Endoscopic suturing device for supporting a stapling needle in various orientations

Abstract

A surgical suturing device is provided that is configured for one-handed operation that enables a suturing needle to be passed through tissue with minimal operational requirements. A surgical needle is selectively secured to a tool assembly of the surgical suturing device. The tool assembly includes a jaw that is configured to securely support a variety of surgical needles in a variety of orientations.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit and priority of U.S. Provisional Patent Application No. 63 / 116,580, filed November 20, 2020, the entire contents of which are incorporated herein by reference. Technical Field

[0003] This disclosure relates to surgical devices for suturing or stitching, and more specifically to an endoscopic suturing or stitching device comprising jaws configured to support suture needles thereto in various orientations. Background Technology

[0004] One recent advancement in reducing the invasiveness of surgical procedures is endoscopic surgery. Endoscopic surgery typically involves cutting through the body wall. A cannula is usually used to create the incision through which the endoscope is performed. The cannula or insertion device is extended into the abdominal wall and left in situ to provide access for endoscopic instruments. A camera or endoscope is inserted through a relatively large-diameter cannula, typically located at the abdominal incision site, allowing for visual inspection and magnification of the body cavity. The surgeon can then perform diagnostic and therapeutic procedures at the surgical site using specialized instruments designed to work with additional cannulas, such as forceps, scalpels, and dressings.

[0005] In many surgical procedures, including those involving endoscopy, it is often necessary to suture body organs or tissues. In such surgical procedures, a surgical suture device must be used to manipulate a suture needle with a length of suture material attached to it. Summary of the Invention

[0006] This disclosure describes a surgical suturing device that demonstrates a practical method for meeting performance requirements and overcoming usability challenges associated with in vivo suturing.

[0007] According to this disclosure, a surgical suturing device includes: an arcuate suture needle; a handle assembly; an elongated shaft assembly extending distally from the handle assembly; and a tool assembly. The handle assembly includes a housing, a pair of handles, and an axial rod slidably supported within the housing. The axial rod is operatively coupled to the pair of handles such that actuation of the pair of handles causes axial displacement of the axial rod. The elongated shaft assembly includes an actuating rod and an outer tube, the actuating rod being operatively coupled to the axial rod for reciprocating in opposite directions, the outer tube defining an inner cavity therethrough. The axial rod is slidably disposed within the inner cavity of the outer tube. The tool assembly includes jaws coupled to the actuating rod. The jaws include a recessed portion configured to engage a portion of the arcuate suture needle. The jaws can switch between a retracted configuration and an advanced configuration. In the retracted configuration, the recessed portion is positioned proximally to clamp the arcuate sewing needle against the elongated shaft assembly. In the advanced configuration, the recessed portion is spaced apart from the elongated shaft assembly. The recessed portion has a first arcuate surface, a first flat surface proximally to the first arcuate surface, a second arcuate surface proximally to the first flat surface, and a second flat surface proximally to the second arcuate surface. The first arcuate surface has a first radius of curvature, and the second arcuate surface has a second radius of curvature different from the first radius of curvature.

[0008] On one hand, the arc-shaped sewing needle may have an arc-shaped portion having the same radius of curvature as the first arc-shaped surface of the recessed portion of the jaws.

[0009] On the other hand, the arcuate portion of the arcuate sewing needle may have the same radius of curvature as the second arcuate surface of the recessed portion of the jaw.

[0010] On another front, the first flat surface may be connected to the first arcuate surface of the recessed portion of the jaws.

[0011] On another front, the second flat surface may be connected to the second arcuate surface of the recessed portion of the jaws.

[0012] On one hand, the recessed portion of the jaws may also include a third arcuate portion located near the second flat surface.

[0013] On the other hand, the third arcuate portion of the recessed portion of the jaws may have a third radius of curvature that is different from the first radius of curvature or the second radius of curvature.

[0014] On another front, the third arcuate portion can be connected to the second flat surface of the recessed portion of the jaws.

[0015] In another aspect, the elongated shaft assembly may also include an inner tube fixed to the distal end portion of the outer tube. The inner tube may define a second cavity sized to slidably receive the actuating rod passing through it.

[0016] On the one hand, the inner tube may also include a radially inwardly extending lip.

