if the surgeon has not, or is unable to find the
correct placement for the insertion of the needle, or if the device
needs to be withdrawn without delivering the needle into the
tissue, the needle is quickly retracted when force is removed from
the spring.
[0024] Alternatively, the diameter of the shaft may be sized in
order to fit through a cannula. Often, in endoscopic surgery, a
trocar and cannula are used in order to create a passageway into
the body cavity. The cannula may be made relatively airtight in
order that gas can be pumped into the body cavity expanding the
cavity. In this manner, the body cavity is made more accessible and
visible to the surgeon. It is possible that in order to close the
wound when a trocar and cannula have been used, the diameter of the
shaft of the present invention may be sized so that it fits through
the cannula. In this alternative embodiment, the shaft tip at the
distal end of the suture device may be inserted through the
cannula, the needles moved from a first position in the needle
recess of the shaft to a second position extended from the shaft so
that the surgeon may pull upwardly on the suture device inserting
the needles into the tissue of the body wall at a location chosen
by the surgeon. Once inserted, the needles are released from the
needle receiver and the suture is pulled from the suture chamber in
the shaft. The shaft can then be removed from the cannula (if
present) and the body cavity, leaving the needles inserted through
the tissue wall with the suture strung between them inside the
tissue wall. Once the present invention and cannula are removed,
the needles can then be drawn from the body wall to the outside of
the body leaving suture line to pull close the tissue layers. The
present invention works in similar fashion if the cannula is
removed first, then the suture devise is inserted for deployment of
the needles and suture.
BRIEF DESCRIPTION OF THE DRAWINGS
[0025] FIG. 1. is a partial perspective view of the present
invention.
[0026] FIG. 2. is a partial perspective view of the present
invention.
[0027] FIG. 3A. is a partial side view of the present
invention.
[0028] FIG. 3B. is a partial side view of the present
invention.
[0029] FIG. 3C. is a partial side view of the present
invention.
[0030] FIG. 3D. is a partial side view of the present
invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0031] Referring to the figures, FIG. 1. illustrates the distal end
of the suture device. The distal end of the suture device includes
a means for extending the needle (26). The proximal end of the
suture device includes a means for activating the means for
extending the needle (26). However, because it is anticipated that
there will be a variety of embodiments of the means for activating,
a specific embodiment is not shown. The means for activating,
regardless of the embodiment, is required to place a force on the
spring upper portion (41) such that the spring crimped portion (40)
is bent outwardly from the shaft (10).
[0032] In the portion of the suture device shown, the shaft (10) is
divided into three portions, the upper shaft (12), the inner shaft
(14), and the lower shaft (16). The lower shaft (16) ends in a
shaft tip (18) of the distal end of the suture device. In this
embodiment of the suture device, the spring (38) is a straight
spring that is attached by its spring lower portion (42) to the
lower shaft (16). This attachment provides an anchor for the spring
(38). The diameter of the lower shaft (16) is anticipated to be
generally the same as that of the upper shaft (12). However, the
inner shaft (14) is intended to be of a lesser diameter. This
allows the spring lower portion (42) to extend into a lower shaft
shoulder (34) and be anchored therein. The spring crimped portion
(40) lays along the inner shaft (14) where it is exposed to the
exterior environment. The spring upper portion (41) extends through
an upper shaft shoulder (36) into a spring slot (20) in the upper
shaft (12). The spring (38) is movably positioned inside the spring
slot (20). The shaft (10) has a longitudinal axis (X-X) that
extends between its proximal end and its distal end. The activation
means is in operational engagement with the extension means, and
thus the spring upper portion (41) through the spring slot
(20).
[0033] Upon activation, force is placed upon the spring upper
portion (41) parallel to the shaft longitudinal axis (X-X) from the
proximal end to the distal end. This force on the spring upper
portion (41) causes the spring upper portion (41) to slide distally
within the spring slot (20). Because the spring lower portion (42)
is attached to the lower shaft (16), the compression of the spring
(38) causes the spring crimped portion (40) to bend outwardly from
the inner shaft (14).
[0034] Because of the anchoring of the spring lower portion (42) in
the lower shaft (16) and the positioning of the spring upper
portion (41) within the spring slot (20), the only portion of the
spring (38) that can deform upon a force being applied is the
spring crimped portion (40) which is exposed to the external
environment. Because the first position of the spring crimped
portion (40) is adjacent to the inner shaft (14), the only
direction the spring crimped portion (40) will deform is
perpendicular to the shaft (10). Additionally, the apex of the bend
of the spring crimped portion (40) will be at a predetermined point
along the spring crimped portion (40). To further encourage the
bend to occur at that predetermined point, the suture device may
have a pre-made bend or crimp, or include a crimp member (30), each
of which will cause a slight bend or weakness at the predetermined
point of the spring crimped portion (40) which will encourage
repeated bending at that same point. When the force is applied to
the spring upper portion (41) and the spring upper portion (41)
slides distally through the spring slot (20), the spring crimped
portion (40) bends perpendicular to the shaft (10). Because of the
elastic characteristics of the spring (38), the spring (38) will
move from a first relaxed position when no force is applied, to a
second tensioned position when force is applied.
