Magnetically Assisted Suture Grasper

Abstract

A magnet assisted suture grasper for grasping a magnetic suture is provided. The magnet assisted suture grasper includes a suture retrieval needle, a retriever body, a grasper arm, and a grasper magnet. Translation of the retriever body within the needle lumen of the suture retrieval needle in a first direction moves the grasper arm from a first position to a second position, thereby exposing the grasper magnet and allowing contact between the grasper magnet and the magnetic suture attracted thereto. Translation of the retriever body within the needle lumen in a second direction opposite the first direction moves the grasper arm from the second position to the first position, thereby isolating the grasper magnet and grasping the magnetic suture within the needle lumen. Another magnet assisted suture grasper is also disclosed, including a handle, a shaft, first and second grasper jaws, a grasper magnet, and an actuator body.

Description

[Technical Field]

[0001] The present invention relates to a magnet-assisted suture grasper for grasping a magnetic suture, and more particularly to a magnet-assisted suture grasper for grasping a magnetic suture comprising a suture retrieval needle, a retriever body, a grasper arm, and a grasper magnet, and to a magnet-assisted suture grasper for grasping a magnetic suture comprising a handle, a shaft, first and second grasper jaws, a grasper magnet, and an actuator body. [Background technology]

[0002] Suture passing is required in many surgical procedures. A suture passing instrument is a surgical instrument that provides a means for the delivery and / or retrieval of a suture through some body tissue. There are many existing instruments on the market that utilize mechanical solutions to secure the suture for passing.

[0003] Minimally invasive techniques are increasingly being used in open surgery due to reduced risks, faster recovery times, and generally better cosmesis. Minimally invasive techniques typically utilize scopes and specialized tools that can be inserted through existing orifices in the patient (e.g., by endoscopes, colonoscopes, etc.) or artificially created orifices in the patient (e.g., by laparoscopes, arthroscopes, etc.) to gain access to targeted internal working spaces.

[0004] Working with indirect visualization of surgical instruments through a scope presents significant technical challenges in the use of suture threaders for retrieval. Retrieving a suture using a typical suture threader requires precise positioning and careful manipulation of the suture threader to position one or more of the suture threader's gripping elements around the suture. The suture threader must be held relatively steady in place while the gripping elements close around the suture, capturing the suture and holding it firmly so that it can be retrieved. Skilled operation in this manner is hindered by the fact that most scopes employ a single camera and present a two-dimensional image to the suture threader operator, thus not providing stereoscopic imaging. The lack of stereoscopic imaging hinders the operator's ability to perceive depth, which increases the difficulty associated with accurately positioning the gripping elements around the suture. While three-dimensional imaging systems exist, they are expensive and, to this day, remain relatively rare in practice.

[0005] Most existing suture threader designs utilize a multi-arm design, where two or more arms are opened, brought around the suture, and then closed around the suture to capture it. The arms may be separate, creating a scissor-style grasper with jaws to grasp the suture, or the arms may be connected, forming a snare-type grasper that forms an eye through which the suture can be threaded.

[0006] Unfortunately, regardless of the arm design, these devices require precise positioning to bring the grasper jaws around the suture or to thread the suture through the snare eye before it can be captured. As mentioned, this is difficult under indirect visualization because the camera systems for indirect visualization are typically non-stereoscopic. Without three-dimensional images, the surgeon must rely on visual cues to determine the instrument's position and depth, which makes it difficult to properly position the instrument. Once the instrument is in place, the surgeon then needs to hold the instrument and suture extremely steady while attempting to close the grasper around the suture. The long moment arm created by the instrument's length magnifies even fairly small movements, which can result in misalignment of the two components. Failed attempts to grasp the suture can extend the procedure time and lead to frustration in the operating room.

[0007] A magnetic U-stitch suturing device intended to solve these difficulties is disclosed in U.S. Patent No. 10,245,021. The magnetic U-stitch suturing device is made with two hypodermic needles that allow one or more sutures and a retrieval probe to be simultaneously advanced into a patient's cavity, such as the abdominal cavity. The one or more sutures may be magnetic sutures, each including a suture magnet as described in U.S. Publication No. 2021 / 0059667. Both the suture and the retrieval probe are equipped with magnets of opposite polarity at their tips. Thus, after the suture and retrieval probe are placed inside the abdominal cavity, they can be mated, and the suture can be transferred from one hypodermic needle to the other using magnetic force. In doing so, the suture forms a loop through the stomach. When removed, this loop, with two ends positioned outside the patient's body, can be pulled tight to draw the stomach wall closer to the surface of the patient's body. With the stomach wall close to the surface of the patient's body, it is easier to insert the gastrostomy device.

[0008] Unfortunately, certain procedures, such as inguinal herniotomy through high ligation of the patent processus vaginalis, require passage of sutures through spaces, e.g., the peritoneal cavity, that are not large enough to allow simultaneous advancement of the two hypodermic needles of the Magnetic U-Stitch suturing device.

[0009] Other suture devices and / or sutures containing magnets have been disclosed. For example, U.S. Patent No. 10,299,786 discloses a suture insertion device utilizing a small-gauge needle for threading one or more sutures through subcutaneous tissue. The suture insertion device may include a magnetic capture mechanism for contacting magnetically attracting strands in a transverse arrangement. U.S. Patent Nos. 6,719,765 and 9,770,238 disclose devices for threading medical instruments through tissue using magnetic force. U.S. Patent No. 8,702,753 and U.S. Publication No. 2008 / 0243148 disclose sutures equipped with magnetic anchors. U.S. Publication No. 2020 / 0360017 discloses a suturing device in which a suture can be automatically threaded between a needle and a transfer tube. The suturing device may include an electromagnetic coil for engaging and releasing the suture from the system. U.S. Publication No. 2020 / 0214695 discloses a suturing system including a clamp arm and a suture that are magnetic and therefore can engage with each other. U.S. Publication No. 2022 / 0104802 discloses a suturing system including a rod with a magnetic tube extending from its end and a magnetic needle with an end that is attracted into and magnetically engages with the tube. U.S. Publication No. 2021 / 0059667 discloses a magnetic suture having a ferrule with a tapered region in which a knotted suture is provided and secured with adhesive, and a straight region in which a magnet is provided.

