Suture needle abstract
A suture needle manipulating device having an elongated substantially
cylindrical shaft. A slot for receiving a suture needle is configured
in a distal end of the shaft, and a handle is suitably affixed to
a proximal end of the shaft. In addition, the needle manipulating
device includes a slidable sheath assembly affixed around the shaft
and is configured to engage the suture needle when it is in an initial
retracted position. When the needle is in the retracted position,
the device with the needle can be inserted through an endoscopic
portal. Once through the portal, the surgeon can then place the
needle in an active, suturing position by retracting the sheath
and applying tension to a suture attached to the suture needle.
By applying tension to the suture, the swaged portion of the suture
needle is retracted into a hollow cannula in the shaft until the
needle becomes secured therein. At this point, the suture needle
is extended and ready for suturing.
Suture needle claims
1. A suture needle manipulating device, comprising:
an elongated shaft having a proximal end and a distal end, the
distal end of said shaft having a first slot on a first side of
said shaft configured to receive a suture and a second slot on a
second side of said shaft configured to receive a suture needle;
a handle rigidly affixed to the proximal end of said shaft; and
a sheath slidably affixed around said shaft, said sheath configured
to engage said suture needle in a retracted position when said sheath
is extended, and further configured to release said suture needle
when said sheath is retracted;
wherein said suture needle may be moved from said retracted position
to an engagement position by retracting said sheath and applying
tension to said suture attached to said suture needle.
2. The device as recited in claim 1 wherein said sheath further
comprises a malleable distal end portion for securely engaging said
suture needle in the retracted position.
3. The device as recited in claim 1 wherein said sheath further
comprises a frictional drag interface configured to prevent said
sheath from sliding along said shaft of said device.
4. The device as recited in claim 1 further comprising:
a spring fixedly attached between said handle and said sheath,
said spring configured to keep said sheath in said extended position;
a guide slot in said shaft, said slot having a locking notch; and
a pin connected to said sheath and configured to engage and follow
said guide slot and lock within said locking notch;
wherein said sheath can be locked into a retracted position by
moving said sheath toward said handle until said spring is at least
partially compressed, and locking said pin into said locking notch.
5. The device as recited in claim 1 wherein said sheath comprises
a suture cleat for securing a suture thereto.
6. The device as recited in claim 5 wherein said suture cleat
comprises a deformable tab configured to pinch said suture between
said tab and said sheath.
7. The device as recited in claim 5 wherein said suture cleat
comprises a substantially circular disk having a rubber ring about
the periphery of said disk and configured to pinch said suture between
said rubber ring and said sheath.
8. The device as recited in claim 1 wherein said suture needle
receiving slot comprises at least one tapered side configured for
limiting the lateral movement of said suture needle in said receiving
9. The device as recited in claim 1 further comprising a plunger
extending along the bore of said shaft, said plunger configured
for pushing said suture needle out of the distal end of said shaft.
Suture needle description
The present invention relates, generally, to a surgical instrument
for use in an endoscopic cannula, and, more particularly, to an
apparatus for holding and manipulating a suture needle through an
endoscopic cannula during surgery.
1. Background Art and Technical Problems
With laparoscopic and endoscopic surgery, the surgeon typically
creates an incision in a patient's body near an area where the surgery
is to occur. The surgeon then places an endoscopic cannula or portal
into the incision, which allows the surgeon to insert various surgical
instruments such as scissors, dissectors, retractors, biopsy instruments,
or the like to perform diagnostic procedures and/or surgery inside
the patient's body.
After the diagnostic procedure and/or surgery has been completed,
it is often necessary to close incisions or repair tissue inside
the patient's body. Unfortunately, because the surgeon is conducting
the surgery through a relatively small access portal, it is often
very difficult to manipulate the necessary suture needle inside
Various different endoscopic needle manipulating crevices are currently
known in the art. However, most of the currently known devices typically
have a pair of opposing jaws positioned at the distal end of an
elongated member which is inserted through the endoscopic portal.
With many of these devices, one jaw is commonly held stationery
while the opposing jaw is operated between an open and a closed
position. In addition, with some of these known devices, the opposing
jaws commonly include a plurality of teeth for further grasping
the suture needle.
Some of these needle grasping devices currently known in the art
include: U.S. Pat. No. 5601575 issued on Feb. 11 1997 to Measamer
et al.; U.S. Pat. No. 5376096 issued on Dec. 27 1994 to Foster;
U.S. Pat. No. 5304185 issued on Apr. 19 1994 to Taylor; U.S.
