Suture needle abstract
Described herein is a device that may be used in various applications,
such as medical applications, and, particularly in laparoscopic
procedures, to manipulate and/or introduce objects within or into
the body. In one embodiment of the invention, a device includes
a cannula with a handle that remains exterior to the body and an
extendable member on a portion of the device that may be inserted
into the body. The handle, which controls the extendable member,
may be moved in an axial direction to extend or retract the extendable
member from the interior of the cannula. It may also be rotated
to swivel the extendable member. Furthermore, the extendable member
may include at least one hole that may be used to, for example,
grasp a surgical suture or suture needle. Thus, the device may be
used to introduce such objects into the body and manipulate them
therein.
Suture needle claims
What is claimed is:
1. A device, comprising: a cannula; a handle slidably disposed
within said cannula; and an extendable member in mechanical communication
with said handle, such that axial and rotational movement of said
handle with respect to said cannula results in corresponding axial
and rotational movement of said extendable member, respectively,
said extendable member having a curvature when extended from an
interior of said cannula and having at least one hole disposed therein.
2. The device of claim 1 further comprising a base member mechanically
affixed to said cannula.
3. The device of claim 1 further comprising an intermediate shaft
mechanically connected at a distal end thereof to said extendable
member and at a proximal end thereof to said handle, said intermediate
shaft being slidably disposed within said cannula.
4. The device of claim 1 wherein said handle comprises a substantially
elongated portion that is slidably disposed within said cannula
and said handle is mechanically connected to said extendable member.
5. The device of claim 1 wherein said handle and said extendable
member are components of a unitary element.
6. The device of claim 1 wherein said cannula and said handle
are constructed of stainless steel.
7. The device of claim 1 where said cannula and handle are constructed
of material suitable for disposable use.
8. The device of claim 1 wherein said extendable member is constructed
of a malleable material.
9. The device of claim 1 wherein said extendable member is constructed
of a nickel cadmium composite material.
10. The device of claim 1 wherein said hole further comprises
a notch.
11. The device of claim 1 wherein a distal end of said extendable
member is of a blunt shape.
12. The device of claim 1 further comprising at least one circumferential
projection located between said cannula and a proximal end of said
device.
13. The device of claim 1 further including a locking mechanism
to lock said handle and said extendable member in a rotational orientation.
14. A device, comprising: a cannula; a handle slidably disposed
within said cannula; a base member mechanically affixed to said
cannula; and an extendable member in mechanical communication with
said handle, such that axial and rotational movement of said handle
with respect to said cannula results in corresponding axial and
rotational movement of said extendable member, respectively, said
extendable member having a curvature when extended from an interior
of said cannula and having at least one hole disposed therein.
15. The device of claim 14 further including a locking mechanism
to lock said handle and said extendable member in a rotational orientation.
16. A method for introducing a surgical suture into a body, comprising:
providing a device, comprising: a cannula, a handle slidably disposed
within said cannula, and an extendable member in mechanical communication
with said handle, such that axial and rotational movement of said
handle with respect to said cannula results in corresponding axial
and rotational movement of said extendable member, respectively,
said extendable member having a curvature when extended from an
interior of said cannula and having at least one hole disposed therein;
extending said extendable member; inserting said surgical suture
through said hole; retracting said extendable member; and inserting
a distal end of said device into said body to introduce said surgical
suture therein.
17. The method of claim 16 wherein said device further comprises
a locking mechanism to lock said handle and said extendable member
in a rotational orientation, and wherein said method further comprises
performing a locking action selected from the group consisting of
locking said locking mechanism during the course of introducing
said surgical suture into said body, unlocking said locking mechanism
during the course of introducing said surgical suture into said
body, and both locking and unlocking said locking mechanism during
the course of introducing said surgical suture into said body.
18. A method for manipulating a surgical suture within a body,
comprising: inserting a device into said body, said device comprising:
a cannula, a handle slidably disposed within said cannula, and an
extendable member in mechanical communication with said handle,
such that axial and rotational movement of said handle with respect
to said cannula results in corresponding axial and rotational movement
of said extendable member, respectively, said extendable member
having a curvature when extended from an interior of said cannula
and having at least one hole disposed therein; extending said extendable
member; inserting a suture needle attached to said surgical suture
through said hole; disconnecting said suture needle from said surgical
suture; retracting said extendable member; and manipulating said
surgical suture within said body with said device.
