Surgical needle abstract
Channel-bodied surgical needles and surgical incision members are
disclosed having a generally U-shaped cross-sectional body portion
and a penetrating tip portion formed on at least one end thereof.
Preferably, penetrating tip portions are formed at both ends of
the channel-bodied portion. The surgical needle and/or surgical
incision member may additionally includes apparatus engagement structure
formed adjacent either end of the body portion and engagable with
a suitable surgical suturing apparatus. The channel-bodied surgical
needle and/or surgical incision member may additionally include
securement structure for attachment of a length of suture material
thereto. There is also disclosed apparatus for forming a channel-shaped
body portion and the suture attachment structure. Additionally,
methods for suturing tissue sections, particularly vascular tissue
sections, with the channel-bodied surgical needle and the channel-bodied
surgical incision members, are disclosed. Also, methods for forming
the channel-bodied surgical needle and channel-bodied surgical incision
member are disclosed.
Surgical needle claims
What is claimed is:
1. A surgical needle comprising:
a) a body portion having a substantially channel-shaped cross-section
and defining a air of generally parallel sides, the channel-shaped
cross-section extending along the entire length of the body portion;
and
b) a first tissue penetrating tip portion formed at one end of
the body portion.
2. The surgical needle according to claim 1 wherein the penetrating
tip portion has a substantially channel-shaped cross-section.
3. The surgical needle according to claim 1 wherein the penetrating
tip portion has a leading edge and is beveled from a leading edge
portion to the body portion to form a cutting edge thereon.
4. The surgical needle according to claim 1 further comprising
a second tissue penetrating tip portion formed at an end of the
body portion opposite the first tissue penetrating tip portion.
5. The surgical needle according to claim 1 further comprising
apparatus engagement structure formed in the body portion.
6. The surgical needle according to claim 5 wherein the apparatus
engagement structure is formed adjacent at least one end of the
body portion.
7. The surgical needle according to claim 5 wherein the apparatus
engagement structure includes an area of the body portion defining
a hole therethrough.
8. The surgical needle according to claim 5 wherein the apparatus
engagement structure includes an inwardly directed bulge formed
in the body portion.
9. The surgical needle according to claim 5 wherein the apparatus
engagement structure includes at least one recessed cross-sectional
area portion formed in an outer surface of the body portion.
10. The surgical needle according to claim 1 further comprising
suture attachment structure formed in the body portion and engagable
with a length of suture material.
11. The surgical needle according to claim 10 wherein the suture
attachment structure is formed intermediate ends of the body portion.
12. The apparatus according to claim 10 wherein the suture securement
structure includes at least one reduced cross-sectional area portion
formed in the body portion.
13. The apparatus according to claim 12 wherein the reduced area
portion includes at least one inwardly directed bulge formed in
a side of the body portion.
14. The apparatus according to claim 10 wherein the securement
structure includes an inwardly direct flap formed from a side of
the body portion.
15. The surgical needle according to claim 1 wherein the penetrating
tip portion comprises tapered edges extending from the body of the
needle and at least one pointed cutting end extending from the tapered
edges and having at least one cutting surface thereon.
16. A method of suturing a tissue section comprising the steps
of:
a) providing a surgical needle having a substantially channel-shaped
body portion extending throughout the entire length of the surgical
needle and defining a pair of generally parallel side walls, and
a length of suture material attached to the body portion;
b) piercing a first tissue section with the surgical needle to
cut a channel-shaped tissue flap; and
c) drawing the surgical needle and a portion of the length of suture
material through the channel-shaped flap of tissue.
17. The method according to claim 16 further comprising the steps
of:
a) piercing a second tissue section with the surgical needle to
cut a second channel shaped flap in the tissue; and
b) drawing the surgical needle and a portion of the length of suture
material through the second channel shaped flap of tissue to thereby
suture the tissue section and the second tissue section together.
18. The method according to claim 17 wherein the step of piercing
a second tissue section comprises piercing a second tissue section
with the opposite end of the needle used to pierce the first tissue
section.
19. The method according to claim 16 wherein the tissue section
to be pierced is a vascular tissue section.
20. A method of suturing a tissue section comprising the steps
of:
a) providing a surgical needle having a substantially channel-shaped
body portion having generally parallel side walls and a length of
suture material attached thereto;
b) piercing a first tissue section with the surgical needle to
cut a flat incision in tissue; and
c) drawing the surgical needle and a portion of the length of suture
material through the flat incision in tissue.
21. A surgical needle comprising:
a) a body portion having a substantially channel-shaped cross-section
extending the entire length thereof;
b) apparatus engagement structure formed in the body portion, the
apparatus engagement structure defining at least one opening formed
through the body portion and transverse to a longitudinal axis thereof;
and
c) at least one cutting edge formed at a location adjacent to the
body portion wherein the apparatus engagement structure includes
at least one notch formed in a side wall of the body portion.
Surgical needle description
BACKGROUND
1. Technical Field
This disclosure relates generally to surgical needles and, more
particularly, to a surgical suturing needle having a channel-shaped
body portion.
2. Description of Related Art
Surgical suturing needles are available in numerous types and sizes
depending on the intended use or application. Surgical incision
members are a type of surgical grade needle designed for use with
surgical suturing instrumentation. Surgical incision members have
points formed at either end and, preferably, a length of suture
material attached intermediate the points. Typically, surgical incision
members have a substantially uniform round cross-section, although
other solid bodied cross-sections may be provided. Apparatus engagement
structure may also be formed in a body portion of the surgical incision
member to facilitate its use with a suitable surgical suturing apparatus.