[0010] What is needed is an improved suture passing instrument that reduces the technical difficulties associated with capturing and retrieving sutures under indirect, non-stereoscopic visualization. Summary of the Invention

[0011] A magnet-assisted suture grasper for grasping a magnetic suture is disclosed, the magnet-assisted suture grasper comprising: (a) a suture retrieval needle having a proximal end, a distal end, and a needle body extending therebetween, the needle body defining a needle body axis between the proximal and distal ends of the suture retrieval needle, the needle body having a proximal bore, a distal bore, and a needle lumen extending therebetween along the needle body axis; (b) a retriever body disposed within the needle lumen and translatable therein along the needle body axis; (c) a retriever body having a proximal end, a proximal-midsection, a distal section, and a distal section; The magnetic-assisted suture grasper includes (d) a grasper arm having a distal end, the grasper arm extending from the distal end of the retriever body and reversibly movable between a first position and a second position, and (d) a grasper magnet disposed adjacent a proximal-medial portion of the grasper arm, the grasper magnet isolating the grasper magnet within the needle lumen when the grasper arm is in the first position and exposing the grasper magnet from the needle lumen when the grasper arm is in the second position. The distal end of the grasper arm extends further distally than the grasper magnet. Translation of the retriever body within the needle lumen in a first direction along the needle body axis moves the grasper arm from the first position to the second position, thereby exposing the grasper magnet and allowing contact between the grasper magnet and a magnetic suture attracted thereto. Translation of the retriever body within the needle lumen in a second direction opposite the first direction along the needle body axis moves the grasper arms from the second position to the first position, thereby isolating the grasper magnets and grasping the magnetic suture within the needle lumen.

[0012] In some embodiments, the suture retrieval needle is straight and the needle body shaft is thus straight.

[0013] In some embodiments, the suture retrieval needle is curved and the needle body shaft is thus curved.

[0014] In some embodiments, the suture retrieval needle has a sharp tip.

[0015] In some embodiments, the grasper arms are integral with the retriever body.

[0016] In some embodiments, the grasper magnet is fixedly attached, either directly or indirectly, to the distal end of the retriever body.

[0017] In some embodiments, the grasper magnet is fixedly attached to the grasper arm, either directly or indirectly, at a proximal to intermediate portion of the grasper arm.

[0018] In some embodiments, the magnet-assisted suture grasper further comprises a magnet wire having a proximal end and a distal end, the proximal end of the magnet wire being fixedly disposed within the retriever body and the grasper magnet being fixedly attached, either directly or indirectly, to the distal end of the magnet wire.

[0019] In some embodiments, the grasper arm further comprises an enlarged distal terminal point at a distal end of the grasper arm, the grasper arm being reversibly movable between a first position and a second position upon translation of the grasper arm from inside the needle lumen to outside the needle lumen through the distal bore of the needle body, the enlarged distal terminal point at the distal end of the grasper arm having a size that is small enough to allow contact between the grasper magnet and a suture magnet of a magnetic suture attracted thereto when the grasper arm is in the second position and that allows threading of a suture of the magnetic suture when the grasper arm is in the first position, and that is large enough to obstruct the suture magnet of the magnetic suture from exiting the needle lumen through the distal bore of the needle body when the grasper arm is in the first position. In some of these embodiments, the enlarged distal terminal point comprises a hook.

[0020] In some embodiments, the grasper arm is a first grasper arm, and the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-midsection, a distal section, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between a first position and a second position, the first grasper arm further comprising an enlarged distal terminal point at the distal end of the first grasper arm, and the second grasper arm further comprising an enlarged distal terminal point at the distal end of the second grasper arm, and the first grasper arm and the second grasper arm are adapted to move the first grasper arm and the second grasper arm from inside the needle lumen through a distal hole in the needle body to outside the needle lumen. The magnetic suture grasper is reversibly movable between a first position and a second position based on translation of the second grasper arm, and the enlarged distal end points of the first and second grasper arms have a size small enough to allow contact between the grasper magnet and the suture magnet of a magnetic suture attracted thereto when the first and second grasper arms are in the second position, and large enough to prevent the suture magnet of the magnetic suture from passing through the distal bore of the needle body and exiting the needle lumen when the first and second grasper arms are in the first position. In some of these embodiments, the magnet-assisted suture grasper further comprises at least one additional grasper arm extending distally from the retriever body.

[0021] In some embodiments, the grasper arm is a first grasper arm, and the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-midsection, a distal section, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between a first position and a second position, the first grasper arm and the second grasper arm being connected at their distal ends to form a grasper arm loop, the grasper arm loop being adapted to guide the suture into the needle through the distal bore of the needle body. The retainer arm loop is reversibly movable between a first position and a second position based on translation of the retainer arm loop from inside the lumen to outside the needle lumen, the retainer arm loop enclosing an area large enough to allow contact between the retainer magnet and a suture of the magnetic suture attracted thereto when the retainer arm loop is in the second position, and the retainer arm loop having a thickness large enough to prevent the suture magnet of the magnetic suture from exiting the needle lumen through the distal hole in the needle body when the retainer arm loop is in the first position.