19. The method of claim 18 wherein said device further comprises
a locking mechanism to lock said handle and said extendable member
in a rotational orientation.
20. The method of claim 19 wherein manipulating said surgical
suture within said body with said device further comprises performing
a locking action selected from the group consisting of locking said
locking mechanism while manipulating said surgical suture, unlocking
said locking mechanism while manipulating said surgical suture,
and both locking and unlocking said locking mechanism while manipulating
said surgical suture.
Suture needle description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. provisional
patent application Ser. No. 60/509745 filed Oct. 8 2003 which
is incorporated by reference herein in its entirety.
FIELD OF THE INVENTION
[0002] The invention relates to the field of medical devices. More
particularly, the invention relates to medical devices that may
be used in connection with laparoscopic medical procedures, such
as those involving the introduction, manipulation and/or tying of
medical sutures.
BACKGROUND OF THE INVENTION
[0003] Laparoscopic techniques are commonly used to perform a variety
of surgical procedures. In general, laparoscopic techniques involve
at least one small incision or puncture through the abdomen or other
region of the body. Various devices can be inserted through the
at least one incision or puncture wound to gain access to the interior
regions of the body. An astounding array of surgical procedures
may then be performed, including, for example, various abdominal
procedures (e.g., gastric bypass, hernia repair, pyeloplasty), organ
removal (e.g., appendectomy, nephrectomy, adrenalectomy, hysterectomy),
endoscopic procedures, vein harvesting, lumbar fusion and others.
[0004] One significant challenge to the successful implementation
of laparoscopic procedures is the difficulty associated with manipulating
various objects inside the body. These objects include tissues,
organs, tumors, blood and lymphatic vessels and other components
of internal anatomy, as well as the foreign objects that may be
introduced and used in the course of a surgical procedure, such
as surgical sutures, suture needles, surgical sponges and the like.
To that end, a host of medical devices have been developed and are
commercially available to assist surgeons in performing operations.
By way of example, the ENDO MINI-RETRACT (available from United
States Surgical Corporation; Norwalk, Conn.) may be used in connection
with various laparoscopic techniques. However, while this particular
device may be used to manipulate objects inside the body, its use
is limited by its linear, non-swiveling range of motion. It also
cannot be used to manipulate surgical sutures or suture needles.
[0005] There is a need in the art for a device that may be used
in connection with laparoscopic techniques. There is a further need
in the art for a device that may be used in connection with such
techniques to manipulate surgical sutures and suture needles in
the body. There is a still further need in the art for a device
that may be used in connection with such techniques to introduce
surgical sutures into the body, and to thereafter manipulate them.
SUMMARY OF THE INVENTION
[0006] The invention is based on a device that may be used in connection
with various laparoscopic procedures, and methods of using the same.
For instance, the device is particularly well suited to introducing
and/or manipulating surgical sutures and/or suture needles into
and within the body. The device may be used to manipulate objects
inside the body, such as, but not limited to, blood and lymphatic
vessels and tissue, as well as other non-biological objects, such
as surgical sponges. The device of the invention can also be used
to bluntly dissect tissue, to isolate large vessels, to permit the
passage of suture ties intracorporally or extracorporally for vessel
ligation, and to permit the passage of suture needles intracorporally
or extracorporally for vessel ligation and oversewing.
[0007] To achieve the foregoing and in accordance with the purposes
of the present invention, one embodiment of the present invention
comprises a swivel or rotational feature, and a hole at the distal
end of an extendable member. These features provide enhanced manipulation
capability in vivo, and further enable one to introduce and manipulate
surgical sutures during a laparoscopic procedure.