As used herein, the terms "surgical needle" and "surgical
incision member" refer to fully formed surgical grade needles
ready for suture attachment and use in surgical procedures. Further,
as used herein, the term "needle blank" refers to a piece
of needle stock at various stages of completion but not filly formed
into a surgical grade needle or surgical incision member suitable
for use during surgical procedures.
Solid bodied surgical incision members are disclosed in U.S. patent
application Ser. Nos. 08/260579 filed Jun. 16 1994 entitled SURGICAL
INCISION MEMBERS; and 29/024594 filed Jun. 16 1994 entitled SURGICAL
INCISION MEMBER, the disclosures of which are incorporated by reference
herein. Suitable apparatus for manipulation of surgical needles
and surgical incision members are disclosed in U.S. patent application
Ser. Nos. 06/954013 filed Sep. 30 1992 entitled SUTURING APPARATUS;
08/134145 filed Oct. 8 1993 entitled SURGICAL SUTURING APPARATUS
WITH LOADING MECHANISM; 08/319703 filed Oct. 7 1994 entitled VASCULAR
SUTURING APPARATUS; and 08/319840 filed Oct. 7 1994 entitled ENDOSCOPIC
VASCULAR SUTURING APPARATUS.
During surgical procedures it is often necessary to join or rejoin
tissue or vessels to form an anastomosis. Various methods of joining
tissue or vascular tissues to create an anastomosis are used, such
as, for example, suturing, stapling or clipping the tissue together.
The anastomosis of vascular tissue involves particularly delicate
and precise suturing in order to insure a secure and fluid tight
seal. Given the very small size of typical vascular tissue, accurate
and precise suturing on a small scale is imperative. Working in
a highly magnified field, the surgeon uses a very small suturing
needle having a length of suture material attached thereto to suture
the vessels together. The suturing needle is typically grasped by
a needle holder and passed through one vessel and then the opposite
vessel. The procedure is repeated to thread or impart a series of
stitches to the vessels to suture them together. Because of the
extremely small size of the suturing needle used, typically on the
order of ten thousands of an inch in diameter, and the highly magnified
field, handling problems may arise while manipulating the suturing
needle through the vascular tissues. Drawing the needle and suture
through a vessel requires the controlled and accurate release and
acquisition of the needle and suture during the procedure. Precise
control of the needle is often difficult when using typical needle
holders. Thus surgical suturing apparatus which manipulate either
surgical needles or surgical incision members are particularly useful
in vascular surgery. They can provide accurate and reliable transfer
of the needles or incision members through vascular tissue, particularly
in small operating fields.
Care must be taken to ensure only a minimal puncture is performed
and that the tissue is not damaged as the suture is drawn through.
Round punctures in vascular tissues can take longer to heal than
a non-circular incision or cut. Further, when using round-bodied
surgical needles, the size of the needle and suture should be carefully
matched to ensure the suture does not tear tissue and to prevent
fluid leakage from the vessel. Accordingly, a need exists for a
surgical needle and/or surgical incision member which penetrates
tissue in a less traumatic manner than a conventional needle. It
would be desirable to make a more incision-like penetration of the
tissue to facilitate healing.
Surgical needles and/or surgical incision members typically require
several processes to form the finished product. These processes
may include curving and cutting needle stock to form needle blanks,
altering or refining the tip configurations and curvature radius,
punching or drilling the blank to form a suture hole and/or notching
the blank to provide engaging structure for cooperative instrumentation.
Due to the complexity of forming round-bodied surgical needles
and surgical incision members, the manufacture of surgical incision
members may become complicated and costly. For example, one commonly
used method of manufacturing a round-bodied surgical incision member
is by a process called metal injection molding or "MIM".
The MIM manufacturing process tends to be costly and thus may adversely
affect the otherwise desirable characteristics and traits of a surgical
suturing apparatus utilizing surgical incision members.
It would be desirable to have a surgical suturing needle or incision
member which can be produced with reduced cost and effort. It also
would be desirable to have a vascular surgical suturing needle which
is particularly suited to microscopic suturing of vascular tissues
and which is capable of penetrating, and drawing a suture through,
vascular tissue sections with minimal trauma to the tissue. It would
also be desirable to have an inexpensive surgical suturing needle
or surgical incision member which is easily handled by a surgical
suturing apparatus.
SUMMARY
A surgical suturing needle is disclosed having a channel shaped
body portion, preferably of a U-shaped cross-section, and a penetrating
tip portion formed on at least one end. As used herein, the phrase
"channel-bodied surgical needle" is intended to refer
to a needle having a substantially open-centered body portion. Preferably,
penetrating tip portions are formed at both ends of the channel-bodied
surgical needle with a suture being attached thereto intermediate
the tip portions. The channel-bodied surgical needle may also include
apparatus engagement structure which, in one embodiment, includes
a pair of holes formed adjacent either end of the channel-shaped
body portion. The holes are engagable with corresponding structure
on a suitable surgical suturing apparatus to facilitate transfer
of the needle between jaws thereof. In another embodiment, the apparatus
engagement structure is formed as crimps or notches in the side
walls of the channel-shaped portion and adjacent either end. When
the channel-bodied surgical needle includes penetrating tip portions
at either end it forms a "channel-bodied surgical incision
member".