Pat. No. 5201743 issued on Apr. 13 1993 to Haber et al.; and
U.S. Pat. No. 5015250 issued on May 14 1991 to Foster. One problem
with these currently known suture grasping devices is that a surgeon
often must reposition the needle within the grasping jaws before
it is in a proper position to actually suture tissue. This can be
difficult given the limited amount of space in the portal to manipulate
or reposition the needle. Moreover, given the geometry of the needle
and the manipulating device, it is often very difficult for the
surgeon to reach and suture certain tissues in the body. Thus, surgeons
have long been looking for a more versatile needle manipulating
Another type of endoscopic suturing device is shown in U.S. Pat.
No. 5586986 issued on Dec. 24 1996 to Hinchliffe, and U.S. Pat.
No. 5403329 issued on Apr. 4 1995 also to Hinchliffe. These devices
include sharp needles or trocars on both ends of a suture. The needles
are shuttled from one side of the device to another where they are
alternately apprehended by corresponding jaws and forced through
tissue by coaction of the jaws effectively passing the suture. However,
these devices are limited by the small amount of tissue that can
be penetrated by the needles, and are also limited by the topography
of the tissue that they can reach. Moreover, these devices have
no ability to suture around a corner, which is often needed in endoscopic
2. Summary of the Invention
Accordingly, it is an advantage of the present invention that an
improved endoscopic needle manipulating device be provided that
overcomes the limitations of the prior art.
It is another advantage of the present invention to provide a needle
manipulating device which eliminates the need for movable jaws to
handle the needle.
It is yet another advantage of the present invention to have a
needle manipulating device that shields the needle tip during insertion
through an endoscopic cannula.
It is still another advantage of the present invention to have
a needle manipulating device which can be configured to grasp the
tip of a suture needle and pull it and a suture through tissue after
the needle has been first partially penetrated through the tissue
being sutured with the same device.
The above and other advantages of the present invention are carried
out in one form by a suture needle manipulating device having an
elongated substantially cylindrical shaft. A slot for receiving
a suture needle is configured in a distal end of the shaft, and
a handle is suitably affixed to a proximal end of the shaft. In
addition, the needle manipulating device includes a slidable sheath
assembly affixed around the shaft that is configured to engage the
suture needle when the suture needle is in its initial retracted
In the retracted position, the device with the needle can be inserted
through the endoscopic portal. Once through the portal, the surgeon
can then place the needle in an active, suturing position by retracting
the sheath and applying tension to the suture attached to the suture
needle. By applying tension to the suture, the swaged portion of
the suture needle is retracted into a hollow cannula in the shalt
until the needle becomes secured therein. At this point, the suture
needle is extended and ready for suturing.
BRIEF DESCRIPTION OF THE DRAWING FIGURES
The present invention will hereinafter be described in conjunction
with the appended drawing figures, wherein like numerals denote
like elements, and:
FIG. 1 is a side view of an exemplary suture needle manipulating
FIG. 2 is a side view of the handle and slidable sheath assembly
of the device of FIG. 1 having an exemplary round suture cleat;
FIG. 3 is a top view of a distal end of the suture manipulating
device of FIG. 1 showing a slot configured to receive and hold
the suture needle;
FIG. 4 is a bottom view of the distal end of the suture needle
manipulating device of FIG. 1 showing a second groove configured
to receive the suture connected to the suture needle;
FIG. 5 is a cross-section view of the needle manipulating device
of FIG. 1 showing the sheath assembly engaging the suture needle
in its retracted position;
FIG. 6 is a cross-section view of the needle manipulating device
of FIG. 1 showing the sheath assembly in a retracted position,
and the suture needle in an engaged position;
FIG. 7 is a cross-section view of a needle manipulating device
having a plunger assembly for grasping and retrieving a suture needle;
FIG. 8 is a cross-section view of a needle manipulating device
in which the sheath assembly is used to grasp and retrieve a suture
FIG. 9 is a side-view of a second embodiment of a needle manipulating
device with a suture in an extended position; and
FIG. 10 is a side-view of the needle manipulating device of FIG.
9 with the needle in a retracted position.
FIG. 11 is a side-view of yet another embodiment of a needle manipulating
device having a spring and locking track assembly for controlling
the movement of the sheath.