[0022] In some embodiments, the grasper arm is a first grasper arm, and the magnet-assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-midsection, a distal section, and a distal end, the second grasper arm extending from the distal end of the retriever body and reversibly movable between a first position and a second position, the first grasper arm and the second grasper arm being connected at their distal ends thereby forming a grasper arm loop, the first grasper arm and the second grasper arm further comprising enlarged distal end points at the distal ends of the first grasper arm and the second grasper arm, the grasper arm loop being reversibly movable between the first position and the second position upon translation of the grasper arm loop from inside the needle lumen to outside the needle lumen through a distal bore in the needle body. The grasper arm loops enclose a sufficiently large area to allow contact between the grasper magnet and the suture magnet of a magnetic suture attracted thereto when the grasper arm loops are in the second position, and the enlarged distal terminal points at the distal ends of the first and second grasper arms have a sufficiently small size to allow threading of a suture of the magnetic suture when the grasper arm loops are in the first position, and the enlarged distal terminal points at the distal ends of the first and second grasper arms have a sufficiently large size to obstruct the suture magnet of the magnetic suture from passing through the distal bore of the suture retrieval needle and exiting the needle lumen when the grasper arm loops are in the first position.

[0023] In some embodiments, the grasper arm is a first grasper arm, and the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-midsection, a distal section, and a distal end, the second grasper arm extending from the distal end of the retriever body and reversibly movable between a first position and a second position, the first grasper arm further comprising an enlarged distal terminal point at the distal end of the first grasper arm, and the second grasper arm further comprising an enlarged distal terminal point at the distal end of the second grasper arm, the first grasper arm and the second grasper arm being reversibly movable between the first position and the second position based on translation of the first grasper arm and the second grasper arm from inside the needle lumen to outside the needle lumen through a distal bore of the needle body, The proximal-to-intermediate portion is substantially parallel to the needle body axis when the first and second gripper arms are in the first position, at least one of the first or second gripper arms reversibly pivots outwardly sufficiently far from the needle body axis to allow contact between the gripper magnet and a suture magnet of a magnetic suture attracted thereto when the first and second gripper arms are in the second position, and the enlarged distal ends of the first and second gripper arms are sized sufficiently small to allow threading of a suture of the magnetic suture when the first and second gripper arms are in the first position, and sufficiently large to obstruct the suture magnet of the magnetic suture from exiting the needle lumen through the distal bore of the needle body when the first and second gripper arms are in the first position.

[0024] Also disclosed is a system for threading a magnetic suture. The system includes a magnet-assisted suture grasper comprising (a) a suture retrieval needle, (b) a retriever body, (c) a grasper arm, and (d) a grasper magnet, as described above. The system also includes a magnetic suture, comprising a suture magnet and a suture extending from the suture magnet.

[0025] Another system for threading a magnetic suture is also disclosed. The system includes a magnet-assisted suture grasper comprising (a) a suture retrieval needle, (b) a retriever body, (c) a grasper arm, and (d) a grasper magnet, as described above. The system also includes a magnetic suture loop comprising a suture magnet and a bifurcated suture extending from the suture magnet to form the suture loop. In some embodiments, the system further includes a cartridge tube having a cartridge tube proximal opening, a cartridge tube distal opening, and a cartridge tube lumen therebetween, the suture loop traversing the cartridge tube lumen upon insertion through the cartridge tube distal opening, and the suture magnet disposed outside the cartridge tube lumen adjacent the cartridge tube distal opening.

[0026] Another magnet-assisted suture grasper for grasping a magnetic suture is also disclosed, the magnet-assisted suture grasper comprising: (a) a handle; (b) a handle having a proximal end, a distal end, and a handle body extending therebetween, the handle connected to the handle adjacent the proximal end of the handle, the handle body defining a handle body axis and including a handle lumen extending along the handle; (c) a first grasper jaw having a proximal end, a proximal-to-intermediate portion, a distal portion, and a distal end, the first grasper jaw extending from the handle adjacent the distal end of the handle and reversibly movable between a first position and a second position; (d) a second grasper jaw having a proximal end, a proximal-to-intermediate portion, a distal portion, and a distal end, the second grasper jaw extending from the handle adjacent the distal end of the handle; (e) a proximal-to-intermediate portion of the first grasper jaw; The magnet-assisted suture grasper includes: (f) a grasper magnet disposed adjacent to the intermediate portion, the grasper magnet being isolated between the first and second grasper jaws within a recess formed in at least one of the first or second grasper jaws when the first grasper jaw is in a first position and exposing the grasper magnet from the recess when the first grasper jaw is in a second position; and (f) an actuator body disposed within the handle lumen and translatable therein along a handle body axis, the actuator body connected to the handle and the first grasper jaw and configured for pivotal movement of the first grasper jaw with movement of the handle. Distal ends of the first and second grasper jaws extend further distally than the grasper magnet. Translation of the actuator body within the handle lumen in a first direction along the handle body axis pivots the first grasper jaw from a first position to a second position, thereby exposing the grasper magnet and allowing contact between the grasper magnet and a magnetic suture attracted thereto. Translation of the actuator body within the handle lumen in a second direction opposite the first direction along the handle body axis pivots the first grasper jaw from the second position to the first position, thereby isolating the grasper magnet and grasping the magnetic suture within the recess.

[0027] In some embodiments, the first grasper jaw is straight relative to the handle body axis from the proximal end of the first grasper jaw to the distal end of the first grasper jaw.

[0028] In some embodiments, the first grasper jaw is curved relative to the handle body axis from the proximal end of the first grasper jaw to the distal end of the first grasper jaw.