[0008] The device of the invention may include a cannula with a
proximal end and a distal end. The proximal end may remain outside
the body during a laparoscopic procedure, while the distal end may
be inserted into the interior region of the body. The proximal end
of the device may include a handle that is operated to control an
extendable member at the distal end of the device. Axial motion
of the handle with respect to the cannula results in a corresponding
axial motion of the extendable member. Furthermore, rotational or
circumferential motion of the handle results in similar movement
of the extendable member. A locking mechanism enables the device
user to lock the handle and extendable member in any desirable rotational
orientation. The extendable member maintains a curvature when it
is extended from the interior of the cannula, while also being capable
of becoming substantially linear when it is retracted into the interior
of the cannula. The extendable member may further include at least
one hole. In particular embodiments, a hole may be included in the
extendable member that is capable of accommodating a surgical suture
and/or a suture needle.
[0009] In one aspect, the present invention is directed to a method
for introducing a surgical suture into a body during a laparoscopic
procedure. In another aspect, the present invention is directed
to a method for manipulating a surgical suture. The device of the
present invention can be used to introduce a surgical suture into
a body and/or manipulate a surgical suture and suture needle in
vivo. The surgical suture can be manipulated by movement of the
device and/or user axial movement and/or rotation of the handle.
By moving the device about within the body and, additionally, by
extending and/or rotating the extendable member by user operation
of the handle, the surgical suture may be deposited at a desirable
location within the body (e.g., it may be passed behind a vessel
and/or tied).
[0010] Other features and advantages of the invention will become
apparent from the following detailed description, taken in conjunction
with the accompanying drawings, which illustrate, by way of example,
various features of embodiments of the invention.
BRIEF DESCRIPTION OF THE FIGURES
[0011] FIG. 1 is a superior view of the device of the invention
in a retracted position in accordance with an embodiment of the
present invention.
[0012] FIG. 2 is a posterior view of the device depicted in FIG.
1 in a retracted position in accordance with an embodiment of the
present invention.
[0013] FIG. 3 is a lateral view of the device depicted in FIG.
1 in a retracted position in accordance with an embodiment of the
present invention, wherein the handle of the device is shown rotated
to an alternate position.
[0014] FIG. 4 is a superior view of the device depicted in FIG.
1 in an unretracted position in accordance with an embodiment of
the present invention.
[0015] FIG. 5 is a lateral view of the device depicted in FIG.
4 in an unretracted position in accordance with an embodiment of
the present invention.
[0016] FIG. 6 is a superior-lateral view of the device depicted
in FIG. 4 in an unretracted position in accordance with an embodiment
of the present invention, wherein the handle of the device is shown
rotated to an alternate position.
[0017] FIG. 7 illustrates a user positioning the device of the
invention to an unretracted position by axial movement of the handle
towards the distal end of the device in accordance with an embodiment
of the present invention.
[0018] FIG. 8 illustrates a user positioning the device depicted
in FIG. 7 to a retracted position by axial movement of the handle
towards the proximal end of the device in accordance with an embodiment
of the present invention.
[0019] FIG. 9 illustrates a user rotating the handle of the device
depicted in FIG. 8 in a retracted position in accordance with an
embodiment of the present invention.
[0020] FIG. 10 is a perspective view of the handle and base member
of the device of the invention in a retracted position in accordance
with an embodiment of the present invention.
[0021] FIG. 11 is a perspective view of the extendable member of
the device of the invention in an unretracted position in accordance
with an embodiment of the present invention.
DETAILED DESCRIPTION OF THE INVENTION
[0022] The invention is based on a device that may be used in connection
with various laparoscopic procedures, and methods of using the same.
The device itself is not limited to use in this particular field
of art, as it may find application in other areas; particularly
in a surgical setting, although use of the device and methods of
the invention are not in any way limited to the medical field. With
respect to laparoscopic procedures, however, the device is particularly
well suited to introducing and/or manipulating surgical sutures
and/or suture needles into and within the body. Other uses in the
field of laparoscopy exist, as well. For example, the device may
be used to manipulate objects inside the body, such as, but not
limited to, blood and lymphatic vessels and tissue, as well as other
non-biological objects, such as surgical sponges. The device can
be also used to bluntly dissect tissue, to isolate large vessels,
to permit the passage of suture ties intracorporally or extracorporally
for vessel ligation, and to permit the passage of suture needles
intracorporally or extracorporally for vessel ligation and oversewing.
