Suture needle abstract
A surgical instrument for holding a suture needle is provided.
The instrument is of a 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 jaws. The width of the transverse
channel adjusts to the size of the suture needle by means of a cam
and spring loaded camming surface which move a sliding member against
the side of a suture needle as the jaws of the needle holder are
closed. 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
What is claimed is:
1. A suture needle holding surgical instrument comprising:
first and second elongated members, each of which forms a loop
at a first end for holding said instrument and a needle holder jaw
at a second end for receiving a suture needle, said first and second
elongated members being pivotally mounted in a scissors configuration;
wherein at least one of said jaws includes an adjustable transverse
channel in an inner jaw surface for fixedly holding the suture needle
at a right angle to the axis of the needle holder jaws;
a sliding member;
a biasing member associated with said sliding member and said at
least one of said jaws for moving said sliding member at a rearward
open position; and
a camming member for adjusting a width of said transverse channel
when said sliding member moves forward in response to a closure
of an opposing needle holder jaw on the suture needle in said transverse
wherein said camming member includes a rod which connects to said
2. The instrument as recited in claim 1 further comprising a ratchet
locking mechanism for holding said jaws in a pivotally closed position.
3. The instrument as recited in 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. The instrument as recited in claim 3 wherein each of said first
and second elongated members has an adjustable transverse channel
which includes a floor having at least one transverse ridge in said
5. The instrument as recited in claim 1 wherein said inner surfaces
of said jaws not defining said transverse channel are of a serrated
6. The instrument as recited in claim 1 wherein said sliding member
and entire jaw on the second end of the first elongated member as
well as the entire jaw on the second end of the second elongated
member are removable.
Suture needle description
The application hereby encloses the new Continuation-in-part specifications,
claims, and drawings for the suture needle holding instrument. In
the parent patent the biasing member maintained pressure on the
side of the needle by the sliding member. In the new design, the
biasing member moves the sliding member to a maximum open position
when the needle holding instrument is opened.
Once a suture needle is placed in the transverse channel, the sliding
member moves forward against the side of the needle by means of
a newly added cam and camming surface that are activated as the
needle holder jaws are closed. The camming surface is spring loaded
to allow for complete closure of both the sliding member against
the side of the needle and the opposing jaw against the face of
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 accommodate 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 TO 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 varing 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 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, widened 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 height 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 fatigued 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 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 FIGS. 1 and
FIG. 3 is a 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. The sliding member 38 can be removed and replaced in
position by moving it rearward 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.
FIG. 4a is an oblique view of a preferred embodiment of the needle
holder jaw. When the needle holder is opened, the sliding member
38 moves rearward to establish a 3.0 mm opening at the front of
transverse channel 28. The sliding member 38 moves rearward by means
of biasing coil spring 42 which is secured to the forward face of
foot 64 which extends vertically from the under surface of sliding
member 38 into the spring compartment 44. When the needle holder
is opened, the force of spring 42 against the front wall of spring
compartment 44 pushes on foot 64 to move the sliding member 38 rearward
to provide the 3.0 mm opening in transverse channel 28.
When the needle holder jaws are closed, the sliding member moves
forward by means of cam 41 on one jaw surface pressing against camming
surface 43 on the other jaw. The cam 41 may be a separate projection
or the rearward surface of the elongated arms 68 in front of pivot
joint 20. The camming surface is comprised of a push rod 55 which
is connected to coil spring 57. Coil spring 57 is secured to the
rearward face of foot 64 which projects vertically from sliding
member 38. This configuration allows the sliding member of one jaw
to move forward against needles of varying width in the transverse
channel while the other jaw closes in direct contact with the concave
surface of the seated needle. The difference in the closing of the
needle holder jaw for contact of the sliding member against the
needle and the distance for the other jaw to contact the needle
is taken up by spring 57.
Once the needle holder jaws are closed, the sliding member is firmly
held in place against the needle both by the camming 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 reference to FIGS.
4-7. The surface 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 grasping capability. 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 FIGS. 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 simultaneously 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 longitudinal 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.