[0029] In some embodiments, the first gripper jaw defines a first gripper jaw axis, and a proximal to intermediate portion of the first gripper jaw includes a recessed portion along the first gripper jaw axis that defines at least a portion of the recess.

[0030] In some embodiments, the second gripper jaw defines a second gripper jaw axis, and a proximal to intermediate portion of the second gripper jaw includes a recessed portion along the second gripper jaw axis that defines at least a portion of the recess.

[0031] In some embodiments, the first gripper jaw defines a first gripper jaw axis and the second gripper jaw defines a second gripper jaw axis, and proximal to intermediate portions of the first gripper jaw and the second gripper jaw include recessed portions along the first gripper jaw axis and the second gripper jaw axis, respectively, that define recesses.

[0032] In some embodiments, the grasper magnet is fixedly attached to a proximal-medial portion of the first grasper jaw.

[0033] In some embodiments, the grasper magnet is fixedly attached to a proximal-medial portion of the second grasper jaw.

[0034] In some embodiments, the grasper magnet is fixedly mounted to the shank between the proximal to intermediate portions of the first grasper jaw and the second grasper jaw.

[0035] In some embodiments, the second grasper jaw is reversibly movable, and the actuator body is further connected to the second grasper jaw and configured for pivoting movement of the second grasper jaw with movement of the handle, wherein translation of the actuator body within the handle lumen in a first direction pivots the second grasper jaw away from the first grasper jaw, thereby further exposing the grasper magnet and allowing contact between the grasper magnet and the magnetic suture attracted thereto, and translation of the actuator body within the handle lumen in a second direction pivots the second grasper jaw toward the first grasper jaw, thereby contributing to isolating the grasper magnet and grasping the magnetic suture within the recess.

[0036] In some embodiments, the distal ends of the first and second grasper jaws have sharp tips.

[0037] Another system for threading a magnetic suture is also disclosed. The system includes a magnet-assisted suture grasper comprising (a) a handle, (b) a shaft, (c) a first grasper jaw, (d) a second grasper jaw, (e) a grasper magnet, and (f) an actuator body as described above. The system also includes a magnetic suture comprising a suture magnet and a suture extending from the suture magnet.

[0038] Another system for threading a magnetic suture is also disclosed. The system includes a magnet-assisted suture grasper comprising (a) a handle, (b) a shank, (c) a first grasper jaw, (d) a second grasper jaw, (e) a grasper magnet, and (f) an actuator body as described above. The system also includes a magnetic suture loop comprising a suture magnet and a bifurcated suture extending from the suture magnet and forming a suture loop.

[0039] In some embodiments, the system further comprises a cartridge tube having a cartridge tube proximal opening, a cartridge tube distal opening, and a cartridge tube lumen therebetween, the suture loop traversing the cartridge tube lumen upon being inserted through the cartridge tube distal opening, and the suture magnet disposed outside the cartridge tube lumen adjacent the cartridge tube distal opening.

[0040] These and other features, aspects, and advantages of the present disclosure will be better understood when the following detailed description is read in conjunction with the accompanying drawings which follow. [Brief explanation of the drawings]