FIG. 12 is an expanded view of the locking track of FIG. 11.
DETAILED DESCRIPTION OF PREFERRED EXEMPLARY EMBODIMENTS
The present invention relates, generally, to a surgical instrument
for use in an endoscopic portal, and more particularly to an improved
suture needle manipulating apparatus for placing a filament of suture
around or through a structure in the body using an endoscopic portal.
With reference to FIG. 1 an exemplary suture needle holding and
manipulating device 100 is shown. In accordance with the present
invention, needle manipulating device 100 suitably includes a handle
110 a shaft 120 and a needle securing sheath assembly 130.
Handle 110 may comprise any suitable endoscopic surgical instrument
handle currently known or hereinafter developed. However, in accordance
with the illustrated embodiment, handle 110 suitably includes a
plurality of channels 112 (preferably 3) extending along the length
of the handle, and a plurality of cut-out portions 114 uniformly
spaced along the handle. Channels 112 and cut-out portions 114 are
suitably configured to increase the frictional interface between
the handle and a surgeon's hand, thus, improving the ability of
the surgeon to adequately grasp the handle and, therefore, manipulate
In addition, handle 110 may further include an extension 116 configured
to removably attach to shaft 120 and sheath assembly 130. In accordance
with this aspect of the invention, handle 110 may be detached from
the needle manipulating device and used on a different surgical
instrument. Also, with this configuration, a number of different
types of endoscopic surgical handles may be attached to and used
in conjunction with the needle manipulating device of the present
Sheath assembly 130 is positioned around a large portion of, and
is configured to slide along shaft 120. Accordingly, sheath assembly
130 suitably comprises a tube portion 132 a malleable distal end
portion 134 a sheath handle 136 and a frictional drag assembly
138. As discussed in more detail below, sheath assembly 130 is configured
to engage and secure a suture needle in a retracted position in
needle manipulating device 100. In this regard, when sheath 130
is slid forward toward the distal end of shaft 120 malleable end
portion 134 will encase a portion of the suture needle, holding
it in its retracted position.
Malleable end portion 134 is fixedly attached to rigid tube portion
132 and is configured to deform or stretch when it engages the
needle, so that it more firmly secures the needle therein. In accordance
with this aspect of the invention, end portion 134 may be constructed
from a number of different materials, however, in accordance with
a preferred embodiment of the invention, end portion 134 is made
from a malleable plastic or rubber material. In addition, rigid
tube portion 132 may be constructed from a rigid thermoformed plastic
or aluminum material.
Sheath handle 136 is connected to the proximal end of tube portion
132 of sheath assembly 130 and may comprise a variety of different
configurations. For example, in accordance with the illustrated
embodiment of FIG. 1 sheath handle 136 comprises an enlarged circular
collar, which a surgeon may easily grasp and, thus, move along shaft
120. Sheath handle 136 may further include an adjustable frictional
interface 138 which suitably comprises a finger screw passing through
handle 136. The finger screw is a drag inducing device, which prevents
sheath assembly 130 from sliding along the shaft when engaged. With
this configuration, the surgeon can secure sheath 130 in a retracted
or extended position, as necessary, without having to manually hold
it in position.
While frictional interface 138 of the present invention is described
as being a finger screw device, one skilled in the art will appreciate
that frictional interface 138 may comprise any other suitable frictional
drag device, such as, for example, a threaded clamp or the like.
In addition, in accordance with a further embodiment of the invention,
frictional interface 138 may be replaced by the locking mechanism
illustrated in FIG. 11. In accordance with this aspect of the present
invention, the illustrated embodiment of needle manipulating device
100 includes a spring 300 connected to sheath 130 and handle 110.
Spring 300 is suitably configured to move sheath 130 to its extended
engagement position; i.e., so that malleable end (not shown) engages
the suture needle. Sheath 130 further includes a pin (not shown)
which engages a slidable locking track 310 on shaft 120.
As discussed above, when the surgeon wants to extend the suture
needle into its engagement position, he retracts sheath 130 so that
the malleable end portion exposes the suture needle. In accordance
with the present embodiment of the invention, in retracting the
sheath, the surgeon rotates sheath 130 so that the pin 131 attached
to the sheath dislodges from position 312 of track 310 (see FIG.