Suture attachment structure is located between the penetrating
tip portions to secure a length of suture material to the channel-shaped
body portion. This structure may include an inwardly directed flap
cut from a side wall which serves to crimp an end portion of a suture
within the channel-shaped body portion. Alternatively, in a second
embodiment, the suture attachment structure is formed as a pinched
or inwardly directed bulging portion in the channel-shaped body
portion which serves to crimp a suture therein. In a further alternative
embodiment, the suture attachment structure includes a tab portion
projecting from a side wall. The tab portion is foldable within
the channel to secure a length of suture material therein. Preferably,
the suture attachment structure is formed within the channel-shaped
body portion at a location substantially intermediate either end
thereof. Welds, glue and the like also may be used to secure the
suture within the channel-shaped body portion.
Also disclosed is an apparatus for forming a channel-bodied surgical
needle, or a channel-bodied surgical incision member, which generally
includes a forming die for producing the channel-shaped body portion
of the needle. The forming die generally includes a first member
having a blade or mandrel projecting therefrom. A second member
is provided which generally includes a ledge for support of a needle
blank and a slot positioned beneath the ledge for receipt of the
mandrel therein. As the mandrel is forced down against the needle
blank, it forces the needle blank into the slot thereby forming
the channel-shaped body portion in the needle blank.
Structure is also provided for imparting apparatus engagement structure
to the needle blank including providing a pre-stamped blank having
holes adjacent either end thereof or providing a die or other suitable
structure for crimping or coining side walls of a channel-bodied
needle portion. Additionally, suture attachment structure is provided
in the form of a crimping or suture attachment die which has a channel
therein for receipt of a channel-bodied surgical needle. The suture
attachment die has a cutting wedge or pin which, when a length of
suture material is positioned within the channel-shaped body portion,
is forced down to cut a flap in the side wall of the channel-shaped
body portion. The flap is folded inwardly against the length of
suture material to firmly secure the suture material within the
surgical needle. Alternatively, one or more dies for crimping a
center portion of the surgical of the channel-shaped body portion
to crimp a suture without creating such a flap may be provided.
There is also disclosed a method of suturing body tissue utilizing
a channel-bodied surgical needle as well as a method of suturing
vascular tissue utilizing a channel-bodied surgical incision member.
The latter method generally includes providing a channel-bodied
surgical incision member having a length of suture material attached
thereto and positioning the channel-bodied surgical incision member
within suitable suturing apparatus having needle engagement structure.
The channel-bodied surgical incision member is forced against a
tissue section to pierce the tissue section and cut a flap of tissue
in the side wall. As the channel-bodied surgical incision member
is passed through the tissue section, the suture material lies substantially
within the channel-shaped body portion to minimize tissue trauma.
The surgical suturing apparatus draws the surgical incision member
and length of suture material through the tissue section without
increasing the size of the cut tissue flap. The size of the surgical
incision member can be closely matched to the size of the suture,
and the creation of a flap rather than a punctured hole in tissue
provides good sealing of the tissue around the suture. In the case
of a surgical incision member the method also includes passing the
surgical incision member back and forth through tissue, piercing
the tissue alternately with each end of the channel bodied surgical
incision member.
There is also provided a method of forming a channel-bodied surgical
incision member or a channel-bodied surgical needle. A method generally
includes providing a flat needle blank, preferably with ends pre-ground
or preformed with cutting edges and with apparatus engagement structure.
The needle blank is folded substantially in half to create a U-shaped
channel-shaped body portion and may be ground to form cutting edges
at either end thereof. Once the needle blank has been formed with
a channel-shaped body portion, cutting ends at either end thereof
and suitable apparatus engagement structure a channel-bodied surgical
incision member has been formed. There are also disclosed a channel-bodied
surgical needle and channel-bodied surgical incision member formed
on the above apparatus and according to the above methods.
BRIEF DESCRIPTION OF THE DRAWINGS
Various embodiments are described herein with reference to the
drawings, wherein:
FIG. 1 is a perspective view of a preferred embodiment of a channel-bodied
surgical incision member,
FIG. 2 is an alternate perspective view of a channel-bodied surgical
incision member similar to the surgical incision member of FIG.
1;
FIG. 3 is a perspective view of a stamped needle blank;
FIG. 4 is a perspective view similar to FIG. 3 illustrating apparatus
engagement structure stamped in the needle blank;
FIG. 5 is a perspective view of a piece of needle stock material
stamped to form cutting or beveled edges at either end thereof;
FIG. 5a is a perspective view of needle stock material stamped
to form substantially pointed ends with cutting edges;
FIG. 6 is a side elevational view, partially shown in section,
of a channel body forming die;
FIG. 7 is a perspective view of the channel body forming die, partially
shown in section;
FIG. 8 is a partial cross-sectional view taken along the line 8--8
of FIG. 7;
FIG. 9 is a perspective view of a channel-bodied needle blank;
FIG. 9a is a perspective view of a channel-bodied surgical needle
having a single tissue penetration end prior to suture attachment;
FIG. 10 is a perspective view of a channel-bodied surgical incision
member having tissue penetrating tips formed at either end thereof
prior to suture attachment;
FIG. 11 is a perspective view of an apparatus for imparting suture
attachment structure to a channel-bodied surgical needle or incision
member,
FIG. 12 is partial cross-sectional view of the apparatus of FIG.
11 with a suture and surgical incision member inserted therein;
FIG. 13 is a view similar to FIG. 12 illustrating a die cutting
a portion of the body portion to secure a suture within a channel-bodied
surgical incision member or needle;
FIG. 14 is a perspective view of the channel-bodied surgical incision
member and a portion of an arm or jaw of a suturing apparatus illustrating
the apparatus engagement structure of the channel-bodied surgical
incision member cooperating with corresponding structure on the
jaw;
FIG. 15 is a cross-sectional view taken along line 15--15 of FIG.
