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WO1997037594A1 - Dispositif pour suture sous laparoscopie et aiguilles de suture - Google Patents

Dispositif pour suture sous laparoscopie et aiguilles de suture Download PDF

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Publication number
WO1997037594A1
WO1997037594A1 PCT/US1996/001789 US9601789W WO9737594A1 WO 1997037594 A1 WO1997037594 A1 WO 1997037594A1 US 9601789 W US9601789 W US 9601789W WO 9737594 A1 WO9737594 A1 WO 9737594A1
Authority
WO
WIPO (PCT)
Prior art keywords
suture
wings
tube
suture needle
needle holder
Prior art date
Application number
PCT/US1996/001789
Other languages
English (en)
Other versions
WO1997037594A9 (fr
Inventor
Robert J. Greenstein
Original Assignee
Greenstein Robert J
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 Greenstein Robert J filed Critical Greenstein Robert J
Priority to AU59176/96A priority Critical patent/AU5917696A/en
Priority to PCT/US1996/001789 priority patent/WO1997037594A1/fr
Priority to EP96916426A priority patent/EP0836422A4/fr
Publication of WO1997037594A1 publication Critical patent/WO1997037594A1/fr
Publication of WO1997037594A9 publication Critical patent/WO1997037594A9/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B17/06004—Means for attaching suture to needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00637—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for sealing trocar wounds through abdominal wall
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00646—Type of implements
    • A61B2017/00663—Type of implements the implement being a suture
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/047—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/0472—Multiple-needled, e.g. double-needled, instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06042—Means for attaching suture to needle located close to needle tip

