Suture needle abstract
A suture needle instrument having improved connection means enabling
a hollow suture needled to be attached to a handle in a variety
of orientations. The suture needle is provided with user accessible
suture channels and suture advancing wheels to facilitate cleaning
Suture needle claims
What is claimed is:
1. In a suture passer comprising: a handle having an axis; a path
within said handle for guiding suture to a predetermined point;
a hollow needle having a lumen and attachable to said handle; user-operable
wheel means on said handle for engaging said suture at said predetermined
point and moving it into the lumen of said hollow needle; the improvement
comprising: connector means interposed between said handle and said
needle for attaching said needle to said handle in a selected one
of a plurality of predetermined rotational positions.
2. A suture passer according to claim 1 wherein said connector
means comprises: a recess in the distal end of said handle; a collar
axially aligned with and movably attached to the distal end of the
handle, said collar having a proximal end and a distal end and movable
between an open position, in which it can receive said hollow needle,
and a closed position in which it can hold the hollow needle to
said handle; a hub fixedly attached to the proximal end of said
hollow needle, said hub comprising: a body adapted to be received
in said recess; an axial bore within said body and aligned with
said lumen of said hollow needle and said predetermined point; and
a locking means adapted to be engaged by said collar when it is
in said closed position.
3. A suture passer according to claim 2 wherein said collar is
rotatably attached to said handle and rotatably movable between
said open and closed positions.
4. A suture passer according to claim 2 wherein said body is selectively
rotatable about the axis of said handle to a plurality of discrete
5. A suture passer according to claim 4 wherein said body comprises
a plurality of longitudinally extending grooves and wherein said
recess comprises: a peripheral wall; and a pin extending radially
inwardly from said peripheral wall, said pin adapted to slide longitudinally
within a selected one of said grooves while preventing rotation
of said body about said axis.
6. A suture passer according to claim 3 wherein said body has a
proximal end, a distal end and a first predetermined diameter and
further comprises a locking tab transversely affixed to the distal
end of said body, said locking tab having a generally rectangular
structure having a length greater than said first predetermined
diameter and a width less than or equal to said first predetermined
diameter; further comprising: a radially inwardly extending flange
situated at the distal end of said collar, said flange comprising:
an axially aligned circular aperture having a diameter adapted to
receive said body therethrough; and a pair of keyways extending
radially outwardly from said aperture and having a size to receive
therethrough said locking tab; whereby when said body is fully advanced
proximally through said aperture and said keyways, said collar may
be rotated a predetermined amount about said axis to cover said
locking tab and thereby lock said body to said handle.
7. A surgical instrument comprising: a hollow needle having an
axial lumen; a handle for being selectively attachable to said hollow
needle, said handle comprising: a sagittal planar surface within
said handle; a pair of wheels attached to said handle, each rotatable
about its own axis, with the axes of said wheels parallel to each
other, perpendicular to said saggital plane and spaced apart a predetermined
distance to enable the perimeters of said wheels to be adjacent
to each other at a first point; at least one first suture passageway
for guiding a suture from an aperture on the surface of said handle
to said predetermined point between said wheels, said first suture
passageway comprising a groove in said sagittal planar surface,
said groove extending between said aperture on the surface of said
handle and a second point adjacent and proximal to said first point.
8. A surgical instrument according to claim 7 further comprising:
a second suture passageway for guiding a suture from said first
point to said lumen of said hollow needle, said second suture passageway
comprising a groove in said sagittal planar surface extending between
a third point adjacent and distal to said first point and a fourth
point adjacent a recess adapted to receive said hollow needle, said
third point being longitudinally spaced a predetermined distance
distally from said second point.
9. A surgical instrument according to claim 7 further comprising
a wheel recess in said sagittal planar surface for receiving a portion
of each of said wheels.
10. A surgical instrument according to claim 9 wherein each wheel
is received within its own recess and wherein the recesses associated
with each wheel are open to each other in the plane of said wheels.
11. A surgical instrument according to claim 9 further comprising
a bore in said wheel recess for receiving therein an axis pin of
12. A surgical instrument according to claim 9 wherein each wheel
recess is deep enough to receive therein one half of the thickness
of the wheel to be received in the recess.
