Surgical tool for abdominal suturing

Abstract

A surgical instrument (100) for abdominal suturing includes: an elongated body (101) comprising a distal end (102) and a proximal handle (105), and further comprising a pair of transverse notches (103) between the distal end (102) and the proximal handle (105), the elongated body (101) having an oval or elliptical cross-section, wherein the pair of notches (103) are also transversely aligned along the major axis of the oval or elliptical cross-section; and a pair of needles (…) housed in the distal end (102). 106), the pair of needles having needle tips pointing towards the proximal handle (105), the pair of needles (106) being configured to slide longitudinally and engage with the needle tip (115); sutures (113), each end of which is fixed to the pair of needles (106); a mover device (107) configured to move the pair of needles (106) proximally to engage with the pair of notches (103), and also configured to move the pair of needles (106) further proximally beyond the pair of notches (103).

Description

Technical Field

[0001] This invention relates to a surgical tool for abdominal suturing.

[0002] Typically, this invention is applied in the field of surgical tools, particularly for closing small incisions in the abdominal wall, especially in relation to laparoscopic surgery. Background Technology

[0003] In abdominal surgery, laparoscopic techniques allow surgical procedures to be performed without creating long incisions in the abdominal wall. Instead, small incisions (typically 5 to 15 mm long) are used to introduce a suitable hollow instrument (“cannula”), a camera, and specialized tools through which the surgery is performed. The incision required for cannula introduction is called the “cannula site” or often also referred to as the “port site.”

[0004] To date, the following surgeries can be performed using laparoscopic techniques: cholecystectomy, gastroesophageal joint surgery, surgery for morbid obesity, and colon surgery.

[0005] Cannulas are hollow, cylindrical instruments made of plastic or metal that are inserted through the abdominal wall at the start of surgery and removed at the end of the procedure, leaving a hole in the patient's abdominal fascia.

[0006] If the opening is not properly closed, several complications can occur, one of the main ones being an "incisional hernia," an abdominal hernia that forms over the scar of a previous incision. This can cause internal organs to protrude through the fascia and lead to further complications such as intestinal obstruction or even intestinal necrosis.

[0007] To avoid future incisional hernias and related complications, the hole left by the cannula needs to be closed manually or with the aid of traditional or specialized laparoscopic tools, especially by suturing the abdominal wall layer known as the myofascia fascia (or most commonly, "fascia").

[0008] Closing the cannula at the end of a surgical procedure often presents technical challenges related to the fact that the skin incision is the same length as the fascial incision. This limitation makes it difficult to even "see" the openings in the fascia through the skin openings, and consequently, it makes reaching the fascia and properly suturing it extremely difficult. This problem is even more pronounced in obese patients, as the thicker layer of fat further separates the skin openings from the fascial openings.

[0009] As mentioned above, difficulties in closing the cannula site occur at the end of the procedure, which can last up to several hours, leaving the surgical team exhausted. This often results in the procedure being performed poorly or not at all, or in surgical assistants treating the procedure as "routine," even though they are typically less skilled.

[0010] Known techniques for closing the abdominal wall include "internal" closure techniques, which require two additional port sites; "external" techniques, which require additional port sites; and techniques with or without additional port sites, whether displayed or not. In addition to "manual" closure techniques, several devices for closing the abdominal wall have been proposed: spinal puncture needles, subcutaneous injection needles, Deborah aneurysm needles, Birch needles, and aneurysm needles.

[0011] None of these techniques are overly complex and / or time-consuming, have proven satisfactory, and are generally considered the "gold standard" for closure sites after laparoscopic surgery. Summary of the Invention

[0012] One objective of this invention is to overcome the shortcomings of known technologies.

[0013] A specific objective of this invention is to close the peritoneum and fascia within seconds.

[0014] Another specific object of the present invention is to provide maximum safety assurance in laparoscopic surgery.

[0015] Another specific object of the present invention is to allow the suture to be positioned in the most correct location within the fascial incision.

[0016] Another specific object of the present invention is to provide an ergonomic device that can be used with fewer and simpler gestures.

[0017] These and other objectives are achieved by surgical instruments for abdominal suturing, as characterized by the appended claims that form an integral part of this disclosure.

[0018] The basic idea of ​​this invention is to provide a surgical tool consisting of several parts, the purpose of which is to allow a suture needle, initially contained in the distal part of the tool itself, to pass through the abdominal wall and be retrieved in the proximal "tail" of the tool.