Definitions

  • This invention is in the field of laparascopic suturing devices and suturing needles used therewith, and surgical techniques for closure of trochar holes and other openings and wounds particularly in abdominal surgery.
  • Deep Suture is a needle holder made by REMA® Medizintechnik GmbH of Germany, D-7201 Durbheim-Tuttlingen, Inumblen 10 Germany. It is believed that a German patent corresponding to this device is DE 42 10 724 CI, a copy of which in German is attached hereto as Appendix A and incorporated herein by reference.
  • the prior device has a central shaft with proximal and distal ends. Extending through the shaft is a rotatable rod having a control handle at the proximal end and a drive gear at the distal end. A pair of driven gears are positioned at the periphery of the drive gear at opposite sides thereof, each driven gear coupled to an arm or wing that pivots radially outward from the shaft when the control handle is turned. Each wing includes a recess or blind hole for receiving the proximal end of a suture needle.
  • a single strand of suture material has its ends threaded through the eye of each of the needles, the suture then extending as a double strand from each needle.
  • the proximal ends of the needles are then inserted in the wings, and the wings are pivoted to their retracted position whereby they and the needles are radially inward of the outer cylindrical boundary established by the central shaft.
  • an axial groove is provided in the shaft into which each needle can move.
  • the device with wings retracted, is inserted down into the opening in the abdominal wall produced by a trocar. During insertion the suture is dragged down.
  • the wings When adequately inserted downward the wings are pivoted to open position exposing the needles now pointing upward.
  • the shaft is withdrawn until the needles pierce the wall and protrude out of the wall.
  • These needles are engaged individually by a clamp, forceps or a needle holder or by a clamping device movable axially on the shaft and drawn through the tissue, pulling the suture until it forms a loop beneath the opening.
  • the wings, now empty of needles, are pivoted closed, and the shaft is extracted from the opening. The needles are cut off the suture ends and the suture is tied.
  • the new invention provides in combination an improved needle and improved insertion device with a groove in the distal end of the central shaft.
  • Each needle has a groove in its side wall to receive one end of the suture which is secured therein, as by swedging.
  • the grooves in the needles are preferably inclined downward. The suture exits the groove oriented angularly downward toward the proximal end of the needle which is also in the direction toward the wing and toward the distal end of the central shaft.
  • Fig. 2A is an elevation of the new device
  • Figs. 2B, 2C, and 2D are fragmentary elevations of the distal end of the device at different stages.
  • Fig. 4 is a sectional view taken along line 4-4 in Fig. 3, with the wings closed.
  • Fig. 5 is a sectional view similar to Fig. 4 with the wings open.
  • Figs. 7 and 8 are fragmentary front and side views of the needle of Fig. 6.
  • Fig. 9 is a fragmentary' front view shown schematically of a needle with a groove swedged closed capturing the end of a suture.
  • Fig. 10 is a schematic view of the new device when inserted and the wings are open.
  • Fig. 1 shows a first embodiment 10 of the new suturing device including the central shaft 12 with proximal end 13 and distal end 14. At the proximal end is handle 15 and control knob 16. At the distal end are wings 17, grooves or channels 18 corresponding in length to the needles to receive the needles and guide notch 19. In handle 15 is a cleaning port 20. Along the length of shaft 12 is a depth gage 21. Also shown are needles 21 and suture 22 positioned for insertion into blind holes 23 in the wings.
  • Fig. 2A shows device 10 oriented upside down relative to Fig. 1, with the wings 17 in fully closed condition;
  • Fig. 2B shows the distal end 19 of the device with the wings partially open;
  • Fig. 2C shows the distal end with the wings fully open; and
  • Fig. 2D shows the distal end with the suture 22 lying in groove 19.
  • Figs. 3 and 4 show a typical drive mechanism 30 for the new device, the components thereof corresponding generally to the device of Figs. 1 and 2A.
  • the shaft 31 has a distal end 34 with the suture guide groove 36 shown in dotted line.
  • Through shaft 31 is drive rod 32 coupled to drive gear 41 which is further coupled to driven gears 39, each of which is secured to a wing 37.
  • Needles 42 are removably situated in blind holes 38 in the wings.
  • the wings in closed position are designated by 37' in Fig. 3 along with needles 42' in closed position.
  • Driven gears 39 revolve on pivots 40.
  • Figs. 6-16 show a new needle 45 with its groove 46 and end 47 of suture 48 swedged therein.
  • the groove 46 may extend to various depths or as a blind hole for receiving the end of the suture.
  • the groove and/or hole may be formed by cutting, lancing, forging or other techniques.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne une aiguille de suture (45) chirurgicale constituée d'une tige de forme allongée se définissant par une première extrémité s'affinant en une pointe, par une seconde extrémité et par une partie médiane. Dans la partie médiane se trouve une rainure (46) axialement alignée menant à un trou aveugle dans lequel une suture (48) chirurgicale est retenue de façon fixe. L'invention concerne également un porte-aiguille (10) constitué d'un tube (31) de forme allongé comportant une cavité interne et une face distale (35) arrondie. Une rainure externe (36) présente une profondeur suffisante pour y retenir une suture. Le porte-aiguille de suture comporte également, au voisinage de l'extrémité distale, une paire d'ailettes (37), chaque ailette étant fixée en l'une de ses extrémités au tube par un pivot, l'autre extrémité de chaque ailette étant pourvue d'un dispositif de fixation d'aiguille (38). Pour commander le mouvement de pivotement des ailettes, le porte-aiguille de suture comporte en outre un organe de commande (32) raccordé à la paire d'ailettes.
PCT/US1996/001789 1996-03-08 1996-03-08 Dispositif pour suture sous laparoscopie et aiguilles de suture WO1997037594A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
AU59176/96A AU5917696A (en) 1996-03-08 1996-03-08 Laparascopic suturing device and suture needles
PCT/US1996/001789 WO1997037594A1 (fr) 1996-03-08 1996-03-08 Dispositif pour suture sous laparoscopie et aiguilles de suture
EP96916426A EP0836422A4 (fr) 1996-03-08 1996-03-08 Dispositif pour suture sous laparoscopie et aiguilles de suture

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US1996/001789 WO1997037594A1 (fr) 1996-03-08 1996-03-08 Dispositif pour suture sous laparoscopie et aiguilles de suture

Publications (2)

Publication Number Publication Date
WO1997037594A1 true WO1997037594A1 (fr) 1997-10-16
WO1997037594A9 WO1997037594A9 (fr) 1997-12-31