[0041] [Figure 1] 1 is a side view of a first magnet-assisted suture grasper as disclosed herein. The magnet-assisted suture grasper includes a suture retrieval needle, a retriever body, a grasper arm, and a grasper magnet. The grasper arm is in a position, referred to as a second position, that exposes the grasper magnet and allows contact between the grasper magnet and a magnetic suture attracted thereto, as discussed herein. The grasper magnet is attached directly to the retriever body. [Figure 2] 2 is a cross-sectional view of the magnet-assisted suture grasper of FIG. 1 with the grasper arms in a second position. [Figure 3] 2 is a front view of the magnetically assisted suture grasper of FIG. 1 with the grasper arms in a second position. FIG. [Figure 4] FIG. 2 is a rear view of the magnetically assisted suture grasper of FIG. 1. [Figure 5] 2 is a side view of the distal end of the magnet-assisted suture grasper of FIG. 1, including the distal end of the suture retrieval needle, the distal end of the retriever body, the grasper arms, and the grasper magnet, with the grasper arms in a second position. [Figure 6] 1 , including the distal end of the suture retrieval needle, the distal end of the retriever body, the grasper arms, and the grasper magnet, with the grasper arms in a second position. FIG. [Figure 7]2 is a side view of the distal end of the magnet-assisted suture grasper of FIG. 1 with the grasper arms in a second position and the grasper magnets attracting the magnetic suture. FIG. [Figure 8] 2 is a perspective view of a distal portion of the magnet-assisted suture grasper of FIG. 1 with the grasper arms in a second position and the grasper magnets attracting and in contact with the magnetic suture. FIG. [Figure 9] FIG. 2 is a perspective view of a distal portion of the magnet-assisted suture grasper of FIG. 1 with the grasper arms in a position, referred to as a first position, that isolates the grasper magnet within the needle lumen, with the grasper magnet attracting and in contact with the magnetic suture, such that the magnetic suture is captured within the needle lumen of a suture retrieval needle of the magnet-assisted suture grasper. [Figure 10] FIG. 2 is a cross-sectional view of a distal portion of the magnet-assisted suture grasper of FIG. 1 with the grasper arms in a first position and the grasper magnets attracting and in contact with the magnetic suture, resulting in the magnetic suture being captured within a needle lumen of a suture retrieval needle of the magnet-assisted suture grasper. [Figure 11] 2 is a cross-sectional view of a distal portion of the magnet-assisted suture grasper of FIG. 1 , with the grasper arms in an intermediate position between a first position and a second position, and with enlarged distal termini at the distal ends of the grasper arms grasping the magnetic suture such that the magnetic suture remains captured within a needle lumen of a suture retrieval needle of the magnet-assisted suture grasper. [Figure 12] FIG. 10 is a side view of a first alternative embodiment of a grasper arm of a magnet assisted suture grasper as disclosed herein, the grasper arm being in a second position. [Figure 13] FIG. 10 is a top view of a first alternative embodiment of a grasper arm of a magnet assisted suture grasper as disclosed herein, the grasper arm being in a second position. [Figure 14]FIG. 1 is a cross-sectional view of a first alternative embodiment of a grasper arm of a magnet-assisted suture grasper as disclosed herein, wherein the grasper arm is in a first position and the grasper magnet is attracting and in contact with the magnetic suture, such that the magnetic suture is captured within a needle lumen of a suture retrieval needle of the magnet-assisted suture grasper. [Figure 15] FIG. 10 is a cross-sectional view of a first alternative embodiment of a grasper arm of a magnet-assisted suture grasper as disclosed herein, wherein the grasper arm is in an intermediate position between a first position and a second position, and an enlarged distal terminal point at a distal end of the grasper arm grasps a magnetic suture such that the magnetic suture remains captured within a needle lumen of a suture retrieval needle of the magnet-assisted suture grasper. [Figure 16] FIG. 10 is a side view of a second alternative embodiment of a grasper arm of a magnet assisted suture grasper as disclosed herein, the grasper arm being in a second position. [Figure 17] FIG. 10 is a top view of a second alternative embodiment of a grasper arm of a magnet assisted suture grasper as disclosed herein, the grasper arm being in a second position. [Figure 18] FIG. 10 is a cross-sectional view of a second alternative embodiment of a grasper arm of a magnet-assisted suture grasper as disclosed herein, wherein the grasper arm is in a first position and the grasper magnet is attracting and in contact with the magnetic suture, such that the magnetic suture is captured within a needle lumen of a suture retrieval needle of the magnet-assisted suture grasper. [Figure 19] FIG. 10 is a cross-sectional view of a second alternative embodiment of a grasper arm of a magnet-assisted suture grasper as disclosed herein, wherein the grasper arm is in an intermediate position between a first position and a second position, and an enlarged distal terminal point at a distal end of the grasper arm grasps a magnetic suture such that the magnetic suture remains captured within a needle lumen of a suture retrieval needle of the magnet-assisted suture grasper. [Figure 20]FIG. 10 is a perspective view of a third alternative embodiment of a grasper arm of a magnet-assisted suture grasper as disclosed herein, wherein the grasper arm is in a second position and the grasper magnet is attached to the retriever body by a magnet wire. [Figure 21] FIG. 10 is a perspective view of a fourth alternative embodiment of a grasper arm of a magnet assisted suture grasper as disclosed herein, wherein the magnet assisted suture grasper comprises a first grasper arm and a second grasper arm, the first grasper arm and the second grasper arm forming a grasper loop and comprising an enlarged distal end at their distal ends, and the grasper magnet is attached to the retriever body by a magnet wire. [Figure 22] 2 is a perspective view of the distal end of the magnetically assisted suture grasper of FIG. 1, with the enlarged distal termini at the distal ends of the grasper arms comprising hooks and with a non-magnetic suture being captured by the hooks. FIG. [Figure 23] 2 is a perspective view of the distal end of the magnet-assisted suture grasper of FIG. 1 with the grasper arms in a first position and a non-magnetic suture captured within the needle lumen of the suture retrieval needle; FIG. [Figure 24] 2 is a cross-sectional view of the distal end of the magnet-assisted suture grasper of FIG. 1 with the grasper arms in a first position and a non-magnetic suture captured within the needle lumen of the suture retrieval needle; FIG. [Figure 25] FIG. 1 is a perspective view of a second magnet-assisted suture grasper as disclosed herein, the magnet-assisted suture grasper comprising a handle, a shaft, first and second grasper jaws, a grasper magnet, and an actuator body, the first grasper jaw being in a position that exposes the grasper magnet from a recess formed in at least one of the first or second grasper jaws, referred to as the second position as discussed herein, the second grasper jaw being pivoted away from the first grasper jaw, and the distal ends of the first and second grasper jaws having sharp tips. [Figure 26] FIG. 26 is a side view of the magnet-assisted suture grasper of FIG. 25 with the first grasper jaw in a second position, the second grasper jaw pivoted away from the first grasper jaw, and the grasper magnet attracting the magnetic suture. [Figure 27] FIG. 26 is a cross-sectional view of the magnet-assisted suture grasper of FIG. 25 with the first grasper jaw in a second position, the second grasper jaw pivoted away from the first grasper jaw, and the grasper magnet attracting the suture magnet of the magnetic suture. [Figure 28] FIG. 26 is a cross-sectional view of the proximal rotation collar of the magnet-assisted suture grasper of FIG. 25. [Figure 29] 26 is a cross-sectional view of the distal end of the magnet-assisted suture grasper of FIG. 25 with the first grasper jaw in a second position, the second grasper jaw pivoted away from the first grasper jaw, and the grasper magnet attracting the suture magnet of the magnetic suture (the suture of the magnetic suture is not shown). [Figure 30] FIG. 26 is a perspective view of the distal end of the magnet-assisted suture grasper of FIG. 25 with the first grasper jaw in a second position, the second grasper jaw pivoted away from the first grasper jaw, and the grasper magnet attracting the magnetic suture. [Figure 31] FIG. 26 is a perspective view of the distal end of the magnet assisted suture grasper of FIG. 25 with the first grasper jaw in a position, referred to as the first position, in which the grasper magnet is isolated in a recess between the first and second grasper jaws, and the grasper magnet is attracting and in contact with the magnetic suture, resulting in the magnetic suture being captured in the recess of the magnet assisted suture grasper. [Figure 32] 26 is a cross-sectional view of the distal end of the magnet assisted suture grasper of FIG. 25 with the first grasper jaw in a position, referred to as a first position, in which the grasper magnet is isolated in a recess between the first and second grasper jaws, and the grasper magnet is attracting and in contact with the magnetic suture, such that the magnetic suture is captured in the recess of the magnet assisted suture grasper. [Figure 33] FIG. 26 is a perspective view of a first alternative embodiment of the magnet-assisted suture grasper of FIG. 25, in which the first grasper jaw is in a second position, the second grasper jaw is not pivotally movable relative to the handle, and the grasper magnet is attracting the magnetic suture. [Figure 34]FIG. 26 is a perspective view of a first alternative embodiment of the magnet-assisted suture grasper of FIG. 25, with the first grasper jaw in a first position and the grasper magnet attracting and in contact with the magnetic suture, resulting in the magnetic suture being captured within a recess of the magnet-assisted suture grasper. [Figure 35] FIG. 26 is a perspective view of a second alternative embodiment of the magnet-assisted suture grasper of FIG. 25, in which the distal ends of the first grasper jaw and the second grasper jaw do not have sharp tips, the first grasper jaw is in a second position, the second grasper jaw is pivoted away from the first grasper jaw, and the grasper magnet is attracting the magnetic suture. [Figure 36] FIG. 26 is a perspective view of a second alternative embodiment of the magnet-assisted suture grasper of FIG. 25, with the first grasper jaw in a first position, the second grasper jaw pivoted toward the first grasper jaw, and the grasper magnet attracting and in contact with the magnetic suture, such that the magnetic suture is captured within a recess of the magnet-assisted suture grasper. [Figure 37] FIG. 26 is a perspective view of a third alternative embodiment of the magnet-assisted suture grasper of FIG. 25, in which the distal ends of the first grasper jaw and the second grasper jaw do not have sharp tips, the first grasper jaw is in a second position, the second grasper jaw is not pivotally movable relative to the handle, and the grasper magnet is attracting the magnetic suture. [Figure 38] FIG. 26 is a perspective view of a third alternative embodiment of the magnet-assisted suture grasper of FIG. 25, with the first grasper jaw in a first position and the grasper magnet attracting and in contact with the magnetic suture, resulting in the magnetic suture being captured within a recess of the magnet-assisted suture grasper. [Figure 39] FIG. 26 is a perspective view of a fourth alternative embodiment of the magnet-assisted suture grasper of FIG. 25, in which the distal ends of the first grasper jaw and the second grasper jaw do not have sharp tips, the first grasper jaw is in a second position, the second grasper jaw is pivoted away from the first grasper jaw, and the grasper magnet is attracting the magnetic suture. [Figure 40]FIG. 26 is a perspective view of a fourth alternative embodiment of the magnet-assisted suture grasper of FIG. 25, with the first grasper jaw in a first position, the second grasper jaw pivoted toward the first grasper jaw, and the grasper magnet attracting and in contact with the magnetic suture, such that the magnetic suture is captured within a recess of the magnet-assisted suture grasper. [Figure 41] FIG. 26 is a perspective view of a fifth alternative embodiment of the magnet-assisted suture grasper of FIG. 25, in which the distal ends of the first grasper jaw and the second grasper jaw do not have sharp tips, the first grasper jaw is in a second position, the second grasper jaw is not pivotally movable relative to the handle, and the grasper magnet is attracting the magnetic suture. [Figure 42] FIG. 26 is a perspective view of a fifth alternative embodiment of the magnet-assisted suture grasper of FIG. 25, with the first grasper jaw in a first position and the grasper magnet attracting and in contact with the magnetic suture, resulting in the magnetic suture being captured within a recess of the magnet-assisted suture grasper. [Figure 43] FIG. 1 is a top view of a magnetic suture loop as disclosed herein. [Figure 44] FIG. 44 is an enlarged view of the loop end and magnet end of the magnetic suture loop of FIG. 43. [Figure 45] FIG. 44 is a front view of the magnetic suture loop of FIG. 43. [Figure 46] FIG. 44 is a rear view of the magnetic suture loop of FIG. 43. [Figure 47] FIG. 44 is an enlarged cross-sectional view of the magnetic end of the magnetic suture loop of FIG. 43. [Figure 48] FIG. 1 is a side view of a pre-filled magnetic suture cartridge as disclosed herein. [Figure 49] FIG. 49 is a cross-sectional view of the magnet end of the pre-filled magnetic suture cartridge of FIG. 48. [Figure 50] FIG. 49 is a cross-sectional view of the loop end of the pre-filled magnetic suture cartridge of FIG. 48. [Figure 51] FIG. 49 is a side view of the pre-filled magnetic suture cartridge of FIG. 48 within an introducer needle. [Figure 52]FIG. 10 is a side view of an alternative embodiment of a pre-filled magnetic suture cartridge as disclosed herein, wherein the magnetic end of the pre-filled magnetic suture cartridge is curved. DETAILED DESCRIPTION OF THE INVENTION

