Suture needle abstract
A surgical instrument for holding a suture needle is disclosed.
The instrument is of scissors configuration with elongated arms
having finger loops at one end and jaws at the other end to grasp
a suture needle. This improved instrument has specialized jaws containing
a transverse channel that securely holds a suture needle at a right
angle to the axis of the needle holder. The width of the transverse
channel automatically adjusts to the size of the suture needle as
it is being placed in the needle holder. This improved configuration
significantly reduces the long standing problem of suture needle
twisting or rotation in the needle holder jaws as the surgeon passes
the needle through tissue.
Suture needle claims
1. A suture needle holding surgical instrument comprising:
first and second elongated members, each of which form finger loops
at a first end and jaws to hold a suture needle at a second end;
said first and second elongated members being pivotally mounted
in a scissors configuration;
at least one jaw with a specialized transverse channel in an inner
a sliding member; and
a biasing member associated with said sliding member and said at
least one jaw, for moving said sliding member to adjust the width
of said transverse channel in response to the introduction of a
suture needle into said transverse channel.
2. An instrument of claim 1 wherein the instrument includes a ratchet
locking mechanism for holding the jaws in a pivotally closed position.
3. An instrument of claim 1 wherein said transverse channel includes
a floor having at least one transverse ridge for mating with a corresponding
groove in a suture needle surface.
4. An instrument of claim 3 wherein both said first and second
elongated members have a specialized transverse channel including
a floor having at least one transverse ridge in said channel.
5. An instrument of claim 1 wherein inner surfaces of the needle
holder jaws not defining said transverse channel are of a serrated
6. An instrument of claim 1 wherein said sliding member and entire
jaw on the end of the first elongate member as well as the entire
jaw on the end of the second elongate member are removable.
Suture needle description
FIELD OF THE INVENTION
The subject invention relates generally to surgical instruments,
and more particularly to a holding instrument, for a suture needle.
BACKGROUND OF THE INVENTION
It is common surgical practice for a physician to join various
tissues by passing a needle with attached suture through the tissue.
The suture is then tied to approximate the tissues. There are several
prior art plier-like instruments available for gripping and holding
suture needles. A conventional instrument for passing the needle
through the tissues is a needle holder which usually has a pair
of movable, opposed jaws connected to a pair of handles. The handles
in turn have a scissor configuration with a locking ratchet mechanism
to maintain gripping pressure on the needle held in the jaws of
the needle holder.
Needle holder jaws commonly have a tungsten carbide, serrated surface
in a diamond or cross-hatched pattern to enhance the firmness with
which the needle is grasped. The ratchet mechanism between the scissor
handles is locked as the handles close thereby maintaining firm
gripping pressure on the suture needle. Despite this construction,
needles are frequently subject to twisting or slipping in the jaws
of needle holders as they pass through tissue. Normally the surgeon
releases the ratchet mechanism only after the needle has safely
passed through the tissue. If during passage of the suture needle,
the needle twists or moves off the desired axis of travel, tissue
may be torn, needles may be lost, and the operation time prolonged.
Twisting movement of a suture needle in the needle holder jaw is
a frustrating and dangerous problem which has not been solved by
SUMMARY OF THE INVENTION
It is an object of the present invention to provide a surgical
needle holder that securely holds a suture needle as it passes through
tissue. It is an object to minimize slipping or twisting of the
suture needle in the jaws of the needle holder as the needle passes
through tissue. Prior art has not solved the long standing problem
of unwanted motion of the suture needle while still in the grasp
of the needle holder.
The present invention consists of a surgical needle holder with
finger-loop handles which have a ratchet locking mechanism connected
to two elongated scissoring members that in turn define specialized
opposing jaws that hold the suture needle. In this improved invention
the jaws of the needle holder have a distal transverse channel that
securely hold the suture needle at a right angle as it passes through
tissue. The transverse channel in the needle holder jaw is of adjustable
width to accomodate suture needles of different size. The width
is easily adjusted during a surgical procedure, so that needles
of various width can be accommodated without changing needle holders.
