Suture needle abstract
A suture needle holder is described with a ratcheting mechanism
and a optimized set of jaws. These jaws have nitinol inserts for
deformability around a suture needle. The shaft of the endoscopic
suture needle holder is rotatable to allow placement of the jaws.
Also, operation may take place along only one axis, by making the
handles parallel to the shaft axis and the jaws which grip the suture
needle.
Suture needle claims
What is claimed is:
1. An endoscopic suture needle holder comprising an actuating mechanism
remotely connected to a pair of needle holding jaws wherein said
actuating mechanism may be locked with said jaws holding said needle
and said jaws characterized in that each of said jaws containing
a base and a needle facing insert, a said insert attached to a said
base, and each of said inserts on said jaws placed in opposed relationship
toward one another so as to grip a suture needle therebetween, each
said insert formed from nitinol such that the nitinol deforms around
the needle when said needle is placed between said inserts and when
said jaws are in a closed position.
2. The needle holder of claim 1 wherein said locking takes place
on a ratchet system connected to said actuating mechanism.
3. The needle holder of claim 2 wherein said ratchet system exerts
a discriminate set of forces on said needle through said jaws.
4. The needle holder of claim 1 wherein said actuating mechanism
is a pair of handles, one of said handles pivotable about the other,
and one said handle connected by a cable to a first of said jaws,
such that when said handle pivots, said cable causes said first
jaw to pivot about the second of said jaws.
5. The needle holder of claim 1 further having an actuating mechanism
connected to a pair of needle holding jaws, by a shaft, said shaft
fixedly holding one of said jaws, and said shaft rotatable about
its longitudinal axis.
6. An endoscopic needle holding mechanism having an actuating mechanism
connected to a pair of needle holding jaws, by a shaft, said shaft
fixedly holding one of said jaws, and said shaft rotatable about
its longitudinal axis and said jaws characterized in that each of
said jaws contain a base and a needle facing insert, a said insert
attached to a said base, and each of said inserts on said jaws placed
in opposed relationship toward one another so as to grip a needle
therebetween, each said insert formed from nitinol such that the
nitinol deforms around the needle when said needle is placed between
said inserts and when said jaws are in a closed position.
7. The needle holder of claim 6 wherein said shaft contains a clamping
mechanism to clamp said shaft into place after rotation about said
axis.
8. The needle holder of claim 6 further comprising an actuating
mechanism remotely connected to a pair of needling holding jaws
wherein said actuating mechanism may be locked with said jaws holding
said needle.
9. The needle holder of claim 8 wherein said actuating mechanism
is a pair of handles, one of said handles pivotable about the other,
and one said handle connected by a cable to a first of said jaws,
such that when said handle pivots, said cable causes said first
jaw to pivot about the second of said jaws.
Suture needle description
FIELD OF THE INVENTION
Generally, this invention relates to suture needle holders. More
specifically, this invention relates to endoscopic suture needle
holders. Most specifically, this invention relates to suture needle
holders designed for endoscopic use wherein the needle is easily
maintained within the holder, and the holder is easily manipulable
within an endoscopic trocar cannula.
BACKGROUND OF THE INVENTION
Currently, there are very few suture needle holders which are applicable
for endoscopic purposes. And, in fact, any current endoscopic needle
holders have quite a few deficiencies. For instance, most endoscopic
needle holders are able to hold straight suture needles, but curved
suture needles present a difficulty. This is generally because the
curved needles, when placed within current needle holder jaws, tend
to rotate within the pair of jaws which hold the needle.
In addition, current needle holders do not have the capability
of placing a strong and stable grip on the needle. Therefore, in
use, these needle holders tend to damage suture material, because
the needle may tend to slip within the needle holder jaws, so that
the suture comes into to contact with the needle holders. This is
generally due to the lack of pressure and/or lack of control of
the pressure exerted upon the needle.