14;
FIG. 16 is a perspective view partially shown in section illustrating
the channel-bodied surgical incision member piercing a vascular
tissue section;
FIG. 17 is a view taken along line 17--17 of FIG. 16 illustrating
the incision made by the surgical incision member,
FIG. 18 is an alternate embodiment of the channel-bodied surgical
incision member,
FIG. 19 is a cross-sectional view taken along line 19--19 of FIG.
18 and illustrating suture attachment structure;
FIG. 20 is a cross-sectional view taken along line 20--20 of FIG.
18;
FIGS. 21-23 are perspective cross-sectional views illustrating
further cross-sectional configurations for the channel-bodied surgical
needle or incision member,
FIG. 24 is a perspective view of a surgical incision member with
apparatus engagement notches;
FIG. 25 is a plan view of a stamped needle blank with stamped notches
for forming the surgical incision member of FIG. 24;
FIG. 26 is a perspective view of an alternate channel-bodied surgical
needle blank incorporating alternate suture attachment structure;
FIG. 27 is a perspective view of a channel-bodied surgical incision
member formed from the needle blank of FIG. 26 and ready to receive
a suture for attachment thereto;
FIG. 28 is a perspective view of the channel-bodied surgical incision
member of FIG. 27 during suture attachment;
FIG. 29 is a cross-sectional view taken along line 29--29 of FIG.
28;
FIG. 30 is a side view, partly shown in section, illustrating the
channel-bodied surgical incision member of FIG. 28 penetrating tissue;
FIG. 31 is an enlarged perspective view of the tissue penetrating
end of the channel-bodied surgical incision member of FIG. 28;
FIG. 32 is a perspective view, partly shown in section, illustrating
the cutting tip of the channel-bodied surgical incision member penetrating
tissue;
FIG. 33 is a perspective view of an alternate channel-bodied surgical
needle blank incorporating alternate tissue penetrating structure;
FIG. 34 is a perspective view of an end portion of a channel-bodied
surgical incision member formed from the needle blank of FIG. 33
and incorporating the alternate tissue penetrating structure;
FIG. 35 is a perspective view of the penetrating tip portion of
the channel-bodied surgical incision member of FIG. 34 initially
penetrating tissue; and
FIG. 36 is a perspective view similar to FIG. 35 and illustrating
penetration of the channel-bodied surgical incision member through
tissue.
DESCRIPTION OF PREFERRED EMBODIMENT(S)
Referring now to FIG. 1 there is shown a hollow channel-bodied
surgical incision member which may be particularly suited for use
in suturing of vascular tissue sections. As used herein, the term
"channel-bodied", "channel-shaped body" or "channel-shaped
cross-section" refers to a hollow body having a cross-sectional
area such that the walls of body portion form a needle having a
substantially open, hollow body over substantially the entire length
of the needle. Preferably, the channel-bodied needle or surgical
incision member is curved, as shown. Alternatively, it is contemplated
that the channel-bodied needle or surgical incision member could
be straight or substantially straight over its length.
Although the discussion herein below is specifically oriented to
the use of the present surgical incision member with a surgical
suturing apparatus in vascular surgery, other uses are contemplated
including manual suturing and suturing with conventional needle
holders in general surgery. Thus, while the present description
is primarily in terms of endoscopic surgery and vascular surgery,
it should be understood that the surgical needles and incision members
may find use in general surgery as well.
Channel-bodied surgical incision member 10 generally includes a
body portion 12 having a pair of generally parallel sides 14 and
a generally curved base 16 connecting adjacent sides 14. Sides 14
along with base 16 define a channel 18 extending substantially
the length of channel-bodied surgical incision member 10. Channel-bodied
surgical incision member 10 may be formed of various suitable biocompatable
needle stock materials such as, for example, stainless steel, etc.
Body portion 12 preferably has a U-shaped cross-section although
various other cross-sections are contemplated. A preferred length
of a finished channel body needle suitable for use in vascular surgery
is on the order of approximately 0.350 inches. Channel-bodied surgical
incision member 10 further includes a tissue penetrating end or
tip 20 formed on each end of body portion 12. Tissue penetrating
ends 20 are preferably formed with sharp cutting edges 22 to facilitate
piercing a tissue section. When forced against tissue, cutting edges
22 cut a flap of tissue rather than forming a puncture hole. Channel-bodied
surgical incision member 10 is designed to facilitate passing a
length of suture material such as, for example, suture 24 through
a vascular tissue section with minimal disruption of the vascular
tissue.
Referring now to FIG. 2 channel-bodied surgical incision member
10 includes apparatus engagement structure and suture attachment
structure. In this embodiment, the suture attachment structure is
preferably in the form of an inwardly directed flap portion 26 formed
in one side 14. Flap 26 serves to pinch an end 28 of suture 24 within
channel 18 as shown. In order to facilitate holding channel-bodied
surgical incision member 10 and passing the surgical incision member
between arms or jaws of a surgical suturing apparatus (see FIG.
14), channel-bodied surgical incision member 10 further includes
apparatus engagement structure which cooperates with corresponding
needle engaging structure in a surgical suturing apparatus (FIGS.