In addition, the floor of the transverse channel is of ribbed design
to mate with the surface of the suture needle.
Both jaws of the needle holder have a mirror-imaged adjustable
transverse channel design, so there is no top or bottom orientation
required for the needle holder. The needle holding transverse channel
adjusts to the diameter of the needle by a biasing sliding member
of the needle holder jaw. This design allows quick placement of
the needle in the holder and maintains proper, secure alignment
of the needle at right angles to the jaws of the needle holder.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a side view of the subject needle holder showing a suture
needle positioned in the specialized transverse channels 28 30.
FIG. 2 is a cross section of the needle holder jaw showing the
longitudinal grooves in which the top sliding member 38 moves.
FIG. 3 is a top view of the needle holder jaw showing the sliding
member 38 distal transverse channel 28 and proximal spring compartment
FIG. 4a is an oblique view of the needle holder jaw showing the
transverse channel 28 with varying width maintained by sliding member
FIG. 4b is a cross section of the preferred suture needle.
FIG. 5 is a side view of the transverse channel with a small suture
FIG. 6 is a side view of the transverse channel with a large suture
FIG. 7 is a side view of the needle holder jaw showing the removable/disposable
feature for the entire jaw mechanism.
DETAILED DESCRIPTION OF THE INVENTION
FIG. 1 shows the needle holding instrument of the present invention
with the embodiment of a specialized distal transverse channel in
the jaws of the needle holder to securely grasp a suture needle.
The needle holder 14 is preferably constructed of surgical stainless
At the proximal end finger loops 16 and 18 are of a size to accept
thumb or finger within the loop. The finger loops are in turn connected
to elongated arms 6 and 8.
Protruding at or near the junction of the finger loops 16 18 and
the elongated arms 6 8 is a conventional locking ratchet mechanism
22. The ratchet lock 22 consists of two short members, at the junction
of the finger loops with the elongated arms, and perpendicular to
the arms of the needle holder. These members have matching notches
on their opposing surfaces which engage one another, locking, as
the finger loops are brought together. Such locking ratchet mechanism
is well known to the art.
The elongated arms are of equal length and terminate at a pivot
joint 20. Conventionally the pivot joint 20 is constructed such
that the elongated arms of the needle holder terminate in a short,
flat, widended area. Any pivot method can be used, traditionally,
the flat area of one arm passes thru a matched opening in the other
arm with both being united to one another by a pin passing through
the center of the flat zone. Both arms pivot about this pin establishing
the scissors action of the needle holder. This configuration allows
the distal jaws to be centered on one another rather than offset
as is the case with the usual cutting scissors. The elongated arms
for open surface surgery are shorter than those in the case of laparoscopic
The finger loops and elongated arms allow the surgeon to grasp
the instrument and apply pressure to close it. Once closed, the
ratchet mechanism locks to maintain the closed position. The ratchet
mechanism is opened by the surgeon applying opposing pressure to
the finger loops. The pivot joint allows for ease of opening and
closing the jaws 10 and 12. The needle holder jaws taper in both
width and heigth to a terminal, rounded point. This pointed tip
allows for good directional placement and visualization of needle
position by the surgeon using the instrument.
The needle holding jaws with opposed surfaces 24 and 26 contain
specialized transverse channels 28 and 30 shown in greater detail
in FIGS. 2-4. The width of the transverse channel varies by means
of sliding member 38. Construction of the needle holder jaws is
of surgical stainless steel. Alternatively the jaws may be made
of high impact plastic to afford a disposable nature to this functional
section of the surgical instrument. This would allow for cleaning
and sterilizing the reusable parts and for discarding the jaws in
the case of fatiqued surfaces that no longer securely grasp the
FIG. 2 is a section across one needle holder jaw. The sliding member
38 is of surgical stainless steel or tungsten carbide construction.