In addition, some needle holders are not capable of holding needles
within tight endoscopic spaces. This is generally due to the design
of the needle holder jaws. Currently, needle holder jaws are deficient
in that they are relatively incapable of maintaining the needle,
and yet fit within tight spaces. Finally, there is a perceived deficiency
in that current needle holders are neither rotatable, nor fixedly
rotatable within a trocar cannula. That is, without rotatability,
these endoscopic suture needle holders are less easy to manipulate
than may be desired. These needle holders are used in such narrow
confines, that it is desirable to be able to reliably rotate the
suture needle within this confine. Of course, it is also necessary
to lock the mechanism after rotation, so the needle holder must
be capable of maintaining a rigid position when locked.
SUMMARY OF THE INVENTION
Accordingly, it is the object of the invention to provide a reliably
adjustable suture needle holder. This needle holder should be capable
of reliably applying pressure to the suture needle to be held, and
also reliably manipulating the suture needle when emplaced within
a trocar cannula and in pneumoperitoneum.
It is another object to the invention to provide a suture needle
holder with an adjustable clamping force.
It is yet another object of the invention to provide a needle holder
which is able to rotatably fit within the abdomen through a cannula.
It is yet another object of the invention to provide a suture needle
holder which will not damage the suture while inserting the needle
into a trocar cannula with the suture attached.
Yet another object of the invention is to provide for a suture
needle holder which is rotatable and locking either before or during
insertion within a trocar cannula.
Finally, it is an object of the invention to provide for a suture
needle holder having jaws which have a low modulus of elasticity
combined with high yield strength in order to prevent slippage of
the suture needle after insertion.
These and other objects of the invention are accomplished in an
endoscopic needle holder with an actuating mechanism remotely connected
to a pair needle holding jaws. Each of the jaws have a serrated
surface for gripping the needle and each of the jaws have a needle
clamping profile which comprises a pair of walls such that the walls
approach each other toward the distal end of the jaws. The actuating
mechanism is remotely connected to the pair of jaws, and the actuating
mechanism may formed into a handle-shaped mechanism which may be
locked or rotated while holding the jaws within the needle. Also,
the shaft of the needle holder is rotatable about its longitudinal
axis, so that the jaws themselves may rotate in orientation. At
the desired moment, the shaft may be locked so that the jaws stay
firmly in place during emplacement of a suture. Finally, the jaws
themselves are created from a serrated insert, generally formed
from nitinol, which allows secure grip on the needle, and yet no
damage to the needle.
The objects of the present invention will be more readily understood
from the attached Detailed Description of the Drawings taken in
combination with the Detailed Description of the Invention.
DETAILED DESCRIPTION OF THE DRAWINGS
FIG. 1 is a side elevation view of an endoscopic needle holder
of the present invention;
FIG. 2 is a side view of an alternate handle for endoscopic needle
holder of the invention.
FIG. 3 is an enlarged perspective view of the jaws containing nitinol
inserts.
DETAILED DESCRIPTION OF THE INVENTION
As seen in FIG. 1 there is described an endoscopic needle holder
100 which contains a pair of serrated jaws 6 7 for applying a firm
grip. One of the jaws 7 is stationary, while the other jaw 6 is
pivotable at pivot 9 with relation to the first jaw 7. This pivotable
jaw 6 is controlled by a cable 8 extending the entire length of
the shaft 11 of the endoscopic needle holder 100. It is this shaft
11 which is emplaced within the cannula of a surgical trocar, for
instance the Endopath.TM. trocar currently marketed by Ethicon,
Inc., Somerville, NJ.
The rotatable and pivotable jaws of the endoscopic needle holder
100 are held within a handle mechanism. This handle mechanism contains
a support handle, which maintains the shaft 11 on a longitudinal
axis. Also, this holder mechanism contains an actuating handle 2
which is connected with the cable 8 so that it actuates the pivotable
jaw 6 of the suture needle holder 100. These handles 1 2 are attachable
by a ratcheting system 13 14 as seen at the base of the handle
so that when the jaws are closed, the handles 1 2 may be locked
together.
The ratcheting system 13 14 ensures easy locking or unlocking
of the handles 1 2 and provides an adjustable force for holding
the needle in the jaw. This force adjustment is necessary to hold
various sizes and shapes of needles for different body tissue and
for smooth penetration of soft as well as hard tissue. Once the
ratchet teeth 13 are engaged on lock 14 the surgeon knows that
the locked handles 1 2 are conveniently holding the suture needle
and may easily and readily manipulate the needle to pass through
the tissue. The ratchet teeth 13 may be readily unlocked with one
hand by positioning a finger inside the ring 15 of one handle 1
and another finger within the ring 16 of the opposite handle 2 and
pushing the ratchet 13 14 apart while exerting a scissor-like force
on the ratchets.