13. A surgical instrument according to claim 6 further comprising:
a cover for enclosing said wheels and said first suture passageway.
14. A surgical instrument according to claim 11 wherein said cover
is provided with recesses to receive the other portion of said wheels
and bores to receive the respective other ends of the axis pins
of said wheels.
15. A surgical instrument according to claim 13 wherein the outer
surface of said cover conforms to the adjacent surface of said handle.
Suture needle description
BACKGROUND OF THE INVENTION
 1. Field of the Invention
 The invention relates to devices used for suturing tissue
during surgical procedures. More particularly, the invention relates
to devices used to advance suture through tissue via a hollow needle
piercing the tissue to be sutured. Still more particularly, the
invention relates to suturing devices for use during endoscopic
 2. Background of the Prior Art
 Devices for facilitating the suturing of tissue during endoscopic
surgical procedures are commonly used. One such device is the Spectrum.RTM.
tissue repair system made by Linvatec Corporation. The system incorporates
a suture hook handle adapted to receive a variety of suture hooks,
i.e. hollow needles, each suture hook having a distal tip shaped
in varying ways. The suture hook handle is provided with a pair
of opposed suture advancing wheels, the perimeters of which are
covered with an elastomeric material. The wheels are aligned in
a common plane and rotatable about their respective axes which are
spaced a predetermined distance apart so that the perimeters of
the wheels may be adjacent or contiguous to each other. The suture
hook handle comprises a pair of diametrically opposed suture passageways
leading to the nip of the wheels so that a suture inserted into
a selected passageway is guided to the nip of the wheels and by
rotation of one of the wheels may be advanced through the lumen
of the selected needle.
 The various suture hooks are attachable to the suture hook
handle by means of an axially aligned recess at the distal end of
the handle, the recess being adapted to receive a complementarily
shaped hub attached to the proximal end of each suture hook. The
end wall of the recess has an axially aligned aperture to receive
suture from the nip of the wheels and guide it to the needle lumen.
Once a suture hook is assembled with the suture hook handle, it
is secured thereto by a transverse set screw which is advanced radially
into the recess to engage a dimple on the hub of the suture hook
to secure the hook to the handle.
 While offering significant advantages and facilitating the
suturing of tissue during endoscopic surgical procedures, the prior
art device is not easily disassembled for cleaning or repair and
does not allow reorientation of the suture hook during a surgical
procedure. Orientation of this prior art device is generally accomplished
by inserting a different suture hook rather than simply reorienting
the one currently in use. Accordingly, it is an object of this invention
to produce a suture hook system overcoming the disadvantages of
the prior art device.
 It is also an object of this invention to produce a suture
hook handle which is easily disassembled for cleaning or repair.
 It is also an object of this invention to produce a suture
hook system which enables the reorientation of a selected suture
hook during a surgical procedure.
SUMMARY OF THE INVENTION
 These and other objects of the invention are achieved by
the embodiments of the invention disclosed herein. In one aspect,
the invention comprises a suture passer comprising a handle having
an axis and a path within the handle for guiding suture to a predetermined
point. A hollow needle is attachable to the handle and a user-operable
wheel means is mounted on the handle for engaging the suture at
the predetermined point and moving it into the lumen of the hollow
needle. The hollow needle has a proximal hub which cooperates with
a collet on the distal end of the handle to produce a connector
means interposed between the handle and the needle for attaching
them together in a selected one of a plurality of predetermined
rotational positions. The connector means comprises an extension
member at the distal end of the handle, the extension having a recess
and a collar axially aligned with and rotatably attached to the
extension member. The collar has a proximal end and a distal end
and is rotatable between an open position, in which it can receive
the hollow needle, and a closed position in which it can hold the
hollow needle to the handle. A hub is fixedly attached to the proximal
end of the hollow needle, the hub comprising a body adapted to be
received in the recess and an axial bore within the body. The bore
is aligned with the lumen of the hollow needle and the predetermined
point when the needle is assembled with the handle. A locking means
is adapted to be engaged by the collar when it is in the closed
 In another aspect, the aforementioned handle comprises a
sagittal planar surface within the handle. A pair of wheels is attached
to the handle, each rotatable about its own axis, with the axes
of the wheels parallel to each other, perpendicular to the sagittal
plane and spaced apart a predetermined distance to enable the perimeters
of the wheels to be adjacent to each other at a first point. At
least one first suture passageway is provided for guiding a suture
from an aperture on the surface of the handle to the predetermined
point between the wheels. The first suture passageway comprises
a groove in the sagittal planar surface, the groove extending between
the aperture on the surface of the handle and a second point adjacent
and proximal to the first point.