[0019] In one embodiment, the present invention provides a surgical tool for abdominal suturing, comprising: an elongated body including a distal end, a proximal handle, and a pair of transverse notches between the distal end and the proximal handle, the elongated body having an oval or elliptical cross-section, wherein the pair of notches are also transversely aligned on the long axis of the oval or elliptical cross-section; a pair of needles received in the distal end with needle tips pointing toward the proximal handle and configured to slide longitudinally and engage with needle tips [2]; a suture having a suture attached to the respective ends of the pair of needles; and a mover device configured to move the pair of needles proximally to engage with the pair of notches, and further configured to move the pair of needles proximally beyond the pair of notches.

[0020] Advantageously, the surgical tool according to the invention allows the surgeon to easily close the incision left by the cannula in the abdominal fascia within seconds, facilitating the operator's placement of the sutures, directly contributing to an increase in the number and quality of sutures performed, and thus demonstrating advantages for the patient, the surgeon, and the healthcare system itself.

[0021] Advantageously, the surgical tool according to the invention allows the needle to pass quickly through the abdominal wall fascia in the correct position with minimal and ergonomic movement, and once withdrawn, the needle leaves the two ends of the thread to be knotted to the surgeon in order to effectively close the abdominal wall.

[0022] Preferably, the proximal handle attached to the elongated body is operable by a surgeon. The mover device includes two levers: a first lever configured to be removably attached to the pair of needles to move the pair of needles proximally to engage the pair of notches; and a second lever configured to be further attached to the pair of needles to move the pair of needles further proximally relative to the pair of notches.

[0023] Preferably, the first and second levers are at least partially located inside the body of the surgical tool and are coaxial, and the surgical tool includes a pair of triggers associated with the proximal handle and operable conveniently by the surgeon.

[0024] Further features and advantages will become more apparent from the following detailed description of preferred, non-limiting embodiments of the invention and from the dependent claims that summarize preferred and particularly advantageous embodiments of the invention. Attached Figure Description

[0025] The invention is illustrated with reference to the following figures, which are given by way of non-limiting example, wherein:

[0026] Figure 1 A perspective view illustrating an embodiment of the surgical tool according to the present invention is shown.

[0027] Figure 2 Another perspective view of surgical instruments is shown.

[0028] Figure 3 A cross-sectional view of a surgical instrument in its first operating mode is shown.

[0029] Figure 4 Details of the surgical instruments in the first operating mode are illustrated.

[0030] Figure 5 Further details of the surgical instruments in the first operating mode are illustrated.

[0031] Figure 6 A cross-sectional view of a surgical instrument in its second operating mode is shown.

[0032] Figure 7 Details of the surgical instruments in the second operating mode are illustrated.

[0033] Figure 8 Further details of the surgical instruments in the second operating mode are illustrated.

[0034] Figure 9 A cross-sectional view of a surgical instrument in the third operating mode is shown.

[0035] Figure 10 Details of the surgical instruments in the third operating mode are illustrated.

[0036] Figure 11 Further details of the surgical instruments in the third operating mode are illustrated.

[0037] Figure 12 A cross-sectional view of a surgical instrument in the fourth operating mode is shown.

[0038] Figure 13 Details of the surgical instruments in the fourth operating mode are illustrated.

[0039] Figure 14 The three operating states of the surgical tool in the fifth operating mode are illustrated.

[0040] Figure 15 This illustrates another operating state of a surgical tool in its fifth operating mode.

[0041] In different figures, similar elements will be identified by similar reference numerals. Detailed Implementation

[0042] Figure 1 A perspective view illustrating an exemplary and non-limiting embodiment of a surgical tool 100 for abdominal suturing according to the present invention is shown.

[0043] The surgical instrument 100 includes an elongated body 101 having a distal end 102 and a pair of transverse notches 103.

[0044] A pair of needles (not visible) are housed in the distal end 102 and are configured to slide longitudinally and engage the pair of notches 103 by the corresponding needle tips, the pattern of which will be described below.

[0045] The distal end 102 has an oval profile and is configured for insertion into a hole through the abdominal wall.

[0046] To conform to the anatomy of the abdominal fascia, the transverse notches 103 are on opposite sides of the elongated body 101 and are longitudinally aligned with each other.

[0047] Furthermore, the transverse notch 103 tapers relative to the elongated body 101 to facilitate the insertion and withdrawal of the surgical instrument 100 through the opening in the abdominal wall.