14-16). In this embodiment, the apparatus engagement structure is
provided in the form of holes 30 formed in base 16. Preferably,
one hole 30 is formed adjacent either end of base 16 as shown. Alternatively,
holes 30 may be formed at various locations, such as, for example,
in sides 14. Notches and other comparable apparatus engagement structure
are also contemplated, such as notches coined into base 16 or into
the edges of side walls 14. Preferably, when apparatus engagement
structure is produced in the form of holes, the holes have a diameter
on the order of 0.01 inches to 0.02 inches and more preferably about
0.016 inches.
Referring now to FIGS. 3-8 and initially to FIGS. 3-5a, a preferred
method of forming a channel-bodied surgical incision member 10 win
be described. A needle blank such as, for example, flat rectangular
needle blank 32 is stamped out of needle stock material. Needle
blank 32 may be substantially rectangular, as shown in FIG. 3 in
which case one or both ends of the blank preferably are ground to
form pointed ends, either before or after forming the rectangular
blank into a channel-bodied structure as described below. Additionally,
as shown in FIG. 4 apparatus engagement structure such as, for
example, holes 30 may be stamped or punched into the needle blank
32 prior to forming into a channel-bodied structure. Alternatively,
as shown in FIG. 5 needle blank 32 can be stamped to have cut corners
40. Preferably, cut corners 40 and ends 34 are beveled or ground
to produce sharp cutting edges. Alternatively, corners 40 and ends
34 may be stamped to form beveled sharp cutting edges at the time
the flat blank is formed. It is also contemplated that pointed cut
corners 40 could join to form a substantially pointed tip at each
end of blank 32 without a straight transverse edge 34 or that the
length of transverse edge 34 could be varied to obtain different
tip configurations. It also is contemplated that corners 40 could
be stamped to provide a curved corner having one or more radii of
curvature. By way of example only, FIG. 5a illustrates an alternate
needle blank 32 having substantially pointed ends 41 with rounded
tips 43. Cutting edges may be stamped into the edges of the pointed
tip. In the embodiment of FIG. 5 the needle blank includes apparatus
engagement apertures 30. Referring now to FIG. 6 there is disclosed
a channel forming die for forming the channel body portion 12 in
needle blank 32. Channel forming die 44 generally includes a first
portion 46 having a forming mandrel 48 positioned therein and a
second portion 50 having a needle blank ledge 52 for support of
a needle blank 32. Second portion 50 further includes a forming
slot 54 for receipt of mandrel 48.
In order to form a curved channel-bodied surgical incision member,
mandrel 48 preferably has an arcuate edge 56 and channel 54 has
an arcuate base 58. Thus, when needle blank 32 is positioned on
ledge 52 and compressed between first portion 46 and second portion
50 it will assume the arcuate shape of edge 56 and base 58. Preferably,
forming die 44 is configured to impart an arcuate radius on the
order of 0.775 inches to the needle blank. It also is contemplated
that the leading edge 56 of mandrel 48 and base 58 of slot 54 may
be straight in order to produce a straight channel-bodied needle,
as opposed to a curved channel-bodied needle. A straight surgical
incision member may be desirable for use with a suturing apparatus
having straight parallel jaw structure.
Referring now to FIG. 7 first portion 46 generally includes first
and second sides 60A and 60B which are configured to clamp mandrel
48 therebetween by means of a pair of bolts 62. Second portion 50
also includes first and second halves 64A and 64B, held together
by a pair of bolts 66.
As shown in FIG. 8 channel 54 generally has a U-shaped cross-section
including an arcuate base 68 for receipt of edge 56 and a pair of
parallel sides 70. Referring again to FIG. 6 a needle blank 32
is positioned in registration on ledge 52. Channel forming die 44
is positioned within a suitable press or forming apparatus and first
portion 46 is positioned above second portion 50. First portion
46 is forced downwardly towards second portion 50 causing mandrel
48 to force needle blank 32 downwardly within slot 54. As needle
blank is forced downwardly into slot 54 by mandrel 48 it is forced
formed into an arcuate shape in both the longitudinal and cross-sectional
directions (FIGS. 7 and 8). Arcuate edge 56 of mandrel 48 along
with arcuate surface 58 of channel 54 serve to form the longitudinal
curvature in needle blank 32.
As best shown in FIG. 8 arcuate base portion 68 along with parallel
sides 70 serve to impart the channel and U-shaped cross-sectional
area to needle blank 32 in response to mandrel 48. Upon separating
portions 46 and 50 there is formed a channel-bodied needle blank
72 as best shown in FIG. 9. Channel-bodied needle blank 72 generally
includes a base portion 74 having the shape imparted to it by mandrel
48 and arcuate base portion 68. Additionally, blank 72 has a pair
of substantially parallel sides 76.
As noted hereinabove, needle blanks to be formed into channel-bodied
needles or surgical incision members may be ground or stamped to
have cutting edges at either ends or at one end either before or
after the channel forming operation. Channel-bodied needle blank
72 of FIG. 9 has a pair of flush ends 78 as would be achieved with
a substantially rectangular needle blank (see FIGS. 3 and 4). Blank
72 may then be taken to suitable grinding machinery to impart ground
edges and points.
A channel-bodied needle having a tissue penetrating end on only
one end thereof is best illustrated in FIG. 9a. Channel-bodied needle
71 also has a U-shaped configuration including a channel 73 defined
by sides 75 and base 77. As noted, channel-bodied needle 71 has
a single tissue penetrating end or tip 77 having a cutting edge
91 formed thereon. An opposite end 79 of needle 71 remains flush
for subsequent suture attachment, such as by crimping a suture tip
within end 79 or when used with a suitable surgical instrument,
provides a surface against which channel-bodied needle 71 may be
pushed to force it through tissue.