BRIEF DESCRIPTION OF THE DRAWINGS
 FIG. 1 is a front perspective view of a suture hook handle
and suture hook constructed in accordance with the principles of
 FIG. 2 is a top plan view of FIG. 1.
 FIG. 3 is a right side elevational view of FIG. 1 showing
the suture hook handle in an open position.
 FIG. 4 is a view of FIG. 3 showing the suture hook handle
in a locked position.
 FIG. 5 is a front perspective exploded view showing the
various parts of the invention in relation to each other.
 FIG. 6 is a side elevational view of the suture hook system
shown in FIG. 1 with a cover portion removed from the handle.
 FIG. 7 is a cross-sectional view of FIG. 2 taken along the
 FIG. 8a is a side elevational view of a suture hook for
use with the suture hook handle shown in FIG. 1.
 FIG. 8b is a top plan view of FIG. 8a.
 FIG. 8c is a left end view of FIG. 8a.
 FIG. 8d is a left side perspective view of FIG. 8a.
 FIG. 9a is a side elevational view of a suture hook for
use with the suture hook handle shown in FIG. 1.
 FIG. 9b is a top plan view of FIG. 9a.
 FIG. 9c is a left end view of FIG. 9a.
 FIG. 9d is a left side perspective view of FIG. 9a.
 FIG. 10a is a side elevational view of a suture hook for
use with the suture hook handle shown in FIG. 1.
 FIG. 10b is a top plan view of FIG. 10a.
 FIG. 10c is a left end view of FIG. 10a.
 FIG. 10d is a left side perspective view of FIG. 10a.
BRIEF DESCRIPTION OF THE PREFERRED EMBODIMENT
 The suture hook system 10 as shown in the drawings comprises
handle 12 and suture hook 14. It will be understood that suture
hook 14 may be provided in a variety of lengths, diameters and needle
curves. Handle 12 is provided near its distal end with a pair of
rotatable wheels 16 and 18 which are mounted with their axes 20
and 22 parallel to each other and spaced apart symmetrically about
the handle axis 24. The wheels each have a perimeter which may be
covered with a polymeric or otherwise friction enhancing surface
26. The surface 26 may be ribbed or smooth, or may have a central
smooth band portion bounded by ribbed band portions. The wheels
are mounted in such a way that their perimetral surfaces contact
each other at the nip 28 of the wheels. In the preferred embodiment
nip 28 lies on axis 24. As will be understood below, rotation of
either one of the wheels 16 17 will cause rotation of the other
wheel and will cause suture 27 (situated between the wheels) to
be urged along suture path 29.
 Handle 12 is provided near its distal end 15 with a collar
30 which is adapted to rotate within a limited range about axis
24 in order to lock suture hook 14 to handle 12 as will be understood
 Collar 30 has a transverse distal end wall 32 in the form
of a radially inwardly extending flange defining a circular aperture
34 concentrically aligned about axis 24. Aperture 34 is further
provided with a pair of diametrically opposed keyways 36 38. As
will be explained below, keyways 36 and 38 facilitate the engagement
of suture hook 14 with handle 12.