[0035] It is anticipated that the spring will be made of metal or
plastic, where metal, as used herein, is intended to include any
metallic substance or compound containing a metallic substance, and
plastic, as used herein, is intended to include any of the numerous
organic, synthetic, or processed materials that are mostly
thermoplastic or thermosetting polymers. The spring may also be
made of one or multiple pieces that are cooperatively engaged in
order to effect the same results as a single spring piece. It is
intended that the spring (38), regardless of its material or the
number of pieces, have the inherent characteristic that causes it
to deform upon having a force applied to it, but elastically return
to its original shape after the force is removed.
[0036] The goal of the suture device is to have the needle (26)
extend parallel to the longitudinal axis (X-X) of the shaft (10).
Also due to the characteristics of the spring (38), when the spring
crimped portion (40) moves from the first position to the second
position, the apex of its bend will move perpendicularly to the
longitudinal axis (X-X). A needle receiver (28) is attached at the
apex of the bend in the spring crimped portion (40). Therefore,
because the apex of the bend in the spring crimped portion (40)
moves perpendicular to the longitudinal axis (X-X) of the shaft
(10), the needle receiver (28) will move perpendicularly as
well.
[0037] A needle (26) is removably attached at its second end (26B)
to the needle receiver (28). The needle's second end (26B) is
further attached to a suture (32) at a suture first end (32A). The
suture (32) extends out of the needle receiver (28) and a suture
excess portion (32C) may be removably inserted into a suture
chamber (22) in the shaft (10). If multiple needles (44A and 44B,
as shown in FIG. 2) are incorporated in the suture device, then the
suture first end (32A) is attached to the first needle (44A, as
shown in FIG. 2) and the suture second end (32B) is attached to the
second needle (44B, as shown in FIG. 2) with the suture excess
(32C) removably inserted in the suture chamber (22).
[0038] In order to more easily extend the shaft tip (18) and lower
shaft (16) (the distal end of the suture device) through the tissue
layer (2, as shown in FIGS. 3A, 3B, 3C, and 3D), the upper shaft
(12) may include a needle recess (24) that accepts the needle (26)
so that the needle (26) is held in the first position inside the
diameter of the shaft (10). In this manner, the needle (26) is less
likely to snag or catch on the tissue layer (2, as shown in FIGS.
3A, 3B, 3C, and 3D) when the shaft (10) is inserted through the
tissue layer (2, as shown in FIGS. 3A, 3B, 3C, and 3D). When the
extension means is moved from the first position to the second
position, the needle (26) is extended along with the needle
receiver (28) to a position outside the outer diameter of the shaft
(10). This exposes the needle first end (26A) for engagement with
the tissue layer (2, as shown in FIGS. 3A, 3B, 3C, and 3D).
[0039] FIG. 2. shows the suture device with a first needle (44A) in
the second tensioned position and a second needle (44B) in the
first relaxed position. As shown in this figure, multiple needles
(26) are shown as first needle (44A) and second needle (44B). The
second needle (44B) remains in the first position within the needle
recess (24). Conversely, the means for exerting force on the first
spring (38A) has been activated causing the first spring (38A),
first needle receiver (28A), and first needle (44A) to move to the
second position with the first needle (44A) outside of the needle
recess (24). Because it is anticipated that a surgeon may wish to
use a first needle (44A) and a second needle (44B) connected by a
common suture (32), that provision may be accommodated in an
embodiment of the suture device.
[0040] It is further anticipated that there may be other multiple
pairings of needles (26). In this manner, a paired first needle
(44A) and second needle (44B) would be joined by a common suture
(32) where the surgeon would be able to insert the distal portion
of the shaft (10) through the tissue layer (2, as shown in FIGS.
3A, 3B, 3C, and 3D) and into the body cavity (not shown), move the
suture device so as to choose an insertion point in the tissue
layer (2, as shown in FIGS. 3A, 3B, 3C, and 3D) for the first
needle (44A), then the means for activating the means for extending
is engaged and the first needle (44A) is moved from the first
position to the second position, and finally the first needle (44A)
is inserted into the tissue layer (2, as shown in FIGS. 3A, 3B, 3C,
and 3D). The first needle (44A) can then be disengaged from the
first needle receiver (28A) and the process is repeated for the
second needle (44B). Once both the first needle (44A) and the
second needle (44B) are engaged in the tissue layer (2, as shown in
FIGS. 3A, 3B, 3C, and 3D), the suture device can be removed leaving
the first needle (44A) and the second needle (44B) partially
exposed on the external surface of the tissue layer (2, as shown in
FIGS. 3A, 3B, 3C, and 3D). The surgeon can then pull out the first
needle (44A) and the second needle (44B) and draw together with the
suture (32) the wound in the tissue layer (2, as shown in FIGS. 3A,
3B, 3C, and 3D).