All stainless steel or tungsten carbide parts can be sterilized
and re-used. Alternatively, it is made of high impact plastic for
disposable application. The sliding member 38 is rectangular in
shape and comprises a major portion of the needle holder jaw. The
surface of the sliding member is preferably finished in a serrated
or cross-hatched pattern. This provides an alternative grasping
surface for a needle or suture (the latter being the case when the
needle holder is used to tie the suture). The sliding member moves
back and forth as constrained by longitudinal grooves 40. The longitudinal
grooves are provided in the side of the needle holder jaw to a depth
to securely hold tabs 46 and 48. Two or more tabs 46 and 48 which
are part of the rolled over edge of the sliding member maintain
the sliding member in position on the needle holder jaw. The motion
of the sliding member back and forth in the longitudinal grooves
40 allows for variation in the width of the transverse channel described
in FIG. 1 and 5-7.
FIG. 3 is a detailed top view of the needle holder jaw. In the
pictured embodiment the sliding member 38 moves in the longitudinal
grooves 40 by means of four tabs 46 48 50 52. These tabs are
introduced and removed through vertical openings 56 58 60 62
in the side of the needle holder jaw to allow the tabs to enter
the longitudinal groove 40. Once seated in the groove the sliding
member is held in position by a biasing spring 42 such as a leaf
spring, in proximal compartment 44. The leaf spring is held in place
in the compartment by one fitting the ends into spring locating
grooves in the end wall of the compartment. This prevents the spring
from inadvertant dislocation from the compartment. The spring 42
exerts moderate forward pressure on the sliding member 38. The amount
of forward pressure is such that a suture needle can be easily placed
into transverse channel 28 and the sliding member 38 move to accomodate
the size of the needle.
Once the needle is in the transverse channel and the needle holder
jaws are closed, the sliding member is firmly held in place against
the needle both by the biasing member and by the closing force of
opposing jaws. In a preferred embodiment, the suture needle is further
securely held in position in the transverse channel 28 by virtue
of one or more transverse ribs or elevations 66 in the floor of
the transverse channel. These ribs mate with corresponding longitudinal
grooves in the surface of the suture needle as will be described
in more detail with referance to FIGS. 4-7. The surfaces of the
needle holder jaw not involved with the transverse channel are preferably
of a serrated or cross hatched design to allow for alternate needle
FIG. 4a is an oblique view of a preferred embodiment of the needle
holder jaw. The sliding member 38 is positioned such that in a resting
state there is a 1.5 mm opening at the front of the transverse channel
28. This allows ease of placement of a suture needle as it seats
directly in this opening. If the diameter of the needle is larger
than 1.5 mm the sliding member moves back to allow full seating
of the larger diameter. As the sliding member moves back there is
compression of the spring 42 in compartment 44.
The sliding member 38 can be removed and replaced in position by
compressing the spring 42 with maximum pressure pushing it back
until tabs 46 48 50 52 meet four matching vertical openings 56
58 60 62 in the upper edge of the longitudinal grooves 40. The
motion is to push the sliding member back as far as possible so
that the tabs engage the vertical openings and the sliding member
can be lifted up and free. The reverse motion allows replacement
of the sliding member in the needle holder jaw.
The opening of the spring compartment 44 is covered by an extension
54 of the sliding member 38. In addition, there is an inferior small
projection 64 of the sliding member 38 which is in contact with
and holding the spring 42 in functional position.
The depth of the transverse channel 28 is approximately 1 mm. In
the floor of the transverse channel 28 there are one or more transverse
triangular ridges or elevations 66 which are designed to engage
longitudinal grooves 68 on the surface of the suture needle 70.
The preferred cross-section of the suture needle is depicted in
FIG. 4b. This configuration allows the suture needle 70 to seat
in the transverse channel 28 and maintain its position at a right
angle to the axis of the needle holder jaws. In surgical applications
the needle must maintain its location in the needle holder as it
passes through tissue. Any motion of the suture-needle from the
desired right angle results in lost time or a lost needle in addition
to the potential damage of tissue by unwanted needle motion.
FIG. 5 shows the side view of the needle holder jaw with a suture
needle 70 in position in the transverse channel 28. This needle
is fairly small resulting in opening of the sliding member 38 only
a minimal amount. FIG. 6 depicts a larger needle in the transverse
channel 28 resulting in an increased opening of the sliding member
38. Note that in both FIG. 5 and 6 there is mating of the transverse
ridges 66 in channel 28 with the grooves 68 in the needle 70 surface.