 As will be noted in FIG. 5 collar 30 is situated over a
distal extension member 40 situated at the distal end 15 of handle
12. Extension 40 has a cylindrical external surface 41 and defines
a recess 42 for receiving a proximal portion of the suture hook
14 as will be explained below. Extension 40 further comprises a
pair of diametrically opposed throughbores 44 (only one of which
is shown in FIG. 5), each throughbore adapted to receive a guide
pin 46 which extends through the wall of the extension 40 and partially
into recess 42 (as best seen in FIG. 7). Extension 40 is also provided
on its exterior surface with a diametrically opposed pair of cam
tracks 50 (only one of which is shown in FIG. 5) which are slightly
helically situated about axis 24. When collar 30 is assembled with
handle 12 its peripheral wall 52 will cover extension 40 and collar
30 will be rotatably attached to the handle via diametrically opposed
pins 54 (only one of which is shown in FIG. 5) which extend through
wall 52 and into cam track 50. It will be understood that the two
ends of cam tracks 50 serve to limit the rotation of collar 30 about
axis 24 by virtue of the abutment of pins 54 against the ends of
the cam tracks 50.
 Suture hook 14 has a distal end 60 and a proximal end 62.
Distal end 60 is provided with a conventional hollow needle 64 having
a predetermined shape. It will be understood that the suture hook
system may be produced with suture hooks having a variety of distal
tip shapes. Proximal end 62 of suture hook 14 is provided with a
hub 66 comprising a body 68 of a given diameter and a transverse
locking bar 70 of a greater diameter. The suture hook 14 may comprise
a pair of concentric tubes as shown in FIG. 7 the outer tube serving
as reinforcement for the inner tube which defines the actual lumen
and needle tip. Body 68 is provided with a pair of diametrically
opposed and longitudinally extending channels 72 (best seen in FIGS.
8c and 8d). Transverse bar 70 is fixedly secured to the distal-most
end of body 68 and facilitates the engagement of suture hook 14
to handle 12.
 The method of attachment of suture hook 14 to handle 12
is best understood by reference to FIGS. 3 and 4. Prior to assembly
of suture hook 14 with handle 12 the collar 30 is placed in an
open or unlocked position as shown in FIG. 3. This enables aperture
34 to receive body 68 and further enables keyways 36 and 38 to receive
transverse bar 70. As body 68 is moved further proximally into recess
42 the distal most surface 76 of transverse bar 70 will be situated
proximal to the proximal side of flange 32 of collar 30. To accomplish
this of course suture hook 14 must be rotated about axis 24 to align
transverse locking bar 70 with keyways 36 and 38 while also aligning
longitudinal grooves 72 with guide pins 46. When suture hook 14
is properly seated, collar 30 may be rotated from its open position
shown in FIG. 3 to its locked position shown in FIG. 4 thereby
retaining transverse bar 70 behind flange 32 and securing suture
hook 14 to handle 12. As collar 30 is rotated from the open to the
locked position, locking pins 54 slide within their respective grooves
50 to urge collar 30 slightly proximally to enhance the force with
which flange 32 presses against the opposing ends of transverse
bar 70. The degree of force thus exerted by collar 30 on transverse
bar 70 may be varied by changing the pitch of the helical tracks
50. It will be further understood that the ends of the tracks near
the locked position of collar 30 may be transverse rather than helical
or may be provided with some other shape in order to securely lock
collar 30 in place.
 It will be understood that suture hook 14 may be easily
repositioned to a different rotational position during a surgical
procedure by momentarily disengaging it from handle 12 rotating
it 180.degree. about axis 24 and reattaching it.
 Referring now to FIGS. 1 2 and 6 it is noted that handle
12 is provided with a removable cover 80 which comprises a portion
of the outer surface of handle 12. The purpose of cover 80 is to
enable handle 12 to have an ergonomically favorable external shape
while also enabling handle 12 to be structured internally in such
a way as to facilitate cleaning and repair of handle 12.