[0017] On the other hand, the lip edge may have a recessed portion that is configured to engage part of the arcuate stitching needle.

[0018] On another front, the recessed portion of the lip edge may have the same radius of curvature as the arcuate portion of the arcuate stitch.

[0019] On one hand, the arc-shaped stitching needle may have a penetrating end portion and a flat-head end portion.

[0020] On the other hand, the jaws may define a cutting opening communicating with the recessed portion. The cutting opening may be configured to receive a portion of the curved sewing needle therein.

[0021] According to another aspect of this disclosure, a surgical suturing device includes: an elongated shaft assembly including a tube having a radially inwardly extending lip; and a jaw movable relative to the tube to clamp an arcuate suture needle between the jaw and the tube. The jaw includes a recessed portion comprising a first arcuate surface, a first flat surface proximal to the first arcuate surface, a second arcuate surface proximal to the first flat surface, and a second flat surface proximal to the second arcuate surface. The first arcuate surface has a first radius of curvature, and the second arcuate surface has a second radius of curvature different from the first radius of curvature.

[0022] On one hand, the recessed portion of the jaws may also include a third arcuate surface located near the second flat surface.

[0023] On the other hand, the lip of the tube may define a recess having the same radius of curvature as the second arcuate surface of the recessed portion of the jaw.

[0024] On the other hand, the first flat surface may be connected to the first arcuate surface and the second arcuate surface.

[0025] In another aspect, the surgical suturing device may also include a suture needle having a flat-ended end portion and a penetrating portion that are opposite each other along the diameter.

[0026] In another aspect, the jaws may also define a cutting opening configured to receive a portion of the sewing needle therein, the cutting opening communicating with the recessed portion of the jaws. Attached Figure Description

[0027] The above and other aspects and features of this disclosure will become more apparent when considered in conjunction with the following detailed description, in which like reference numerals denote similar or identical elements.

[0028] Figure 1 This is a perspective view of the surgical suturing apparatus according to this disclosure;

[0029] Figure 2 yes Figure 1 A perspective view of the handle assembly of a surgical suture device, in which the first half of the housing has been removed;

[0030] Figure 3 yes Figure 2 An exploded perspective view of the handle assembly, showing the parts separated;

[0031] Figure 4 yes Figure 1 A perspective view of the inner tube of the slender shaft assembly of a surgical suture device;

[0032] Figure 5 yes Figure 1 A perspective view of the jaws of the tool assembly of a surgical suturing device;

[0033] Figure 6 yes Figure 1 A magnified perspective view of the indicated detail area;

[0034] Figure 7 yes Figure 1 A partial side sectional view of the slender shaft assembly and tool assembly of the surgical suturing device;

[0035] Figure 8 It is along Figure 1 Section line 8-8 is taken Figure 1 A side sectional view of a surgical suture device;

[0036] Figure 9 for Figure 8 An enlarged sectional view of the indicated detailed area;

[0037] Figure 10 yes Figure 1 A partial perspective view of the slender shaft assembly and tool assembly of the surgical suture device, showing its connection with... Figure 1 The use of suture needles together;

[0038] Figure 11 yes Figure 1 A perspective view of a surgical suturing device, in which half of the housing has been removed, showing the actuation of the handle assembly;

[0039] Figure 12 yes Figure 11 A magnified perspective view of the indicated detail area;

[0040] Figure 13 It is along Figure 12 Section line 13-13 is taken Figure 12 A side sectional view of the slender shaft assembly and tool assembly;

[0041] Figure 14 yes Figure 12 A partial perspective view of the slender shaft assembly and jaws, showing its orientation in the second direction. Figure 12 The use of suture needles together;

[0042] Figure 15 It is along Figure 14 Section line 15-15 cut Figure 14 A side sectional view of the slender shaft assembly and jaws;

[0043] Figure 16 yes Figure 15 A partial side sectional view of the slender shaft and jaws, showing the aspect ratio. Figure 14 The use of a smaller second sewing needle; and

[0044] Figure 17 yes Figure 16 A partial side sectional view of the slender shaft assembly and tool assembly, showing its orientation in a second direction. Figure 16 The second suture needle is used together. Detailed Implementation

[0045] The surgical suturing apparatus disclosed herein is described in detail with reference to the accompanying drawings, wherein in each of the several views, similar reference numerals designate the same or corresponding elements.