[0023] The device of the invention may be similar in configuration
to the ENDO MINI-RETRACT device available from United States Surgical
Corporation. However, it possesses distinct advantages over this
device owing to several novel features being included therein. These
advantages allow one to use the device of the present invention
to introduce and manipulate surgical sutures and suture needles,
while the ENDO MINI-RETRACT device cannot be used in this fashion.
[0024] Referring to FIGS. 1-3 in one embodiment, the device of
the invention may include a cannula 30 with a proximal end and a
distal end. The proximal end may remain outside the body during
a laparoscopic procedure, while the distal end may be inserted into
the interior region of the body. References herein to distal and
proximal ends shall be with reference to this overall configuration
of the system. Thus, individual mechanical elements included in
the device of the invention may be described with reference to their
individual proximal and distal ends, which shall have a similar
orientation as that described above with respect to the cannula.
[0025] As illustrated in FIGS. 4-6 the proximal end of the device
may include a handle 40 that is operated to control an extendable
member 20 at the distal end of the device. The handle 40 may be
of any suitable configuration. In various embodiments, it may be
contoured or otherwise shaped to accommodate a user's fingers. To
that end, the handle may include contours, finger rests, non-slip
surfaces and other elements that may provide enhanced stability,
control and ease of operation, as will be readily appreciated by
one of skill in the art. FIG. 10 depicts a close-up view of the
handle 40 and illustrates an embodiment of the invention wherein
the handle contour 45 is a J-shaped curve. In other embodiments,
the handle contour 40 may take various shapes, as for example, a
C-shaped curve or an arc wherein the radius and extent of the arc
may suitably be changed depending on the surgical procedure to be
performed and the needs of the user.
[0026] As seen in FIGS. 1-6 a base member 50 may be included in
the device and mechanically affixed to the cannula 30 such that
it is not moveable with respect thereto. This base member 50 may
provide additional stability for a user in manipulating the handle,
in both axial and circumferential directions. In an embodiment of
the invention, the base member 50 may also include contours, finger
rests, non-slip surfaces and other elements that may provide enhanced
stability, control and ease of operation, as will be readily appreciated
by one of skill in the art. FIG. 10 depicts a close-up view of the
base member 50 and illustrates an embodiment of the invention wherein
the base member contour 55 of the base member 50 is a J-shaped curve.
In other embodiments, the contour of the base member 50 may take
various shapes, as for example, a C-shaped curve or an arc wherein
the radius and extent of the arc may suitably be changed depending
on the surgical procedure to be performed and the needs of the user.
[0027] As illustrated in FIGS. 1-6 the device of the invention
may also include circumferential projections 61 and 62 located between
the cannula 30 and handle 40 and between the handle 40 and base
member 50 respectively. It should be appreciated that there may
be one or more circumferential projections and that they may be
located at various locations within the device. Such circumferential
projections may be composed of a variety of materials such as stainless
steel and/or non-slip surfaces which would provide comfort and permit
ease of use for the user. Circumferential projections 61 and 62
may function as finger rests, may provide a tactile indication for
the user as to the positioning and degree of penetration of the
device within a body, and may provide enhanced support, stability,
control and ease of operation, as will be readily appreciated by
one of skill in the art.