12). As the sheath is retracted, the pin 131 follows the middle
section 314 of the track. Finally, to lock the sheath in the retracted
position, the sheath is rotated so that the pin 131 locks into section
316 of the track preventing the sheath from returning to the extended
Referring again to FIG. 1 attached to sheath handle 136 is a suture
cleat 140 configured to receive and hold a suture in a tensioned
position. Suture cleat 140 may comprise any suitable suture holding
device, however, in accordance with the present invention, suture
cleat 140 suitably comprises a small deformable tab of metal fastened
to sheath handle 136. In accordance with this aspect of the invention,
when a suture is slid under cleat 140 the cleat will slightly deform
outward away from handle 136 pinching the suture between the cleat
and the handle. With this particular configuration, a surgeon can
quickly and easily secure and release a suture from the cleat.
Referring now to FIG. 2 another embodiment of a suture cleat is
illustrated. Specifically, an alternative suture cleat 150 may suitably
comprise a circular plate 152 with a rubber washer 154 extending
around the outer periphery of the plate. In accordance with this
aspect of the invention, a suture is secured in cleat 150 by sliding
the suture underneath rubber washer 154 so that the suture is secured
between the washer and handle 136.
While the various embodiments of the suture cleat have been described
herein as being connected to sheath handle 136 one skilled in the
art will appreciate that the suture cleat may be positioned anywhere
on device 100 such as, for example, on handle 110 or directly
on sheath 130.
Moreover, while the preferred embodiment of the invention has been
disclosed above as having a slidable sheath for encasing and protecting
the needle during insertion, another embodiment of the invention
may eliminate sheath 130. In accordance with this embodiment of
the invention, the needle will simply dangle from needle receiving
slot 160 as it is inserted through the endoscopic cannula.
Referring now to FIGS. 3 and 4 distal end 122 of shaft 120 and,
in particular, needle receiving slot 160 (see FIG. 3) and suture
receiving slot 170 (see FIG. 4) are illustrated. As discussed in
more detail below, suture needle receiving slot 160 is suitably
configured to secure a suture needle first, in a retracted position
using sheath assembly 130 and second, in an extended suturing position.
In the extended position, the surgeon can conveniently manipulate
the needle to an appropriate suturing position. That is, the surgeon
can pierce the needle through the tissue to be sutured at the appropriate
location. In accordance with this aspect of the invention, needle
receiving slot 160 suitably comprises a tapered edge 162 and a substantially
flat edge 164 which inhibit lateral movement of the needle when
it is in the extended position.
In addition to suture needle receiving slot 160 device 100 may
suitably comprise a second slot 170 (see FIG. 4) for receiving the
suture connected to the suture needle. Slot 170 allows the suture
to pass outside the hollow cannula of shaft 120 so that the surgeon
can have access to the suture without having to run the suture down
the entire cannula and pass it out the end of the handle. However,
while the preferred embodiment of the present invention includes
suture receiving slot 170 a further embodiment of the invention
may omit slot 170. In accordance with this aspect of the invention,
the suture will be end passed through the device.
When the suture needle is in the retracted position, the tip of
the needle will typically rest on a side of shaft 120 (see FIG.
5). In accordance with this aspect of the invention, shaft 120 may
include an indentation for the needle to be secured within. In addition,
in accordance with a further embodiment, shaft 120 may include a
hole or slot for receiving the tip of the needle when it is in the
retracted position. In any event, as discussed above, when the needle
is in the retracted position, sheath 130 will typically cover the
needle and secure it to that configuration.
Referring now to FIGS. 5 and 6 the operation of the suture manipulating
device will now be discussed in more detail.
When inserting a suture needle 180 with a suture 182 through an
endoscopic cannula, the needle is typically placed in a retracted
position so that deformable end 134 of sheath 130 encapsulates or
encases the tip of needle 180 preventing needle 180 from catching
in the cannula or on tissue inside the body as it is inserted. To
move suture needle 180 into its extended engagement position, sheath
assembly 130 is first retracted back toward handle 110 as shown
by arrows A in FIG. 6. In addition, either by retracting the sheath
when the suture is attached thereto, or by separately applying tension
to the suture after the sheath has been retracted, the surgeon will
retract the suture in the direction illustrated by arrow B. The
tension on suture 182 causes the swaged interface 184 between needle
180 and suture 182 to be retracted back into cannula 124 of shaft
120 until swagged interface 184 contacts the upper inner surface
190 of the cannula. When needle 180 is at this point, it is extended
and secured in device 100 by three points of contact: upper inner
surface 190 of cannula 124 the inside corner 192 of slot 160 and
lower surface 194 of cannula 124. In accordance with this aspect
of the invention, suture slot 170 is large enough so that suture
182 may slide down and out of the slot, but is small enough to prevent
needle 182 from pulling through when tension is applied to the suture.