[0042] A magnet-assisted suture grasper for grasping a magnetic suture is disclosed. The magnet-assisted suture grasper includes: (a) a suture retrieval needle, (b) a retriever body, (c) a grasper arm, and (d) a grasper magnet. The suture retrieval needle includes a proximal end, a distal end, and a needle body extending therebetween. The needle body defines a needle body axis between the proximal and distal ends of the suture retrieval needle. The needle body has a proximal bore, a distal bore, and a needle lumen extending therebetween along the needle body axis. The retriever body is disposed within the needle lumen and is translatable therethrough along the needle body axis. The grasper arm includes a proximal end, a proximal-middle portion, a distal portion, and a distal end. The grasper arm extends from the distal end of the retriever body and is reversibly movable between a first position and a second position. The grasper magnet is disposed adjacent to a proximal-medial portion of the grasper arm. The magnet-assisted suture grasper isolates the grasper magnet within the needle lumen when the grasper arm is in a first position and exposes the grasper magnet from the needle lumen when the grasper arm is in a second position. The distal end of the grasper arm extends further distally than the grasper magnet. Translation of the retriever body within the needle lumen in a first direction along the needle body axis moves the grasper arm from the first position to the second position, thereby exposing the grasper magnet and allowing contact between the grasper magnet and the magnetic suture attracted thereto. Translation of the retriever body within the needle lumen in a second direction opposite the first direction along the needle body axis moves the grasper arm from the second position to the first position, thereby isolating the grasper magnet and grasping the magnetic suture within the needle lumen.