[0046] As used herein, the term "far side" refers to the portion described as being farther from the user, while the term "proximal side" refers to the portion described as being closer to the user. Furthermore, the terms parallel and perpendicular should be understood to include substantially parallel and substantially perpendicular relative configurations that differ from true parallel and true perpendicularity by at most approximately +10 degrees or -10 degrees. Moreover, to the extent consistent, any or all of the aspects detailed herein may be used in conjunction with any or all of the other aspects detailed herein.

[0047] exist Figure 1In this embodiment, an exemplary surgical suturing device according to the present disclosure is generally shown as 10. The surgical suturing device 10 is adapted specifically for endoscopic or laparoscopic procedures. For example, the surgical suturing device 10 can be used for abdominal hernia procedures. The endoscopic portion of the surgical suturing device 10, such as, for example, a tool assembly 500, can be inserted into the surgical site via a cannulation assembly, etc. The surgical suturing device 10 includes a suture needle 199 supported on the jaws 504 of the tool assembly 500. The surgical suturing device 10 is configured for single-handed operation, which allows the suture needle 199 to pass through tissue with minimal operational requirements. The suture needle 199 has a circular configuration such that a flat-ended end portion 199t and a penetrating end portion 199p are diametrically opposed to each other. A surgical suture thread 7 is attached, for example, to the flat-ended end portion 199t of the suture needle 199. The surgical suturing device 10 includes a handle assembly 100, an elongated shaft assembly 300 extending distally from the handle assembly 100, and a tool assembly 500 operatively supported on the distal end of the elongated shaft assembly 300.

[0048] Figure 2 and Figure 3 A handle assembly 100 is shown, comprising a housing 102 having a first housing half 102a and a second housing half 102b, a pair of handles 110 pivotally fixed to the housing 102 about corresponding pivots 101a, 101b, and a connecting portion 116. The pair of handles 110 are operatively coupled to an axial rod 152 such that, upon compression of the pair of handles 110, the axial rod 152 is displaced distally. The pair of handles 110 are pivotally coupled to a connecting rod 112, which is pivotally coupled to the connecting portion 116. The connecting portion 116 is coupled to the axial rod 152 to apply the accompanying axial displacement to the axial rod 152. Specifically, the axial rod 152 is biased proximally in the direction of arrow "P" by a spring 118. In this configuration, the proximal biased axial rod 152 biases the connecting portion 116 toward the nearest position, which in turn places the pair of handles 110 in a spaced-apart (i.e., unactuated) configuration. When a clinician squeezes the pair of handles 110, the connecting portion 116 displaces distally in the direction of arrow "D," which applies axial displacement to the axial rod 152 in the same direction.

[0049] Axial rod 152 is operatively connected to tool assembly 500 ( Figure 1 This causes the axial displacement of the axial rod 152 to cause the jaws 504 of the tool assembly 500 to change between an open configuration and a closed configuration toward or away from the elongated shaft assembly 300, as will be discussed below.

[0050] Figures 2 to 3A lever 182 is also shown, pivotally connected to housing 102 about pivot 105. An axial rod 152 is pivotally connected to lever 182 about pivot 107, and an actuating rod 160 is pivotally connected to lever 182 about pivot 109. Pivots 107 and 109 are laterally spaced about pivot 105 on opposite sides of lever 182. Actuating rod 160 is slidably supported through elongated shaft assembly 300. In this configuration, axial displacement of axial rod 152 pivots lever 182, which in turn causes actuating rod 160 to reciprocate in the opposite direction.

[0051] The elongated shaft assembly 300 includes a sleeve 302, an outer tube 310, and an inner tube 320, the sleeve defining a cavity 304 therethrough. The outer tube 310 extends through the cavity of the sleeve 302 and is secured to the sleeve 302. The sleeve 302 is secured to a housing 102. The outer tube 310 defines a cavity 312 therethrough. The cavity 312 is sized to receive an actuator rod 160 passing through it. The inner tube 320 is disposed within the cavity 312 of the outer tube 310. Specifically, the inner tube 320 is secured to a distal end portion 314 of the outer tube 310 such that at least a portion of the inner tube 320 extends distally from the outer tube 310. Furthermore, Figure 4 An inner tube 320 is shown, defining an inner cavity 322 to receive an actuator rod 160 passing through it. Additionally, the inner tube 320 includes a radially inwardly extending lip 324. The lip 324 may include a recessed portion 326 sized to receive a portion of a sewing needle 199 to facilitate securing the sewing needle 199 between the jaws 504 and the elongated shaft assembly 300, as will be discussed below. Specifically, the lip 324 may include, for example, a diametrically opposed recessed portion 326 to further facilitate securing the sewing needle 199 thereto.