[0048] Figure 2 Another perspective view of the surgical instrument 100 is shown.

[0049] This view highlights how a slot 104 connecting the pair of notches 103 is laterally present on the distal end 102, with the purpose of allowing the suture to slide according to a pattern that will be described further.

[0050] The surgical instrument 100, including the distal end 102, has a sheath made of a rigid and smooth material (possibly a high-density polymer) with an elongated shape, a rounded tip, and an oval or elliptical cross-section, which is connected to a T-shaped handle 105 at its proximal end.

[0051] As can be seen, the pair of notches 103 are located between the distal end 102 and the proximal end handle 105.

[0052] As can be seen further, the notches 103 are further aligned laterally on the long axis of the oval or elliptical cross-section of the surgical instrument 100.

[0053] In this specification, reference will be made to the configuration of the device used, wherein the parts referred to as “proximal” are those closest to the surgeon who holds the surgical instruments, while the parts referred to as “distal” are those furthest from the surgeon and intended to reach the patient.

[0054] The surgical instrument 100 has several hollow spaces inside, which allow the rods, needles and articulated arms, except for the sutures, to move according to the pattern described below.

[0055] It should be noted that although the suture line exists conceptually, it will only be shown in some diagrams for the sake of simplification.

[0056] As described above, the outer surface of the elongated body 101 has two features: a deep incision 103 on the sidewall of the tool 100 at approximately halfway along the longitudinal axis, designed to accommodate the edge of an opening where a cannula has been left in the fascia, the edge of which will be pierced sequentially by the needle; and a slit 104, which is actually engaged in the distal portion 102 of the tool 100, along with the two incisions 103, allowing the suture to detach from the tool 100 upon withdrawal. In the distal portion 102, a groove for the suture is present within the tool 100.

[0057] Figure 3 A cross-sectional view of the surgical tool 100 in its first operating mode, referred to as "open," is shown.

[0058] In this view, a pair of needles 106 housed in the distal end 102 can be seen, as will be further described, which are configured to slide longitudinally relative to the elongated body 101 in a proximal direction relative to the proximal handle 105 connected to the elongated body 101, thereby engaging the pair of notches 103 with the corresponding needle tips.

[0059] As can be seen, the pair of needles 106 housed in the distal end 102 has needle tips pointing towards the proximal handle 105.

[0060] The surgical instrument 100 also includes a mover device 107 (or “pusher and puller device” 107) configured to move (or “push”) the pair of needles 106 proximally to engage the pair of notches 103, and is also configured to move (or “retract”) the pair of needles 106 further proximally beyond the pair of notches 103 after passing through the fascia engaged in the notches 103, thereby allowing suturing of the abdominal wall.

[0061] The mover device 107 includes a first lever 108 (“push lever” 108) operable by a handle 105. The first lever 108 is configured to allow removable connection at the distal end of the device to the pair of pins 106 to move (or “push”) the pair of pins 106 proximally to engage with the pair of notches 103, as will be described further.

[0062] The mover device 107 also includes a second lever 109 (“lever” 109), which is always operable via the handle 105. The second lever 109 is configured to allow further connection to the pin pair 106 to further move (or “retract”) the pin pair 106 as it has reached a more proximal position relative to the pair notches, as will be described further.

[0063] It should be understood that the exemplary terms “push” and “retract” refer to the axial direction and are analogous to the needle tip being oriented from the inside to the outside of the fascia, but they are undoubtedly terms that will be obvious to a person skilled in the art when considering the analogy of “sewing”, in which the needle is “push” through the fabric by a loop (similar to the first rod of the present invention) and “retracted” by the tailor’s fingers (similar to the second rod of the present invention).

[0064] Figure 4 Details of the surgical instrument 100 in the first operating mode, referred to as "open," are illustrated.

[0065] In a preferred embodiment, the first rod 108 and the second rod 109 are at least partially inside the elongated body 101 and are coaxial with each other. In particular, the first rod 108 is longer, extending upward to the distal end 102, and is inside the second rod 109, while the second rod is shorter and on the outside.

[0066] The proximal handle 105 includes a preferably T-shaped fixing element 110 and a pair of triggers 111 and 112 that can be operated by traction relative to the fixing element 110, as will be described further.

[0067] The triggers are associated with a first lever 108 for trigger 111 and a second lever 109 for trigger 112, respectively.