A ground and sharpened channel-bodied surgical incision member
is illustrated in FIG. 10. Incision member 80 generally includes
a pair of tissue penetrating ends 82 each having cutting edges 84
ground therein.
Various methods may be utilized to attach a length of suture material
to channel-bodied needles and/or surgical incision members. Referring
now to FIG. 11 there is disclosed a suture attachment die 86 which
is configured for crimping a length of suture material, such as,
for example, suture 24 within a channel-bodied needle or surgical
incision member. Suture attachment die 86 generally includes a needle
holding channel 88 which is configured to conform generally to the
shape of a channel-bodied surgical incision member and to position
the needle or surgical incision member for suture attachment. Suture
attachment die 86 further includes a bore 90 which is oriented substantially
perpendicular to channel 88 and intersects channel 88. A side punch
92 having a sharp cutting tip 94 is provided and is slidable within
channel 90 so as to engage an edge of a surgical incision member
disposed therein.
As shown in FIGS. 12 and 13 in operation, suture 24 is initially
longitudinally disposed within a body channel 18 in channel-bodied
surgical incision member 80 positioned within holding channel 88.
Suture attachment die 86 is then engaged with a suitable press or
punch for forcing die 92 through bore 90. As shown, in an initial
position, die 92 and thus cutting tip 94 is at a position remote
from holding channel 88. Referring now specifically to FIG. 13
as die 92 is forced down within bore 90 cutting tip 94 engages
a side wall 82 and cuts a portion of the side wall to form an inwardly
directed flap 96. Side punch 92 is forced down sufficiently to cause
flap 96 to crimp a portion of suture material 98 within the body
portion 82 of channel-bodied surgical incision member 80. Once flap
92 has been compressed against portion 98 and suture 24 side punch
92 may be retracted to free the now suture loaded channel-bodied
needle 80 and attached suture 24 from suture attachment die 86.
In the resulting needle-suture attachment, the tip of the suture
is positioned behind flap 96 with the body of the suture extending
around the flap in the hollow needle body (compare FIGS. 2 and 16).
At this point a fully formed channel-bodied surgical incision member
having a length of suture material affixed thereto may be sterilized
or otherwise treated for use in a surgical operation. As noted hereinabove,
channel-bodied surgical incision member 10 is particularly suited
for use with a surgical suturing apparatus having needle engaging
structure and which is designed to rapidly and efficiently transfer
a channel-bodied surgical incision member repeatedly between a pair
of jaws, such as the apparatus disclosed in the various U.S. Patent
Applications incorporated by reference hereinabove.
Referring now to FIGS. 14-17 and initially to FIG. 14 in order
to use channel-bodied surgical incision member 10 in a surgical
suturing operation, such as, for example, the suturing of vascular
tissues, channel-bodied surgical incision member 10 is loaded within
an arm or jaw of a suitable surgical suturing apparatus, such as,
for example, jaw 100. Channel-bodied surgical incision member 10
is inserted within jaw 100 by inserting it within a recess 102 in
the jaw, where engaging hole 30 may be engaged with a suitable needle
engaging member 104 disposed within jaw 100.
Channel-bodied surgical incision member 10 provides a unique configuration
for engagement with cooperating structure on a surgical suturing
apparatus. Referring now to FIG. 15 as needle engaging member 104
is advanced within jaw 100 a tip of needle engaging member 104
having a shape generally configured to conform to channel 18 such
as tip 106 is moved within channel 18. Tip 106 additionally includes
a projecting pin or point 108 which is configured and dimensioned
to engage hole 30 and secure channel-bodied surgical incision member
10 within jaw 100.
As illustrated in FIGS. 16-17 channel-bodied surgical incision
member 10 positioned with jaw 100 of a suturing apparatus, may
be utilized to pierce and suture one or more tissue sections such
as, for example, vascular tissue section 110. Upon piercing tissue
section 110 sharp cutting edges 22 on tissue penetrating ends 20
cut a flap of tissue 112 within vessel wall 110 (FIG. 16). As best
shown in FIG. 17 the portion of vessel wall 110 cut, flap 112
generally conforms to the inner shape of channel 18. The cutting
of a flap of tissue 112 rather than forming a puncture hole may
be desirable to promote healing since a channel cut or half moon
slice may be less traumatic than a round puncture, particularly
in vascular tissue. Upon passing channel-bodied surgical incision
member 10 through vessel wall 110 a portion of suture 24 is folded
or forced within channel 18. Thus, on passing through vessel wall
110 or other tissue sections, suture 24 lies within channel 18 and
does not tear or enlarge cut flap 112 formed by sharp cutting edges
22. In addition, the cut flap may promote a seal of vascular tissue
about the suture. Channel-bodied surgical incision member 10 may
be repeatedly passed back and forth between a pair of jaws 100 by
alternatively engaging holes 30 with needle engaging member 104
to repeatedly draw suture material 24 through one or more tissue
sections.