[0052] Figure 5 and Figure 6 The jaws 504 of the tool assembly 500 are shown. The jaws 504 are connected to the actuator rod 160. Figure 3 ), and the size of the jaws is set to extend through the inner cavity 322 of the inner tube 320 ( Figure 4 In this configuration, axial displacement of the actuator 160 applies axial displacement to the jaws 504. On one hand, the actuator 160 and jaws 504 can be integrally formed as a single structure. Specifically, the actuator 160 and jaws 504 can be integrally formed. The jaws 504 define a cutting opening 511, thereby providing a hook profile for receiving and securing the sewing needle 199 against the elongated shaft assembly 300, as will be discussed below. The jaws 504 also have a recessed portion 506 communicating with the cutting opening 511. The recessed portion 506 is distal to the cutting opening 511.

[0053] Figure 7 and Figure 8A recessed portion 506 is shown, having a profile configured to receive various sewing needles 199 in various orientations. The recessed portion 506 has a two-step configuration. Specifically, the recessed portion 506 has: a first arcuate surface 510 having a first radius of curvature; a first relatively flat surface 512 located proximal to and connected to the first arcuate surface 510; a second arcuate surface 514 located proximal to and connected to the first relatively flat surface 512; a second relatively flat surface 516 located proximal to and connected to the corresponding second arcuate surface 514; and a third arcuate surface 518 located proximal to and connected to the corresponding second relatively flat surface 516. The second arcuate surface 514 has a second radius of curvature, and the third arcuate surface 518 has a third radius of curvature. The first, second, and third radii of curvature are different from each other. In this configuration, the tool assembly 500 can securely support the sewing needle 199 in various orientations, as will be discussed. Furthermore, this configuration allows for use with various sewing needles 199 of different sizes, as will be discussed.

[0054] Figure 9 A surgical suture device 10 in an open configuration is shown, wherein a pair of handles 110 are spaced apart, and the cutting opening 511 of the jaws 504 is exposed to receive the suture needle 199. Figure 10 The sewing needle 199 is placed in the cut 511 of the jaw 504 such that the sewing needle 199 is, for example, orthogonal to the longitudinal axis “LL” defined by the elongated shaft assembly 300.

[0055] Figure 11 A pair of handles 110 are shown being squeezed by a clinician to grasp the suture needle 199 through the jaws 504 of the tool assembly 500. When the pair of handles 110 are squeezed in the direction of arrow "T", the axial rod 152 is displaced distally in the direction of arrow "D". At this time, the actuating rod 160 is displaced proximally in the direction of arrow "P", such that the suture needle 199, positioned within the recess 506 and / or the incision 511, is secured against the inner tube 320.

[0056] Figure 12 and Figure 13A sewing needle 199 fixed to the tool assembly 500 is shown. Specifically, the sewing needle 199 is configured to be orthogonal to the elongated shaft assembly 300, i.e., the arcuate profile of the sewing needle 199 is orthogonal to the longitudinal axis "LL" defined by the elongated shaft assembly 300. When the sewing needle 199 is supported against the elongated shaft assembly 300 in this manner, the arcuate portion 199a of the sewing needle 199 engages the second arcuate surface 514 of the recessed portion 506 of the jaw 504, and the relatively flat surface 199b of the sewing needle 199 engages the second relatively flat surface 516 of the recessed portion 506 of the jaw 504. In this way, when the jaw 504 is at arrow "P" ( Figure 12 When retracted in the direction of the suture needle 199, the suture needle 199 is fixed between the recessed portion 326 of the inner tube 320 and the recessed portion 506 of the jaw 504. In this way, the suture needle 199 is fixed in a non-rotatable manner to facilitate suturing by the clinician.