[0068] Figure 5 Further details of the surgical instrument 100 in the first operating mode, referred to as "open," are illustrated.

[0069] The image illustrates a suture 113, which has a corresponding end fixed to the pair of needles 106 and is preferably received in a groove 114 at the distal end 102.

[0070] In this first operating mode, referred to as "open", the operation of the surgical tool 100 can be described as follows.

[0071] The distal end 102 of the surgical instrument 100 is inserted through a skin hole left by a cannula.

[0072] Specifically, during the initial insertion, the long axis of the oval or elliptical cross-section of the surgical instrument 100 remains parallel to the longitudinal long axis of the trocar incision in the fascia.

[0073] Then, specifically under video laparoscopic control, the distal end 102 of the surgical instrument 100 is pushed through the abdominal wall layer and into the abdominal cavity.

[0074] Under the visual control of video laparoscopy, the surgeon rotates the long axis of the cross-section of the surgical instrument 100 (which is oval or elliptical) and orients it to a position perpendicular to the longitudinal long axis of the trocar incision in the fascia, that is, perpendicular to the advancing direction of the trocar incision in the fascia.

[0075] Therefore, the oval or elliptical cross-section of the surgical instrument 100 allows the lateral incision 103 to better include the fascial edge of the cannula incision, which will be precisely positioned in the central incision 103 of the surgical instrument 100 for subsequent suturing.

[0076] In this operating mode, the needle 106 is completely contained within the distal end 102 of the tool.

[0077] Figure 6 A cross-sectional view of a surgical tool 100 in a second operating mode known as "occlusion" is shown.

[0078] As described above, the first lever 108 is operable by the handle 105 and is configured to be removably connected to the pair of pins 106 so that it can be moved proximally (or "pushed") to engage with the pair of notches 103.

[0079] In a preferred embodiment, the first lever 108 is a cylinder made of a rigid material, possibly metal, located at the innermost part of the surgical instrument 100. The first lever 108 is connected at its distal end to two articulated arms 116, which function to transmit motion from the first lever 108 to the needle 106, as will be described further. The proximal end of the first lever 108 is characterized by an L-shaped handle forming a trigger 111, which can be operated by traction of the surgeon's index finger.

[0080] Figure 7 Details of a surgical instrument 100 in a second operating mode known as “occlusion” are illustrated, in which the needle 106 can be seen to include a corresponding needle tip 115 configured to first engage the pair of notches 103.

[0081] As can be seen further, the needle tip 115 points toward and faces the proximal handle 105. Figure 8 Further details of the surgical instrument 100 in a second operating mode, referred to as “occlusion,” are illustrated, in which the pair of needles 106 includes corresponding needle bars 117 that are parallel to and opposite each other, and the arm 116 of the first bar 108 is configured for removable connection to the needle bar 117, as will be described further.

[0082] Specifically, arms 116 connect the first bar 108 to the needle 106; in their proximal portions, they are actually connected to the distal ends of the first bar 108, and in their distal ends, they are interlocked, preferably bi-angular interlocked, which connects them to the needle bar 117.

[0083] In this second operating mode, referred to as "occlusion", the operation of the surgical tool 100 can be described as follows.

[0084] By pulling trigger 111, the surgeon begins to slide needles 106 proximally toward the notch 103 until they find the first reversible resistance point.

[0085] In this "occlusal" position, the needle tip 115 of needle 106 is visible via an intra-abdominal camera, thus visible "from below" or from the distal end of tool 100, allowing the surgeon to simultaneously point them toward the abdominal fascia of the two needles 106 that he deems more suitable. The suture attached to the distal end of needle shaft 117 begins to unwind.

[0086] Figure 9 A cross-sectional view of the surgical instrument 100 in a third operating mode known as "closed" is shown.

[0087] As described above, the second lever 109 is operable by the handle 105 and is configured to be further connected to the pair of needles 106, so that once the corresponding needle tip 115 has passed through the corresponding notch 103, the pair of needles 106 is moved further to a position closer to the pair of notches.

[0088] In fact, in addition to a first stop suitable for reversibly engaging the pair of notches 103 with the needle tip 115, the first rod 108 also includes a second stop suitable for irreversibly disengaging from the needle bar.

[0089] Figure 10 Details of the surgical instrument 100 in a third operating mode, referred to as "closed", are illustrated.

[0090] As described above, arm 116 is configured to engage with needle bar 117 in order to transmit motion from first bar 108 to the pair of needles 106.