[0043] Also disclosed is a magnet-assisted suture grasper for grasping a magnetic suture, comprising: (a) a handle, (b) a shank, (c) a first grasper jaw, (d) a second grasper jaw, (e) a grasper magnet, and (f) an actuator body. The shank comprises a proximal end, a distal end, and a shank body extending therebetween. The shank is connected to the handle adjacent the proximal end of the shank. The shank body defines a shank body axis and includes a shank lumen extending along the shank. The first grasper jaw comprises a proximal end, a proximal-middle portion, a distal portion, and a distal end. The first grasper jaw extends from the shank adjacent the distal end of the shank and is reversibly movable between a first position and a second position. The second grasper jaw comprises a proximal end, a proximal-middle portion, a distal portion, and a distal end. The second grasper jaw extends from the handle adjacent the distal end of the handle. The grasper magnet is disposed adjacent a proximal to intermediate portion of the first grasper jaw. The magnet-assisted suture grasper isolates the grasper magnet between the first grasper jaw and the second grasper jaw within a recess formed in at least one of the first grasper jaw or the second grasper jaw when the first grasper jaw is in the first position, and exposes the grasper magnet from the recess when the first grasper jaw is in the second position. The actuator body is disposed within the handle lumen and is translatable therein along the handle body axis. The actuator body is connected to the handle and the first grasper jaw and configured for pivotal movement of the first grasper jaw with movement of the handle. The distal ends of the first and second gripper jaws extend further distally than the gripper magnet. Translation of the actuator body within the handle lumen in a first direction along the handle body axis pivots the first gripper jaw from a first position to a second position, thereby exposing the gripper magnet and allowing contact between the gripper magnet and a magnetic suture attracted thereto. Translation of the actuator body within the handle lumen in a second direction opposite the first direction along the handle body axis pivots the first gripper jaw from the second position to the first position, thereby isolating the gripper magnet and gripping the magnetic suture within the recess.

[0044] Our magnet-assisted suture grasper solves the technical difficulties associated with capturing and retrieving sutures under indirect, non-stereoscopic visualization. Our magnet-assisted suture grasper involves the use of two dipole magnets—the grasper magnet of the magnet-assisted suture grasper and the suture magnet of the magnetic suture—to assist in the initial positioning and retention of the magnetic suture while it is being captured by the secondary mechanical means of the magnet-assisted suture grasper. The use of two dipole magnets allows for a self-aligning feature, where the attractive forces of the north and south poles of the grasper magnet and suture magnet align the two magnets in a predictable manner, improving the repeatability and reliability aspects of function. Our magnet-assisted suture grasper greatly reduces the need for precise positioning of the suture threading instrument, as the two magnetic sides only need to be brought close enough to each other that their magnetic fields can interact. The magnetic side of the suture is pulled into contact with the grasper magnet. This occurs without the need for precise positioning to make contact. The secondary mechanical means then provides a steady-state connection between the magnetic suture and the magnet-assisted suture grasper that serves to hold the suture to the magnet-assisted suture grasper, allowing for retrieval of the suture through the patient's soft tissue without having to rely on magnetic forces between the grasper magnet and the suture magnet during retrieval.

[0045] The inventors initially conceived of relying on the magnetic force between the grasper magnet and the suture magnet to retrieve the suture from the patient's body, but in vitro experiments revealed a problem: the frictional resistance associated with pulling the suture through soft tissue was greater than the attractive force between the grasper magnet and the suture magnet, resulting in separation of the magnets. The two magnets were too small. The size of the magnets was limited by the need to thread them through a cannula for delivery and the desire to minimize the size of the cannula to minimize the trauma associated with tissue penetration by the cannula. The inventors were unable to increase the size of the magnet to provide greater attractive strength. However, they realized that this problem could be solved by using a mechanical trap that acts in conjunction with the cannula wall to secure the suture against loads greater than those the magnetic connection could withstand.

[0046] More specifically, the inventors initially sought to incorporate a device including a magnetic suture including a suture magnet, such as the magnetic suture described in U.S. Publication No. 2021 / 0059667, and a magnetic suture retriever with a magnetic end, similar to the retrieval probe of the magnetic U-stitch suturing device described in U.S. Patent No. 10,245,021. The suture is introduced using a 17-gauge hypodermic needle. In certain procedures, such as the inguinal herniotomy technique mentioned above, the needle must be removed before introduction of the retriever. In the inguinal herniotomy procedure, the suture is placed with the magnetic end inside the peritoneal cavity and the suture extending through the abdominal wall. The magnetic suture retriever is then introduced through the same percutaneous site using a 17-gauge needle. This can be a second needle, or it can be the same needle used to introduce the suture. The magnetic suture retriever is then brought near the magnetic end of the suture so that the magnets connect. Once the magnets connect, the magnetic retriever is withdrawn, pulling the suture with it.