[0057] Figure 14 and Figure 15 A sewing needle 199 fixed to the tool assembly 500 in a second orientation is shown. Specifically, the sewing needle 199 is disposed on the longitudinal axis "LL" of the elongated shaft assembly 300, that is, the plane defined by the arcuate profile of the sewing needle 199 lies on the longitudinal axis "LL". When the sewing needle 199 is supported against the elongated shaft assembly 300 in this manner, the arcuate portion 199a of the sewing needle 199 engages the third arcuate surface 518 of the recessed portion 506 of the jaw 504 and the recessed portion 326 of the inner tube 320. In addition, the flat surface 199b of the sewing needle 199 is housed within the recessed portion 326 of the inner tube 320, and the relatively flat surface 199b is disposed between the second relatively flat surface 516 of the recessed portion 506 of the jaw 504. In this way, when the jaw 504 retracts in the proximal direction, the sewing needle 199 is fixed between the inner tube 320 and the jaw 504. In this way, the suture needle 199 is fixed in a non-rotatable manner to facilitate suturing by clinicians.

[0058] Figure 16 The diagram shows a sewing needle 1199 fixed between the jaws 504 and the inner tube 320. The sewing needle 1199 has dimensions smaller than those of a sewing needle 199. When the sewing needle 1199 is positioned similarly to... Figure 12When the suture needle 1199 is oriented in such a manner that it is orthogonal to the elongated shaft assembly 300, the arcuate portion 1199a of the suture needle 1199 engages the first arcuate surface 510 of the recessed portion 506 of the jaw 504 and the recessed portion 326 of the inner tube 320. Additionally, the relatively flat surface 1199b of the suture needle 1199 engages the corresponding first relatively flat surface 512 of the recessed portion 506 of the jaw 504. In this manner, when the jaw 504 is retracted, the suture needle 1199 is fixed between the inner tube 320 of the elongated shaft 300 and the jaw 504, thus non-rotatably fixing the suture needle 1199 to facilitate suturing by the clinician.

[0059] Figure 17 It shows that in relation to Figure 14 The suture needle 1199 is fixed between the jaws 504 and the inner tube 320 in a second orientation similar to that of the suture needle 1199 in the second orientation. Specifically, when the suture needle 1199 is oriented in this manner, the arcuate portion 1199a of the suture needle 1199 engages the second arcuate surface 514 of the jaws 504 and the recessed portion 326 of the inner tube 320 of the elongated shaft assembly 300. Additionally, one of the relatively flat surfaces 1199b of the suture needle 1199 engages the recessed portion 326, while the other relatively flat surface 1199b is disposed between the first relatively flat surfaces 512 of the jaws 504. In this way, when the jaws 504 are retracted, the suture needle 1199 is fixed between the inner tube 320 of the elongated shaft 300 and the jaws 504, such that the suture needle 1199 is non-rotatably fixed to facilitate suturing by the clinician.

[0060] In use, the pair of handles 110 are initially compressed to place the surgical suture device 10 into a closed configuration in which the jaws 504 are retracted. At this time, the clinician can position the jaws 504 through the opening in the tissue. Subsequently, the pair of handles 110 are released to change the jaws 504 into an open configuration, such that the jaws 504 are spaced apart from the elongated shaft assembly 300 to expose the incision 511. When the jaws 504 are in the open configuration, the suture needle 199 or 1199 can be placed in the incision 511 or recess 506 of the jaws 504. The pair of handles 110 are then compressed to retract the jaws 504 into the closed configuration. At this time, the suture needle 199 or 1199 engages with the recess 506 of the jaws 504 and the recess 326 of the inner tube 320 in a desired orientation. For example, the suture needle 199 or 1199 can be positioned to extend laterally around the jaws 504. With the suture needle 199 or 1199 secured to the jaw 504, the clinician can rotate the handle assembly 100 to pull the suture thread through the target tissue, thereby suturing the target tissue as needed or desired. The clinician can manipulate the surgical suture device 10 because it is configured for single-handed operation. Specifically, the clinician can rotate the surgical suture device 10 in the direction of the penetrating end portion 199p of the suture needle 199, causing the penetrating end portion 199p to penetrate through the tissue until it is exposed. In this way, the suture needle 199 or 1199 can reliably pass through tissue present along, for example, the edge of a midline hernia. During the procedure, the clinician can switch to different suture needles 199 or 1199 as needed without altering the surgical suture device 10, thereby reducing operative time and trauma to the patient. It is also anticipated that the surgical suture device 10 can be used in conjunction with mesh or other implants in the body.