[0091] Furthermore, the arms 116 are configured to disengage from the needle bar 117, thereby disengaging them from the first bar 108. For this purpose, in a preferred embodiment, the arms 116 include hinged arms 116 having arm ends 118 configured to engage with corresponding surfaces of the needle bar 117.

[0092] Figure 11 Further details of the surgical instrument 100 in a third operating mode, referred to as "closed," are illustrated.

[0093] The elongated body 101 also includes a hollow element 119 configured to deflect the arm end 118, particularly acting on the articulated arm 116. In a preferred embodiment, the insertion element 119 is a hollow element that serves as a track or guide and has a forward direction with a central bend at its proximal end to deflect the arm end 118.

[0094] In this way, the arm end 118, which engages with the corresponding surface of the needle bar 117, can disengage from the needle bar 117, thereby disengaging the first bar 108 from the needle 106.

[0095] The second lever 109 therefore includes a blocking element 120, which is configured to snap into the needle tip 115, or further connected via other safety mechanical connections.

[0096] For this purpose, the needles 106 include corresponding protrusions or notches near the needle tip 115. In a preferred embodiment, the needles 106 have asymmetrical tips that are vertical in the outer portion and sloping in the inner portion; below the needle tip 115, in a central position, they have curved incisions for receiving the end of the blocking element 120 after the needles 106 have passed through the notch 103, pierced the abdominal fascia, and then entered the proximal portion of the elongated body 101. In the distal portion, the needles 106 have square inner incisions for receiving the distal end 118 of the articulated arm 116. The distal end of the needles 106 is joined to the suture 113.

[0097] Specifically, the blocking element 120 includes a pair of flexible elements or tabs configured to engage and block the protrusions or notches of the blocking pin 106.

[0098] Preferably, the needle 106 is located in the laterally outermost portion of the surgical instrument 100, at the lateral edge of the distal end 102, to facilitate suturing of the abdominal fascia and subsequent removal of the surgical instrument 100 from the "cannula site".

[0099] In this third operating mode, referred to as "closed", the operation of the surgical tool 100 can be described as follows.

[0100] When the surgeon is satisfied with the positioning of the needle 106 relative to the abdominal fascia, he begins to pull the trigger 111 of the first lever 108, forcing it to reversibly block so that the needle tip 115 can pierce the abdominal fascia; the needle 106 continues to slide forward, returning to the elongated body 101 in its proximal portion.

[0101] Finally, by pulling the trigger 111 of the first lever 108 upward to its end travel, the irreversible block is preferably engaged, and the needle 106 engages in the appropriate blocking element 120 of the second lever 109.

[0102] The needle 106, whose tip 115 returns to the proximal portion of the elongated body 101, has a corresponding curved cut at the base of the tip 115, which is located at the lateral edge of the pull tab 120 of the second rod 109. At this time, the pull tab 120 blocks the corresponding tip 115 and prevents it from returning.

[0103] Meanwhile, the articulated arm 116, connected to the distal end of the first bar 108, has disengaged from the needle 106, following the curved profile of the insertion element 119 obtained in the distal portion of the elongated body 101 of the surgical instrument 100. The needle 106 is now anchored to the surgical instrument 100 only by the pull tab 120 of the second bar 109, while the suture 113 continues to unwind.

[0104] Figure 12 A cross-sectional view of the surgical instrument 100 in a fourth operating mode known as "engulfing" is shown.

[0105] As already mentioned, the second rod 109 includes a third stop adapted to irreversibly hold the pin pair 106 in a fully retracted position within the proximal portion of the elongated body 101.

[0106] In a preferred embodiment, the second rod 109 is constructed of a hollow cylinder made of a rigid material such as, for example, a high-density polymer, which coaxially houses the first rod 108. Unlike the first rod 108, the second rod 109 is entirely located within the proximal portion of the elongated body 101, and its function is to precisely retrieve the needles 106 once they have pierced and passed through the abdominal fascia, thereby fitting the suture 113 in a position determined by the surgeon. Specifically, the second rod 109 includes two pull tabs 120 at its distal end, which are configured to block the needles 106 and allow them to be retrieved upon piercing the abdominal fascia. The proximal end of the second rod 109 has an L-shaped handle forming a trigger 112.

[0107] Figure 13 Details of the surgical instrument 100 in the fourth operating mode, known as "swallowing," are illustrated.