Referring now to FIG. 18 there is disclosed an alternate embodiment
of a channel-bodied surgical incision member. Similar to channel-bodied
surgical incision member 10 channel-bodied surgical incision member
114 generally includes a body portion 116 having a pair of sides
118 which define a channel 120 therein. Channel-bodied surgical
incision member 114 further includes a pair of tissue penetrating
ends 123 having sharp cutting edges 124 formed thereon and suture
attachment structure. In this embodiment the suture attachment structure
is provided in the form of a reduced cross-sectional area or inwardly
directed crimp formed in sides 118. Referring to FIG. 19 a cross-section
view taken along lines 19--19 of FIG. 18 inwardly directed bulges
126 serve to crimp a portion of length of suture material 24 therebetween
thereby securing suture material 24 with channel-bodied surgical
incision member 114. As will be appreciated, crimping sides 118
also is conducive to attaching suture 24 in substantially perpendicular
orientation relative to body portion 116 should such attachment
be desired.
Channel-bodied surgical incision member 114 also includes apparatus
engagement structure. In this embodiment the apparatus engagement
structure is in the form of reduced cross-sectional area adjacent
either end of body portion 116 and is generally formed by crimping.
Referring now to FIG. 20 a cross-section view taken along lines
20--20 of FIG. 18 reduced cross-sectional areas 128 provide grooves
along an outer edge of channel-bodied surgical incision member 114
for engagement with suitable needle engaging members of surgical
suturing apparatus, such as, for example, blades, etc.
While the preferred embodiments of channel-bodied surgical incision
member includes a generally U-shaped cross-sectional area various
other cross-sectional areas are contemplated and may be useful for
various procedures or instruments. For example, when a very narrow
flap of tissue or incision is required, a channel-bodied needle
having a v-shaped cross-section such as, for example, channel-bodied
structure 130 shown in FIG. 21 may be provided. Channel-bodied structure
130 has a pair of sides 132 joined by a relative narrow base 134
formed thereon. Channel-bodied structure 130 may additionally include
apparatus engagement structure in the form of one or more holes
136. Similarly, where a rectangular cross-section would be desired,
there is provided a channel-bodied structure 138 as best shown in
FIG. 22 having a pair parallel sides 140 and a base portion 142
formed substantially perpendicular to sides 140. Additionally, channel-bodied
structure 138 may include apparatus in engagement structure in the
form a hole or holes 144.
A further alternate embodiment having cross-sectional area in the
form of a W, is best illustrated in FIG. 23. Channel-bodied structure
146 generally includes a pair of sides 148 having a base 150. Base
150 generally includes a pair of inwardly facing concave portions
152 connected by an outwardly facing concave portion 154. Preferably,
apparatus engagement structure in the form of a hole 156 is formed
in concave portion 154. Alternatively, hole 156 may be formed in
one or both concave surfaces 152. Depending upon the desired structure,
i.e., either a surgical needle or a surgical incision member, cutting
edges and tissue penetrating ends may be formed either in a flat
blank or in a blank formed into a channel-bodied needle portion.
Cutting edges may be stamped or ground into opposite ends of the
channel-bodied blank or alternatively channel-bodied needle may
have a tissue penetrating end at only one end thereof.
Referring to FIG. 24 a further alternative embodiment is shown.
Surgical incision member 160 shown in FIG. 24 is substantially similar
to prior embodiments. However, surgical incision member 160 includes
apparatus engagement notches 162 for engaging blades or other structure
of a suturing apparatus to hold surgical incision member 160 in
the jaws of the instrument. Referring to FIG. 25 a needle blank
32 is shown with notches 162 stamped therein. Alternatively, notches
162 may be coined or ground in blank 32 or in surgical incision
member 160 after the blank is curved into the shape shown in FIG.
24. Preferably, blank 32 of FIG. 25 is curved around a mandrel and
pointed tip portions with cutting edges are ground into the curved
needle blank to provide a surgical incision member having pointed
tips with cutting edges. In use, engagement blades of a suitable
suturing apparatus engage notches 162 to control passing of surgical
incision member 160 back and forth between jaws or arms of the instrument.
Referring now to FIG. 26 a further alternative needle blank is
shown. Needle blank 170 generally includes first and second longitudinal
side edges 172 and 174 respectively, and transverse end edges 176
and 178. Alternate blank 170 is suitable for forming into a channel-bodied
surgical needle or channel-bodied surgical incision member and includes
unique suture attachment structure in the form of a tab 180 projecting
from first longitudinal side edge 172. Tab 180 is utilized to crimp
a portion of a suture within a channel of the channel-bodied surgical
needle or channel-bodied surgical incision member formed from needle
blank 170.
Referring now to FIG. 27 there is disclosed a channel-bodied surgical
incision member formed from needle blank 170. Channel-bodied surgical
incision member 182 is formed in the manner described hereinabove
and includes a channel 184 formed between first and second longitudinal
side edges, 172 and 174 respectively. Preferably, transverse end
edges 176 and 178 are ground or otherwise processed in the manner
described hereinabove to result in a cutting or sharpened tip portion
186 and unsharpened tapered portions 188 at transverse end edge
176 and cutting or sharpened tip portion 190 and unsharpened tapered
portion 192 at the opposite transverse end edge 178. Sharpened tip
portions 186 and 190 form cutting edges for slicing and penetrating
tissue. Once needle blank 170 has been formed into channel-bodied
surgical incision member 182 and ground or sharpened to form sharpened
tip portions 186 and 192 channel-bodied surgical incision member
182 is ready to receive a length of suture, such as, for example,
suture 194 for securement within channel 184.
Referring now to FIGS. 28 and 29 in order to secure suture 194
within channel 184 suture 194 is placed within channel 184 and
tab 180 is folded inwardly into channel 184. As tab 180 is folded
inwardly, it forms a first bend 196 adjacent longitudinal side edge
172 and a second bend 198 which serves to secure suture 194 within
channel 184.