[0028] In an embodiment of the invention, the handle 40 may be
mechanically connected to the extendable member 20 by way of an
intermediate shaft that is slidably disposed within the cannula
30 or, in an alternate embodiment, the handle 40 itself may include
a substantially elonged portion that is slidably disposed within
the cannula 30 and mechanically connected to the extendable member
20. In yet a further alternate embodiment, the handle 40 and extendable
member 20 may both be components of a unitary element. In each of
these configurations, axial motion of the handle 40 with respect
to the cannula 30 results in a corresponding axial motion of the
extendable member 20. More specifically, as depicted in FIGS. 1-3
and 8 when the handle 40 is moved in the proximal direction with
respect to the cannula 30 the extendable member 20 is at least
partially retracted within the interior of the cannula 30. Conversely,
as depicted in FIGS. 4-6 7 and 11 when the handle 40 is moved
in the distal direction with respect to the cannula 30 the extendable
member 20 is extended at least partially outward from the interior
of the cannula 30. Furthermore, as seen in FIGS. 3 6 and 9 rotational
or circumferential motion of the handle 40 results in similar movement
of the extendable member 20 regardless of the degree to which the
extendable member 20 is extended from the interior of the cannula
30. This swivel or rotational feature of the extendable member 20
can be achieved with one hand by rotating the handle 40 without
changing the orientation of the entire instrument. A locking mechanism
(not shown) may also be included; thereby enabling the device user
to lock the handle 40 and extendable member 20 in any desirable
rotational orientation with respect to the cannula 30. These are
features of the device that are not incorporated in the ENDO MINI-RETRACT
device, and which represent significant improvements. The ability
to control not only axial, but also rotational motion of the extendable
member 20 provides a greater range of motion that can be readily
controlled by the device user. Moreover, it enables a user of the
device to better control the device in various applications, such
as in the introduction and/or manipulation of a surgical suture
or suture needle. The further ability to lock the handle 40 and
extendable member 20 in a specific rotational orientation with a
locking mechanism is a still further improvement over the prior
art device.
[0029] The extendable member 20 may be constructed of a metallic
or other material that is malleable in nature. In one embodiment,
the extendable member is constructed of a nickel cadmium composite
material; although other materials can be used for this element,
as will be readily appreciate by those of skill in the art. The
material selected for the extendable member may be based upon its
ability to maintain a curvature when it is extended from the interior
of the cannula, while also being capable of becoming substantially
linear when it is retracted into the interior of the cannula. Preferably,
the material will not break or substantially fracture when subjected
to these geometric alterations, particularly because such mechanical
failure may result in damage to tissue and other anatomical structures
in vivo.
[0030] FIG. 11 depicts an embodiment of the invention wherein the
extendable member 20 assumes a C-shaped curvature when it is extended
from the interior of the cannula 30 (i.e., the device of the invention
is in an unretracted position). In alternate embodiments, the curvature
of the extendable member 20 may assume various shapes when the device
is in an unretracted position, as for example, a J-shaped curve
or any arc shape wherein the radius and extent of the arc may suitably
vary depending on the surgical procedure to be performed and the
needs of the user. Furthermore, in another embodiment, the distal
end of the extendable member 20 may include a blunt tip to prevent
inadvertent penetration of tissue and other anatomical structures
in vivo.
[0031] As illustrated in FIG. 11 the extendable member 20 may
further include at least one hole 22. This hole 22 may be configured
to any desirable size and shape. For instance, it may be roughly
round, ovular, square or triangular, or, in alternate embodiments,
it may be configured as an elongate slot either along the length
or the width of the extendable member. Still further configurations
of the hole or holes may be utilized, and, in embodiments wherein
multiple holes are included, it will be readily appreciated by one
of skill in the art that the holes need not be of the same size
or shape. In particular embodiments, a hole may be included in the
extendable member 20 that is capable of accommodating a surgical
suture and/or a suture needle, as will be more readily apparent
with reference to the Examples below, which describe various methods
of using the device of the invention. In embodiments wherein the
device of the invention is configured to accommodate suture and/or
suture needle, the hole 22 may further include a notch which allows
the extendable member 20 to better grip and capture the suture when
the device is in a retracted position; thereby preventing slippage
of the suture.
[0032] Moreover, the incorporation of at least one hole 22 into
the extendable member 20 of the device is yet another improvement
over the ENDO MINI-RETRACT device described above. This feature
of the invention is particularly advantageous for embodiments of
the device that are used in connection with the introduction and/or
manipulation of surgical sutures and suture needles. In fact, a
surgical needle and/or suture may be inserted through the at least
one hole 22 in the extendable member 20.