Family

ID=22254703

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1996/001789 WO1997037594A1 (fr) 1996-03-08 1996-03-08 Dispositif pour suture sous laparoscopie et aiguilles de suture

Country Status (3)

Country Link
EP (1) EP0836422A4 (fr)
AU (1) AU5917696A (fr)
WO (1) WO1997037594A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2465631A (en) * 2008-11-28 2010-06-02 Orthomimetics Ltd Arthroscope with depth gauge
JP2010136733A (ja) * 2008-12-09 2010-06-24 Hirohito Yoshida 内視鏡用縫合装置及び内視鏡用縫合装置を用いて行う胃壁切開部縫合方法
WO2012068005A1 (fr) * 2010-11-15 2012-05-24 Ethicon Endo-Surgery, Inc. Aiguille pour dispositif de suture laparoscopique
CN107661127A (zh) * 2013-02-22 2018-02-06 益安生医股份有限公司 用于经皮缝线传递的系统及方法
CN114424954A (zh) * 2022-03-07 2022-05-03 重庆市北碚区中医院 一种腹腔穿刺缝合器

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3799169A (en) 1972-05-11 1974-03-26 Ethicon Inc Lateral release suture
DE4210724C1 (en) 1992-04-01 1993-07-22 Rema-Medizintechnik Gmbh, 7201 Duerbheim, De Surgical instrument with expander in shaft portion - has expanding member mounting eccentrical on pinion meshing with central gear on shaft passing through stem
US5403329A (en) * 1992-09-23 1995-04-04 United States Surgical Corporation Instrument for closing trocar puncture wounds
US5437680A (en) * 1987-05-14 1995-08-01 Yoon; Inbae Suturing method, apparatus and system for use in endoscopic procedures

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5368601A (en) * 1992-04-30 1994-11-29 Lasersurge, Inc. Trocar wound closure device
US5364408A (en) * 1992-09-04 1994-11-15 Laurus Medical Corporation Endoscopic suture system
US5374275A (en) * 1993-03-25 1994-12-20 Synvasive Technology, Inc. Surgical suturing device and method of use
EP0668056A1 (fr) * 1994-02-22 1995-08-23 SMITH & NEPHEW DYONICS INC Sonde de suture

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3799169A (en) 1972-05-11 1974-03-26 Ethicon Inc Lateral release suture
US5437680A (en) * 1987-05-14 1995-08-01 Yoon; Inbae Suturing method, apparatus and system for use in endoscopic procedures
DE4210724C1 (en) 1992-04-01 1993-07-22 Rema-Medizintechnik Gmbh, 7201 Duerbheim, De Surgical instrument with expander in shaft portion - has expanding member mounting eccentrical on pinion meshing with central gear on shaft passing through stem
US5403329A (en) * 1992-09-23 1995-04-04 United States Surgical Corporation Instrument for closing trocar puncture wounds

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP0836422A4 *

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2465631A (en) * 2008-11-28 2010-06-02 Orthomimetics Ltd Arthroscope with depth gauge
JP2010136733A (ja) * 2008-12-09 2010-06-24 Hirohito Yoshida 内視鏡用縫合装置及び内視鏡用縫合装置を用いて行う胃壁切開部縫合方法
WO2012068005A1 (fr) * 2010-11-15 2012-05-24 Ethicon Endo-Surgery, Inc. Aiguille pour dispositif de suture laparoscopique
US9125646B2 (en) 2010-11-15 2015-09-08 Ethicon Endo-Surgery, Inc. Needle for laparoscopic suturing instrument
US9844366B2 (en) 2010-11-15 2017-12-19 Ethicon Endo-Surgery, Llc Needle for laparoscopic suturing instrument
CN107661127A (zh) * 2013-02-22 2018-02-06 益安生医股份有限公司 用于经皮缝线传递的系统及方法
CN114424954A (zh) * 2022-03-07 2022-05-03 重庆市北碚区中医院 一种腹腔穿刺缝合器

Also Published As

Publication number Publication date
AU5917696A (en) 1997-10-29
EP0836422A4 (fr) 2000-08-16
EP0836422A1 (fr) 1998-04-22

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