Each of the handles 1 2 include finger rings 15 16 which are
useful for positioning and operating the jaws. Also, a small leaf
spring 4 is positioned between the handles 1 2 to insure that jaws
6 7 are normally in their open position, and that there is no interference
with a surgeon's manipulation of the instrument with the jaws 6
7 closed.
Finally, the handle portion 1 2 can easily be disassembled from
the shaft portion by unscrewing the collar 17 on the shaft 8 connected
to threaded opening 18 of handle 1. Then, ball 19 may be lifted
from socket 20 in handle 2. Bumper or absorber 5 is made of rubber
and is connected to shaft 8 to cause smooth interplay of the handles
12 with shaft 8 contained therein. This combination ensures interchangeability
of shafts of the different sized needle holders.
As further seen in FIG. 1 the shaft 8 is placed in a cannula along
its longitudinal axis, which is generally 5 mm in diameter, allowing
the shaft to conveniently be inserted within a trocar cannula. This
shaft 8 contains a luer locking mechanism 3 for attachment to an
insufflation device, to provide insufflation force to the cannula.
It is important to notice that the shaft is rotatable in relation
to the handles. This feature allows the surgeon to manipulate the
needle holder within the abdominal cavity without moving the handle
portions 1 2. The shaft is locked in its normal operating position
by the collar 17 on the shaft threaded into screw 18 on handle 1
so that operation is :readily possible. Also, the luer portion 3
of the shaft 8 allows for easy cleaning after usage.
Importantly, the jaws 6 7 of the invention are serrated so that
a firm grip is placed on a curved needle and so that a curved needle
may obtain a smooth passage through tissue without turning or slipping
of the needle through the jaws 6 7. The density of the jaw serrations
prevents suture damage while passing the needle through the trocar
cannula. The jaws 6 7 are created so that they are narrow at their
forward-most end so that a needle may be held close to the point
in which the needle is passed through thick tissue. The width of
the jaws is gradually enlarged to provide a proper base for placing
the jaw and needle held therein within tissue. The jaws 6 7 are
created with metallic inserts I on which the serrations are formed.
These inserts I are generally formed from nitinol, which has a low
modulus of elasticity and a high yield strength. This combination
allows the inserts to deform around the needle during holding of
the needle so that slippage is prevented. After the needle is released
from the holder, the insert I resumes its original shape, and damage
to the needle does not occur.
As seen in FIG. 2 there is also the possibility that handles 101
102 may be connected to shaft 8 so that the handles be along an
axis generally parallel to the axis of shaft 8. Connection is made
to shaft 8 at threaded opening 118 and socket 120. A spring 104
permits handles 101 102 to remain in an opened position. Ratchets
113 114 lock in the same manner as ratchets 13 14. In this manner,
however, the use of the needle holder is entirely along the same
axis.
In operation, therefore, the needle holder 100 of this invention
is created so that it may have its jaws 6 7 placed about a suture
needle. Then the handles 1 2 are pulled together so that the suture
needle holder jaws grip the suture needle. If desired, the ratcheting
mechanism 13 14 may be used so that the amount of force on the
needle varies. Also, because the inserts in the jaws 6 7 are made
from nitinol, the jaws deform somewhat around the needle as the
needle is placed within the jaws. If desired, the needle may be
rotated by rotating the longitudinal shaft 8 of the suture needle
holder about handles 1 2. When the needle is in its proper desired
needle position, the shaft 8 should be locked at collar 17 and for
positioning through a trocar cannula. Now, with the needle ready
to use, and the needle holder placed down the cannula, suturing
begins. After the needle is properly placed within tissue, the needle
holder can be released and made to regrip the tissue so that it
can be either passed again through tissue or removed through the
trocar cannula.
The objects of the invention are to be understood from the attached
claims and their equivalents. |