[0033] In one embodiment, the device is constructed of stainless
steel or other suitable material. However, in alternate embodiments,
the device can be manufactured for one-time disposable use. Additionally,
it should be appreciated that the device can have various dimensions
depending on the surgical procedure to be performed and the needs
of the user. For example, in one embodiment, the device of the present
invention has a total length of about 50 cm in its retracted position,
an outer sheath length of about 35 cm, a handle length of about
15 cm, a sheath width of about 7 mm, an extendable member length
of about 5 cm, and an extendable member width of about 3 mm.
EXAMPLES
[0034] The Examples described herein demonstrate various uses for
the device of the present invention in connection with the introduction
and manipulation of surgical sutures and suture needles. Such procedures
may be particularly advantageous in the context of a laparoscopic
procedure. However, as noted above, the device of the present invention
has many uses beyond those illustrated herein, and the ensuing Examples
are in no way intended to delineate the extent to which the device
of the present invention may find application with a medical, or
indeed any type of procedure.
Example 1
Introduction of a Surgical Suture
[0035] A device, as described above, is provided. The device includes
a single hole 22 in its extendable member 20. A surgical suture
is also provided. The extendable member 20 is extended from the
interior of the cannula 30 of the device ex vivo by user operation
of the handle 40 (i.e., the user moves the handle 40 axially towards
the distal end of the device), and the surgical suture is inserted
through the hole 22 in the extendable member 20. The extendable
member 20 is then retracted into the interior of the cannula 30
again, by user operation of the handle (i.e., the user moves the
handle 40 axially towards the proximal end of the device); thereby
"grasping" the surgical suture.
[0036] The distal end of the device is then inserted into a body
in the course of a laparoscopic procedure along with a length of
the "grasped" surgical suture. Once inserted into the
body, the extendable member 20 is extended by user movement of the
handle 40 towards the distal end of the device. Optionally, the
surgical suture is thereafter further manipulated by user rotation
of the handle 40. By moving the device about within the body, by
extending and/or rotating the extendable member 20 by user operation
of the handle 40 and/or by locking the extendable member 20 and
handle 40 with the locking mechanism in a specific rotational orientation
at various points throughout the course of the laparoscopic procedure,
the surgical suture may be deposited at a desirable location within
the body (e.g., it may be passed behind a vessel and/or tied).
Example 2
In Vivo Manipulation of a Surgical Suture and Suture Needle
[0037] A device, as described above, is provided. The device includes
a single hole 22 in its extendable member 20. A surgical suture
connected to a suture needle is also provided. The surgical suture
and suture needle are introduced into a body in the course of a
laparoscopic procedure by a methodology conventionally used in the
art. The distal end of the device is also introduced into the body.
[0038] The extendable member 20 is extended from the interior of
the cannula 30 of the device in vivo by user operation of the handle
40 (i.e., the user moves the handle 40 axially towards the distal
end of the device). The suture needle is passed entirely through
the hole 22 in the extendable member 20 such that a portion of
surgical suture remains in the hole 22. The suture needle is then
disconnected (e.g., cut) from the surgical suture. The extendable
member 20 is then retracted into the interior of the cannula 30
again, by user operation of the handle (i.e., the user moves the
handle 40 axially towards the proximal end of the device); thereby
"grasping" the surgical suture.
[0039] The surgical suture is thereafter manipulated by movement
of the device and/or user axial movement and/or rotation of the
handle 40. By moving the device about within the body, by extending
and/or rotating the extendable member 20 by user operation of the
handle 40 and/or by locking the extendable member 20 and handle
40 with the locking mechanism in a specific rotational orientation
at various points throughout the course of the laparoscopic procedure,
the surgical suture may be deposited at a desirable location within
the body (e.g., it may be passed behind a vessel and/or tied).
[0040] While the description above refers to particular embodiments
of the present invention, it should be readily apparent to people
of ordinary skill in the art that a number of modifications may
be made without departing from the spirit thereof. The accompanying
claims are intended to cover such modifications as would fall within
the true spirit and scope of the invention. The presently disclosed
embodiments are, therefore, to be considered in all respects as
illustrative and not restrictive, the scope of the invention being
indicated by the appended claims rather than the foregoing description.
All changes that come within the meaning of and range of equivalency
of the claims are intended to be embraced therein. |