[0041] FIGS. 3A., 3B., 3C., and 3D. illustrate the use of the
present invention. In FIG. 3A., the distal portion of the shaft
(10) has been inserted through a wound or opening in the tissue
layer (2). If a cannula (not shown) was being used, then the
diameter of the shaft (10) would be sized to fit within the
aperture of the cannula (not shown). However, other than size
limitations, it is anticipated that the present invention could be
used with or without a cannula. In this first figure, the needles
(26) are in the first relaxed position as are the springs (38). As
previously described, the relatively larger diameters of the lower
shaft (16) and the upper shaft (12), as well as the needle recesses
(24) help resist unwanted catching or snagging of the tissue layer
(2) by any portion of the suture device.
[0042] In FIG. 3B., the first needle (44A) has been moved to the
second position. A comparison of FIGS. 3A and 3B illustrates how
the first spring crimped portion (40A) bends at the crimped member
(30) and the apex of the bend stays relatively perpendicular at the
second position shown in FIG. 3B as to the first position shown in
FIG. 3A. As a result, the first needle (44A) is held generally
perpendicular to the longitudinal axis (X-X) of the shaft (10).
This helps the surgeon because the first end (26A) of the first
needle (44A) will enter the tissue layer (2) at a generally known
point as opposed to if the first needle (44A) was held at an angle
or was curved, in which case, it is less intuitive for the surgeon
to be able to pick the insertion point of the first needle (44A). A
second benefit is that when the first needle (44A) exits the tissue
layer (2) on the external side, it will be at a known position
relative to the insertion point.
[0043] Once the surgeon has inserted the suture device into the
body cavity as shown in FIG. 3A, the surgeon then chooses a point
for insertion of the first needle (44A) and moves the suture device
relative to the tissue layer (2) in order to align the first
needle's (44A) first end (26A) with that chosen insertion point.
The surgeon then, using the means for activation, exerts pressure
on the first spring (38A) such that the first spring upper portion
(41A) slides through the spring slot (20) and causes the first
spring crimped portion (40A) to bend outwardly with the first
needle receiver (28A).
[0044] FIG. 3C. illustrates the insertion of the first needle (44A)
into the tissue layer (2). By pulling on the suture device, the
surgeon causes the insertion of the needle first end (26A) into and
through the tissue layer (2). The first needle (44A) is supported
in urging it through the tissue layer (2) by the first needle
receiver (28A). During this time, the second needle (44B) remains
in the first position protected from engaging the tissue layer (2)
by being held in the first position within the needle recess
(24).
[0045] FIG. 3D. illustrates the conclusion of the insertion of the
first needle (44A). Once the first needle (44A) is inserted through
the tissue layer (2), it may be grasped by the operator (surgeon)
with a conventional tool and pulled from first needle receiver
(28A) and the wound. Or, the suture device can be urged back into
the body cavity dislodging the first needle (44A) from the first
needle receiver (28A) leaving the first needle (44A) inserted
through the tissue layer. In either case, the suture first end
(32A) remains attached to the first needle (44A) passing back
through the fascia to the suture second end (32B) that is attached
to the second needle (44B). As the needles (44A and 44B) are
removed from the first and second needle receivers (28A and 28B),
the suture excess (32C) is pulled from the suture chamber (22).
After the first needle (44A) is dislodged from the first needle
receiver (28A), the means for activation can be disengaged and the
inherent elastic characteristics of the first spring (38A) cause it
to move from the second tensioned position to the first relaxed
position. Thus, the extension means will, if no force is exerted by
the activation means on it, move to and remain at rest in the first
relaxed position.
[0046] Once the first needle (44A) has been dislodged from the
first needle receiver (28A), the suture device can be repositioned
and the process repeated for the second needle (44B). The first
needle (44A) and the second needle (44B) can be drawn from the
tissue layer (2) and the wound in the tissue layer (2) closed by
the excess suture (32C). The surgeon then ties off the suture (32)
to hold the tissue layer (2) together. If multiple pairs of needles
(26) are used, then the process can be repeated for the requisite
number of times such that multiple sutures (32) are left with
multiple needles (26) and sutures (32) to close the wound.
[0047] Although the invention has been described with reference to
specific embodiments, this description is not meant to be construed
in a limited sense. Various modifications of the disclosed
embodiments, as well as alternative embodiments of the inventions
will become apparent to persons skilled in the art upon the
reference to the description of the invention. It is, therefore,
contemplated that the appended claims will cover such modifications
that fall within the scope of the invention.
* * * * *