[0108] The two ends of the suture 113 are in a straight line with the distal end of the needle bar 117. Before the needle 106 begins to move, the suture 113 is contained in a special groove 114 in the distal end 102 of the surgical instrument 100; as the needle 106 begins its movement under the action of the bars 108 and 109, the suture 113 gradually unwinds.

[0109] The sutures 113 continue to unwind until the needle 106 has ceased its movement after passing through the abdominal fascia, returning to the proximal portion of the elongated body 101, and being completely retracted after being blocked by the pull tab 120 of the second rod 109. At this point, the surgical instrument 100 is withdrawn from the "cannula site" and the sutures 113, which have passed through the abdominal fascia (not shown) after the needle 106, and released through the slot 104, as will be described further.

[0110] In this fourth operating mode, known as "swallowing," the operation of the surgical tool 100 can be described as follows.

[0111] By pulling the trigger 112 connected to the second lever 109, the surgeon gradually retracts the needle 106, which, after passing through the abdominal fascia, now slides in the proximal portion of the elongated body 101, from which point the abdominal fascia will be pierced only by the suture 113. The needle 106 is fully returned to the elongated hollow body of the surgical instrument 100. An additional irreversible obstruction at the end of the stroke of the second lever 109 ends this phase, where the threads engaged on both sides of the fascia are completely unwound.

[0112] Figure 14 The three operating states of the surgical tool 100 in the fifth operating mode, known as "free", are illustrated.

[0113] As described above, the suture 113 can slide laterally from the distal end 102 of the elongated body 101. Specifically, the distal end 102 includes a slot 104 that connects the pair of notches 103 and is configured to slide laterally and release the suture 113 initially received in the slot 114 of the distal end 102.

[0114] Figure 15 This illustrates another operating state of the surgical tool 100 in its fifth operating mode, which is referred to as "free".

[0115] Specifically, as can be understood from the figure, the transverse notch 103 of the surgical instrument 100 is precisely configured to accommodate the fascial edges of the abdominal wall, allowing the pair of needles 106 to pass through them, piercing the fascia, leaving the suture 113 in the surgeon's desired position so that it can subsequently be retracted into the elongated body 101, and allowing the suture 113 to pass freely through the slot 104 to allow the surgical instrument 100 to be removed from the "cannula site".

[0116] In this fifth operating mode, known as "freedom," the operation of the surgical tool 100 can be described as follows.

[0117] With the needle 106 blocked in its proximal position within the elongated body 101 after passing through the fascia and releasing the suture 113, the surgical instrument 100 is removed from the abdominal wall. The suture 113, having already protruded from the distal end 102 of the surgical instrument 100 through the slot 104, is now anchored only to the abdominal fascia. Suturing is accomplished by simply cutting the suture 113 near the surgical instrument and then tying the ends of the suture 113, now anchored only to the fascia.

[0118] Therefore, it is evident that the surgical tool according to the invention allows the surgeon to easily close the "cannula site" within seconds by quickly and accurately passing the needle through the abdominal wall fascia in the correct position, and to effectively close the abdominal wall once the tool is withdrawn by leaving the two ends of the suture to be knotted to the surgeon.

[0119] In light of the description reported herein, those skilled in the art will be able to develop further modifications and substitutions to meet possible and specific requirements.

[0120] For example, a T-shaped handle with two triggers can be replaced by a handle with a more ergonomic shape, such as a "pistol grip".

[0121] For example, a needle can be translated at any point belonging to the length of the needle by a rod of any shape and size.

[0122] For example, the needle may have protrusions and recesses for connecting to the corresponding actuator rod; in particular, the needle does not need to have an asymmetrical tip.

[0123] For example, the center narrows, where the fascia to be sutured is defined by a transverse notch, and may have more or less rounded shoulders to facilitate tool withdrawal, consistent with the length of the needle.

[0124] For example, a slot that allows sutures to overflow can follow a path that is more or less close to the apex of the tool.

[0125] For example, the suture can be attached to the lower end of the needle, and extend along the needle in a specific section of its length, and connect to the needle closer to the tip.

[0126] For example, the movement of each needle can be individually controlled by a mover device, which includes one or more levers dedicated to each needle.

[0127] Finally, for example, surgical instruments may be equipped with two or more pairs of needles and corresponding notches, controlled individually or simultaneously by a movement device.

[0128] Therefore, the embodiments described herein are considered to be exemplary and non-limiting examples of the present invention.