[0061] It is envisioned that the surgical suturing device 10 can be configured to connect to a robotic arm of a robotic surgical system, enabling manipulation and control of that robotic arm. It is also anticipated that the handle assembly 100 ( Figure 1 The handle may be an electric or electromechanical assembly. Therefore, it should be understood that various other changes and modifications can be made therein without departing from the scope or spirit of this disclosure.

[0062] Although this disclosure is shown in the accompanying drawings, it is not intended to limit it, as the scope of this disclosure is expected to be as broad as that permitted in the art and should be read in the same manner. Therefore, the above description should not be construed as restrictive, but rather as exemplary. Those skilled in the art will be able to conceive of other modifications within the scope and spirit of the appended claims.

Claims

1. A surgical suturing device, comprising: Curved seam needle; A handle assembly including a housing, a pair of handles, and an axial rod slidably supported in the housing, the axial rod being operatively coupled to the pair of handles such that actuation of the pair of handles causes axial displacement of the axial rod. An elongated shaft assembly extending distally from the handle assembly includes an actuating rod and an outer tube, the actuating rod being operatively coupled to the axial rod for reciprocating in opposite directions, the outer tube defining an inner cavity therethrough, and the actuating rod being slidably disposed within the inner cavity of the outer tube. and A tool assembly including jaws coupled to the actuating rod, the jaws including a recessed portion configured to engage a portion of the arcuate stitching needle, the jaws being axially convertible between a retracted configuration and an advanced configuration, in which the recessed portion is in a proximal position to clamp the arcuate stitching needle against the elongated shaft assembly, and in the advanced configuration, the recessed portion being spaced apart from the elongated shaft assembly, the recessed portion having a first arcuate surface, a first flat surface proximal to the first arcuate surface, a second arcuate surface proximal to the first flat surface, and a second flat surface proximal to the second arcuate surface, wherein the first arcuate surface has a first radius of curvature, and the second arcuate surface has a second radius of curvature different from the first radius of curvature.

2. The surgical suturing apparatus of claim 1, wherein the arcuate suture needle has an arcuate portion having a radius of curvature that is the same as the first radius of curvature of the first arcuate surface of the recessed portion of the jaws.

3. The surgical suturing apparatus according to claim 1, wherein the arcuate portion of the arcuate suture needle has the same radius of curvature as the second radius of curvature of the second arcuate surface of the recessed portion of the jaws.

4. The surgical suturing apparatus of claim 1, wherein the first flat surface is connected to the first arcuate surface of the recessed portion of the jaws.

5. The surgical suturing apparatus of claim 1, wherein the second flat surface is connected to the second arcuate surface of the recessed portion of the jaws.

6. The surgical suturing apparatus of claim 1, wherein the recessed portion of the jaws further comprises a third arcuate surface located proximal to the second flat surface.

7. The surgical suturing apparatus of claim 6, wherein the third arcuate surface of the recessed portion of the jaws has a third radius of curvature different from the first radius of curvature or the second radius of curvature.

8. The surgical suturing apparatus of claim 6, wherein the third arcuate surface is connected to the second flat surface of the recessed portion of the jaws.

9. The surgical suturing apparatus of claim 2, wherein the elongated shaft assembly further comprises an inner tube fixed to a distal end portion of the outer tube, the inner tube defining a second lumen sized to slidably receive the actuating rod passing therethrough.

10. The surgical suturing apparatus of claim 9, wherein the inner tube further comprises a radially inwardly extending lip.

11. The surgical suturing apparatus of claim 10, wherein the lip margin has a recessed portion, the recessed portion being configured to engage the portion of the arcuate suture needle.

12. The surgical suturing apparatus of claim 11, wherein the recessed portion of the lip margin has the same radius of curvature as the arcuate portion of the arcuate suture needle.

13. The surgical suturing apparatus of claim 1, wherein the arcuate suture needle has a penetrating end portion and a flat-head end portion.

14. The surgical suturing apparatus of claim 1, wherein the jaws define a cut in communication with the recessed portion, the cut being configured to receive the portion of the arcuate suture needle therein.

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