It will be noted that the various apparatus engagement structure,
described hereinabove, may be incorporated into channel-bodied surgical
incision member 182 to facilitate handling by surgical suturing
apparatus. In addition, it will be understood that the channel-bodied
surgical incision member of FIGS. 27-30 alternatively could be made
as a channel-bodied needle having a cutting edge at only one end
thereof.
As noted hereinabove, it is preferable to secure the length of
suture material within the channel portion of a channel-bodied needle
to facilitate passing the channel-bodied surgical needle or channel-bodied
surgical incision member through tissue with minimal tissue damage.
Thus, as shown in FIG. 30 as channel-bodied surgical incision member
182 is advanced into a tissue section, such as, for example, tissue
section A, sharpened tip portion 190 penetrates tissue section A
and cuts a flap of tissue therethrough. As channel-bodied surgical
incision member 192 is further forced against tissue section A,
suture 194 folds inwardly within channel 184 to facilitate passage
through tissue section A. After surgical incision member 192 is
pulled through tissue, the tissue flap closes against the suture
to help seal the opening in the tissue surrounding the suture. As
noted hereinabove, such cutting of an incision or flap of tissue
may be preferable to creating a round or puncture wound within a
tissue section with a needle of enlarged cross-section relative
to the suture.
Referring for the moment to FIGS. 31 and 32 in any of the embodiments
disclosed herein it may be preferable to have only a portion of
transverse end edge 178 sharpened for cutting tissue. For example,
it may be desirable to have only tip portion 190 sufficiently sharpened
to cut tissue while tapered portions 192 spread or wedge open the
incision made by sharpened tissue portion 190 to allow channel-bodied
surgical incision member 182 to pass through a narrow flap of tissue.
Referring now to FIG. 33 there is shown a further alternate needle
blank suitable for forming into channel-bodied surgical needles
or channel-bodied surgical incision members. Alternate needle blank
200 generally includes first and second longitudinal side edges,
202 and 204 respectively, and tapered portions 206 and 208 at opposite
ends of needle blank 200. Needle blank 200 is configured to provide
unique tissue penetrating and cutting structure to facilitate the
passage of a channel-bodied surgical needle or surgical incision
member through tissue with minimal trauma. Thus, cutting end blanks
210 and 212 are formed projecting from tapered portions 206 and
208 respectively. Cutting end blanks 210 and 212 are provided to
be ground or otherwise sharpened to formed penetrating tip portions
on a channel-bodied surgical incision member or surgical needle.
Tapered portions 206 208 preferably also include cutting edges,
but it is contemplated that cutting edges may not required on tapered
portions 206 208. It also is contemplated that a plurality of cutting
end blanks may be provided. Additionally, needle blank 200 further
includes suture attachment structure in the form of a tab 214 which
functions substantially similar to tab 180 described hereinabove.
Further, a channel-bodied surgical incision member formed from needle
blank 200 may include various apparatus engagement structure as
described hereinabove.
Referring now to FIG. 34 once needle blank 200 has been formed
into a channel-bodied surgical incision member or surgical needle,
such as, for example, channel-bodied surgical incision member 216
having a channel 218 formed therein, the cutting ends, such as,
for example, cutting end 212 may be ground or otherwise sharpened
to form sharp cutting edges 220. When needle blank 200 is formed
into a channel-bodied surgical incision member or surgical needle,
tapered edges 208 preferably remain unsharpened to avoid unnecessary
cutting of tissue.
As noted hereinabove, cutting ends 212 are provided to facilitate
and enhance the cutting ability of end portions of a channel-bodied
surgical incision member or surgical needle. Referring now to FIGS.
35 and 36 as cutting end 212 of channel-bodied surgical incision
member 216 is forced into a tissue section T, cutting edges 220
cut tissue section T to form a narrow slit or incision therethrough.
Thus, as shown in FIG. 36 when channel-bodied surgical incision
member 216 is forced into tissue section T, tapered edges 208 wedge
open the slit or incision I to provide a relatively narrow passageway
for channel-bodied surgical incision member 216 to pass through
the tissue section. Preferably, and as noted hereinabove, suture
194 will have been secured within channel-bodied surgical incision
member 216 by means of tab 214. As channel-bodied surgical incision
member 216 is moved through tissue section T, suture material 194
lies within channel 218 to minimize trauma to tissue section T surrounding
incision I.
One advantage of the channel-bodied structure over a round-bodied
structure includes lower drag as the channel-bodied needle passes
through a tissue section. Also, as noted above the suture lays inside
the needle for a smaller size entry hole and reduced tissue damage.
This is especially appreciated during vascular tissue suturing.
The entry point is a cut flap not a round hole.
It will be understood that various modifications may be made to
the embodiments disclosed herein. For example, as noted, various
other cross-sectional shapes may be imparted to the body portion
of the channel-bodied structure as well as alternate straight or
arcuate profiles. It is also contemplated the side walls may not
be parallel, but may be inclined toward one another. Further, locations
for the various apparatus engagement and suture attachment structure
may be provided, for example, in the tissue penetrating end portions,
etc. Additionally, it is contemplated to interchange the various
apparatus engagement structures with the various cross-sections
and methods of suture attachment. Other methods of securing a length
of suture material within or to a channel-bodied needle is contemplated
such as, for example, by welding, crimping, gluing or otherwise.
Therefore, the above description should not be construed as limiting,
but merely as exemplifications of preferred embodiments. Those skilled
in the art will envision other modifications within the scope and
spirit of the claims appended hereto. |