Claims

1. A surgical instrument (100) for abdominal suturing, comprising: - An elongated body (101) including a distal end (102) and a proximal handle (105), and further including a pair of transverse notches (103) between the distal end (102) and the proximal handle (105), the elongated body (101) having an oval or elliptical cross-section, wherein the pair of notches (103) are also transversely aligned on the major axis of the oval or elliptical cross-section; - A pair of needles (106) housed in the distal end (102), the pair of needles (106) having needle tips pointing toward the proximal handle (105), the pair of needles (106) being configured to slide longitudinally and engage with the needle tips (115); -A suture (113) having a corresponding end fixed to the pair of needles (106); - A mover device (107) configured to move the pair of needles (106) proximally and engage the pair of notches (103), and the mover device (107) is further configured to move the pair of needles (106) proximally beyond the pair of notches (103). The mobile device (107) includes: - A first lever (108), which is operable by the proximal handle (105) and configured to be removably connected to the pair of needles (106) to move the pair of needles (106) proximally and engage the pair of notches (103); - A second lever (109), which is operable by the proximal handle (105) and configured to be further connected to the pair of needles (106) so that the pair of needles (106) can be further moved to a more proximal position relative to the pair of notches (103).

2. The surgical tool according to claim 1, wherein, The pair of needles (106) includes corresponding needle bars (117) that are parallel to each other and opposite each other, wherein the first bar (108) includes an arm (116) configured to be removably connected to the needle bar (117).

3. The surgical tool according to claim 2, wherein, The arm (116) is configured to engage with the needle bar (117) and transmit movement from the first bar (108) to the pair of needles (106), and is also configured to disengage from the needle bar (117) to disengage from the first bar (108).

4. The surgical tool according to claim 3, wherein, The arm (116) includes a hinged arm (116) having an arm end (118) configured to engage with a corresponding surface of the needle bar (117), and wherein the elongated body (101) further includes an insertion element (119) configured to deflect the arm end (118) to disengage the arm end (118) from the needle bar (117).

5. The surgical tool according to claim 3, wherein, The first rod (108) is adapted to reversibly engage the pair of notches (103) with the needle tip (115) and is also adapted to irreversibly disengage from the needle bar (117).

6. The surgical instrument according to any one of claims 1-5, wherein, The second rod (109) includes a blocking element (120) configured to snap or securely connect with the needle tip (115).

7. The surgical instrument according to claim 6, wherein, The second lever (109) is also adapted to irreversibly hold the pair of needles (106) in the fully retracted position.

8. The surgical instrument according to claim 6, wherein, The pair of needles (106) includes a corresponding protrusion or notch near the needle tip (115), and wherein the blocking element (120) includes a pair of flexible elements (120) configured to engage and block the protrusion or notch.

9. The surgical instrument according to any one of claims 1-5, wherein, The first rod (108) and the second rod (109) are at least partially inside the elongated body (101) and are coaxial with each other.

10. The surgical tool according to claim 9, wherein, The first rod (108) is longer and located inside, while the second rod (109) is shorter and located outside.

11. The surgical instrument according to claim 10, wherein, The proximal handle (105) includes a fixing element (110) and a pair of triggers (111, 112) operable by traction relative to the fixing element, the triggers (111, 112) being associated with the first lever (108) and the second lever (109), respectively.

12. The surgical instrument according to any one of claims 1 to 5, wherein, The suture (113) is capable of sliding laterally from the distal end (102) of the elongated body (101).

13. The surgical instrument according to claim 12, wherein, The distal end (102) includes a groove (104) that engages the pair of notches (103) and is configured to laterally slide and release the suture (113) which is received in a can (114) in the distal end (102).

14. The surgical instrument according to any one of claims 1 to 5, wherein, The pair of notches (103) are located on opposite sides of the elongated body (101) and are longitudinally aligned with each other.

15. The surgical instrument according to claim 14, wherein, The elongated body (101) has a rounded tip.

16. The surgical instrument according to any one of claims 1 to 5, wherein, The distal end (102) has an oval profile and is configured to be inserted into a hole through the abdominal wall, wherein the pair of notches (103) are tapered relative to the elongated body (101) to facilitate insertion into and withdrawal from the hole through the abdominal wall, and wherein the pair of notches (103) are also configured to receive the fascial edge of the abdominal wall for the pair of needles (106) to pass through the fascial edge.

Images