This provides a secure grasp of the needle 70. The firm positioning
of the suture needle 70 is further enhanced by the closed approximation
of the opposed needle holder jaws 10 12 that aid in maintaining
the sliding member 38 against the seated needle 70. There are three
separate constraints being applied simutaneously to the suture needle
to maintain its position in the transverse channel 28. First, the
transverse ridges 66 in the channel are mating with the grooves
68 in the surface of the suture needle 70 to inhibit lateral movement.
Second, the forward pressure of biasing by the sliding member 38
on the needle maintains the needle in the transverse channel 28.
The third force is the pressure of the closed jaws 10 12 of the
needle holder 14 on each other which is maintained by the locked
ratchet mechanism 22. This last force is additive to the first two
by maintaining the sliding member 38 firmly against the needle 70
and by keeping the needle 70 seated on the transverse ridges 66
in the transverse channel 28. Generally the needle 70 will seat
in the lower jaw as the convex surface of the needle is pushed into
place in the needle holder jaw. Both jaws 10 12 are the same, so
the upper transverse channel 30 facing the concave surface of the
needle will also be utilized if the needle is thick enough to activite
the sliding member 38. With a suture needle 70 properly seated the
opposing surfaces 24 and 26 of the needle holder jaws will be in
Alternatively, depending on the size of the needle holder 14 and
the suture needle 70 being used, only one jaw of the needle holder
14 might have the specialized transverse channel 28 herein described.
The opposing needle holder jaw surface 24 26 would be of flat,
conventional design without a transverse channel 28. This may require
a top/bottom designation to the needle holder jaws 10 12 for ease
of use. This can be done by marking the needle holder handles or
color coding the transverse channel 28 for quick orientation. In
addition, it is possible that in small needle holder, applications
that there would not be a sliding member 38 in the design. This
would require the width of the transverse channel 28 in the needle
holder jaw to be of a fixed dimension. Thusly, in this situation
suture needles 70 of only one size would fit into the transverse
channel 28. This configuration may be desirable in needle holders
for fine vascular or ophthalmologic surgery.
Construction of the improved needle holding instrument is of surgical
stainless steel or tungsten carbide. Alternately, the specialized
jaws may be constructed of high impact plastic and designed to be
disposible and replaceable, as a unit on the needle holder. FIG.
7 shows a side view of a disposable configuration in which the entire
jaw mechanism can be removed from the needle holder. There is a
central longitudinal support 72 extending forward from the needle
holder pivot joint 20. The jaw mechanism with specialized transverse
channel 28 fits over the longitudinal support 72 and snaps in place.
This is done by means of a tongue and groove joint 74 at the distal
portion and a snap-lock 76 at the proximal end of the needle holder
jaw. The tongue and groove joint 74 has an angled projection of
metal from the support 68 which fits into an angled groove in the
inner surface of the disposable jaw insert. The snap-lock mechanism
76 consists of a transverse spring on the jaw, the ends of which
fit into corresponding grooves in the longitudinal support 72 as
the jaw is pressed into position. The motion to place the jaw insert
is to engage the distal tongue and groove joint 74 first then press
the rear of the jaw down to allow the spring ends to snap into place
in the grooves in the longitudinal support 72. To remove the disposable
needle holder jaw insert, the proximal snap-lock joint 76 must be
disengaged on one side with an instrument then the insert can be
lifted up and off the longituidal support.
The above described embodiment of the invention is the preferred
form. However, it is understood that changes in the design construction
may be made without departing from that which is herein claimed.
For example, the transverse channel 28 may be placed at an angle
other than a right angle to the axis of the needle holder for certain
surgical applications. The needle 70 may be more or less curved,
or may be straight. The needle grooves 68 and ridges 66 may be triangular,
squared, rounded or eccentric. The spring 42 may be a leaf or coiled
spring. The sliding member 38 may provide no tabs, 2 tabs, 4 tabs,
or the like. Substitute materials may be used.