 As best seen in FIG. 6 handle 12 is provided with a sagittal
planar surface 82 aligned along axis 24 and extending transversely
across the body of handle 12. In the preferred embodiment, handle
12 is further provided with a pair of recesses 84 and 86 which are
adapted to receive wheels 16 and 18 respectively. (Alternatively,
one recess could be adapted to retain both wheels.) Each wheel has
an axis pin 88 which extends a predetermined distance transversely
along the axis 20 of each wheel. Accordingly, recesses 84 and 86
are each provided with a central bore 89 for receiving axis pins
88 of each wheel. As best seen in FIG. 2 the bores 89 for receiving
axis pins 88 extend into the body of handle 12 and into the cover
80. It will be understood that the depths of recesses 84 and 86
are preferably such as to receive one half the thickness of wheels
16 and 18. Symmetrical recesses are formed in cover 80 in order
to enable wheels 16 and 18 to be aligned with axis 24 as best seen
in FIGS. 2 3 and 4.
 Sagittal planar surface 82 is also provided with a pair
of suture guiding channels 90 and 92 which extend between diametrically
opposed openings 94 and 96 on the surface of handle 12 and a point
adjacent and proximal to the nip 28 of the wheels 16 and 18. While
a pair of suture guiding channels is provided in the preferred embodiment,
this is to enable both right and left handed use of the device.
Alternatively, only one channel may be provided. Sagittal planar
surface 82 may also be provided with a channel 98 extending between
a point adjacent to and distal to the nip 28 of the wheels and the
proximal side of recess 42. It will be noted that the inside surface
of cover 80 that is the surface which lies against saggital planar
surface 82 when cover 80 is assembled with handle 12 need only
be provided with recesses to receive axis pins 88. In the preferred
embodiment, however, the cover is also provided with recesses 100
adapted to receive those sides of the wheels which are not received
within recesses 84 and 86. That is, inside surface of cover 12 need
not be provided with any grooves for guiding suture. It will be
sufficient if grooves 90 and 92 are sufficiently large to accept
the desired size suture. Alternatively, of course, passageways 90
and 92 may be formed by symmetrical and cooperating semi-circular
grooves formed in sagittal planar surface 82 and the inside surface
of cover 80. Additionally, while openings 94 and 96 are shown to
be on the side of the handle, it will be understood that a single
opening could be provided at the back of the handle so that the
channel leading the suture to the nip of the rollers could be coaxial.
The path followed by the suture is sometimes referred to herein
as suture path 29.
 The suture hook 14 shown in FIGS. 1 through 7 is shown in
greater detail in FIGS. 8a through 8d. As noted, body 68 of suture
hook 14 comprises a pair of diametrically opposed grooves 72. An
alternative embodiment of a suture hook is shown in FIGS. 9a through
9d as suture hook 114 which comprises four straight and equiangularly
spaced longitudinal grooves 172 thus enabling four discrete orientations
of suture hook 114 about axis 24. Further embodiment of a suture
hook is shown in FIGS. 10a through 10d as suture hook 214 having
four equiangularly spaced longitudinal grooves 272 each of which
is provided with a J-hook at its distal-most end to enable the suture
hook to be locked to a suture hook handle without the need for a
collar such as collar 30.
 The proximal hubs of each of the suture hook embodiments
are shown with a cylindrical configuration, the axis of body 68
being aligned with axis 24. It will be understood that body 68 may
be made rectilinear so that its cross-section (transverse to axis
24) could be polygonal.
 While collar 30 and its operation with locking tab 70 have
been shown as a rotary embodiment, it will be understood that the
invention could be redesigned as a linear embodiment in which the
opening and closing of a locking mechanism could be effected by
moving a collar longitudinally along the handle axis. For example,
a quick lock mechanism could be used with a collar cam arrangement
moving a plurality of circumferentially spaced fingers into and
out of engagement with a groove on the hub of the needle.
 Wheels 16 and 18 have been described as having their perimetral
surfaces in contact with each other. It will be understood that
the degree of contact is dependent upon the softness of the perimeter
surface and the size of suture to be advanced. In some instances,
contact may be unnecessary if the suture is large enough and the
surface is able to "grip" the suture enough to advance
it as one or both wheels roll. Thus, it is sufficient for the wheel
perimeters to be adjacent to each other, it being understood that
the term "adjacent" may require contact so the suture
may be squeezed sufficiently to be advanced.
 It will be understood that numerous other modifications
and improvements may be made to the preferred embodiment of the
invention disclosed herein without departing from the spirit and