In addition to contact points 190 192 194 sides 162 and 164
of needle slot 160 are suitably configured to prevent the needle
from spinning in the device when it is extended. However, because
there is a relatively large tolerance between the needle and sides
162 164 the needle will have some lateral movement within the
device, allowing the surgeon to easily twist the needle to a desired
angle so that he can reach awkward areas of the tissue.
After suture needle 180 has been extended to its engagement position,
the surgeon will then secure suture 182 under suture cleat 140 so
that the suture is secured. The surgeon will then insert needle
180 into and preferably through tissue at a suitable location. After
the needle is inserted, the surgeon will then release suture 182
from suture cleat 140 allowing needle 180 to fall out the distal
end of shaft 120. In accordance with this aspect of the invention,
the surgeon will simply pull back on handle 110 of device 100 until
needle 180 and suture 182 are freed from needle slot 160 and suture
slot 170 respectively.
After suture needle 180 has been suitably positioned within the
tissue, it is often desirable to have a device that can grasp the
tip of needle 180 and pull it and the suture through the tissue.
Many times, the surgeon will insert a second endoscopic cannula
near the first, so that a grasping instrument such as, tweezers
or the like can suitably grasp and pull needle 180 through the tissue.
In accordance with one aspect of the invention and referring now
to two FIGS. 7 and 8 needle manipulating device 100 may be used
in this manner. Specifically, needle manipulating device 100 may
further include a plunger assembly 200 (see FIG. 7) which extends
down cannula 124 of shalt 120 for grasping the needle. During the
operation, the surgeon may position the tip of suture needle 180
within suture needle slot 160. The surgeon will then extend plunger
200 down cannula 124 until it contacts the tip of needle 180 pinching
it between the end of the plunger and angled side 162. With this
configuration, the surgeon can securely grasp the tip of needle
180 and pull it and attached suture 182 through the appropriate
tissue. In accordance with a further aspect of this embodiment,
plunger 200 may be used to urge the needle out of the distal end
of the device to facilitate further penetration of the needle into
In accordance with a further embodiment of the present invention
and referring now to FIG. 8 sheath assembly 130 may also be configured
to grasp needle 180. In accordance with this aspect of the invention,
the surgeon may suitably position the tip of needle 180 within needle
slot 160 and extend sheath assembly 130 until deformable end 134
of sheath assembly 130 engages needle 180. At this point, deformable
end 134 will encase a portion of needle 180 and, at the same time,
pinch needle 180 against angled edge 162. As with the previous embodiment
discussed above, the surgeon will have a firm grasp on the needle,
so he can pull it and the attached suture through the tissue.
In accordance with yet a further embodiment of the present invention,
to grasp and pull needle 180 through the corresponding tissue, suture
needle slot 160 may be configured, so that when the tip of the needle
is placed in slot 160 device 100 may be twisted or rotated until
the tip is bound and secured in the slot. In accordance with this
aspect of the invention, the surgeon can use the existing slot in
device 100 to actually grasp and pull the needle through the tissue.
Referring now to FIGS. 9 and 10 another embodiment of the present
invention will be discussed. Specifically, shaft 120 as illustrated
in the alternative embodiment of FIGS. 9 and 10 includes a curved
distal end 220. In accordance with this configuration, needle 180
can be manipulated to reach certain tissues that otherwise would
not be reachable; for example, the offset provided by the curved
distal end enables the surgeon to access tissue that is obstructed
to some degree by the topography of the body between the cannula
and the site to be sutured. Also, this particular configuration,
typically facilitates further penetration of needle 180 into the
tissue being sutured. Finally, in accordance with another advantage
of this configuration, the needle receiving slot 160 (FIG. 3) may
be omitted because the curved end portion will prevent the needle
from spinning or rotating in the cannula.
It will be understood that the foregoing description is preferred
exemplary embodiments of the invention, and that the invention is
not limited to the specific form shown or described herein. Various
modifications may be made in the design, arrangement, and type of
elements disclosed herein without departing from the scope of the
invention as expressed in the appended claims.