[0047] While prototyping this device, the inventors determined that the attractive force between the magnets of the magnetic suture retriever and the magnetic suture was not strong enough to overcome the frictional resistance resulting from pulling the suture through soft tissue. In comparison, in the magnetic U-stitch device described in U.S. Pat. No. 10,245,021, the suture never contacts tissue during retrieval. Instead, the suture passes through one cannula, into an open space, and then returns through another cannula. The resistance offered by threading the suture through these cannulas is minimal. However, for inguinal hernia procedures typically performed on pediatric patients, there is not enough room for two needles to simultaneously occupy the relevant space within the patient. The suture must first be released from the introducer needle, which must then be removed. The magnetic suture retriever must then be able to retrieve the suture.

[0048] However, the inventors discovered that the frictional resistance caused by pulling the suture through the soft tissue was problematic. The resistance creates a tensile load on the suture, which is greater than the attractive force between the magnets, causing the magnets to detach and the suture to become dislodged. Due to the small size of pediatric patients, increasing the size of the introducer needle is inconvenient. However, without increasing the needle size, the diameter of the magnet that can be used is limited, which limits the strength of the attractive force between the magnets. The current design for the magnetic U-stitch device uses a 17-gauge XT-wall hypodermic needle with an inner lumen diameter of 0.049 to 0.051 inches (1.24 to 1.30 mm), taking into account manufacturing tolerances. The corresponding magnet has a nominal outer diameter of 0.035 inches (0.889 mm) and a ferrule diameter of 0.037 ± 0.001 inches (0.940 ± 0.025 mm). Each magnet has an attractive force of approximately 0.102 lbf (0.454 N). Increasing the magnet diameter to its theoretical maximum of 0.042 inches (1.07 mm), which allows for manufacturing tolerances and a minimum clearance on the order of 0.001 inches (0.025 mm), only increases the attractive force to approximately 0.145 lbf (0.645 N). Much larger magnets would be needed to overcome the resistance of the soft tissue, but larger magnets cannot be used due to the limitations imposed on needle size.

[0049] The inventors have solved this problem, among other ways, by pairing magnets on the retrieval device, called grasper magnets, with mechanical arms, called grasper arms or jaws, where the grasper arms have enlarged distal ends, loop configurations, and / or other features that can mechanically block the exit passage of the magnetic suture when the suture is pulled into the needle of the retrieval device, or where the first and second grasper jaws can be pivotally closed around the magnetic suture to form a recess into which the suture magnet of the magnetic suture can fit, which in turn can mechanically block the exit passage of the magnetic suture when the grasper jaws are pivotally closed around the magnetic suture. With the mechanical blocks in place, the ability to hold the magnetic suture against a tensile load is limited only by the strength of the mechanical arms, which can be much greater than the attractive force between the small grasper magnets and the small suture magnets. Our testing shows that the grasper arms advantageously hold the magnetic suture against forces much greater than what the grasper magnets and suture magnets can withstand. In fact, the grasper arms advantageously hold the magnetic suture against forces great enough to break sutures, which USP standards require to have a tensile strength of at least 3 lbf (13 N). The grasper jaws should be similarly effective. Thus, the mechanical solution is at least approximately 30 times stronger than the grasper magnets and suture magnets alone.

[0050] Importantly, the inventors realized that the retrieval device with its grasper magnets only needs to be brought close enough to the magnetic suture that the magnetic fields of the grasper magnets and suture magnets interact. Advantageously, this does not require very precise positioning. The magnetic fields are oriented so that when the magnetic fields begin to interact, the suture magnets are pulled toward the grasper magnets, and the magnets self-align and connect in the same orientation every time. While the strength of the grasper magnets and suture magnets is not great enough to pull the magnetic suture through soft tissue by itself, the inventors realized that the strength is strong enough to keep the magnets in contact with each other while the retrieval device is manipulated, allowing the user to mechanically capture the magnetic suture even if the retrieval device and magnetic suture are not held very securely.

[0051] FIGS. 1-11 illustrate a first embodiment 1001 of a magnet-assisted suture grasper 100, comprising (a) a suture retrieval needle, (b) a retriever body, (c) a grasper arm, and (d) a grasper magnet as disclosed herein. FIGS. 12-15 illustrate a second embodiment 1002. FIGS. 16-19 illustrate a third embodiment 1003. FIGS. 20 and 21 illustrate a fourth embodiment 1004 and a fifth embodiment 1005, respectively. The magnet-assisted suture grasper 100 will be discussed primarily with respect to the first embodiment 1001. Differences between the second through fifth embodiments 1002-1005 and the first embodiment 1001 will also be discussed. Except where differences are indicated or apparent, the discussion regarding the first embodiment 1001 also applies to the second through fifth embodiments 1002-1005.

[0052] 7, magnetic suture 200 to be grasped may include suture magnet 202 and suture 204 extending from suture magnet 202. Magnetic suture 200 may be, for example, a magnetic suture as described in U.S. Publication No. 2021 / 0059667, which is incorporated herein by reference. Thus, magnetic suture 200 may further include ferrule 206 with tapered region 208 to which suture 204 is tied and secured with an adhesive, and straight region 210 to which suture magnet 202 is provided.

[0053] 1-4 for a first embodiment 1001, the magnet-assisted suture grasper 100 includes a suture retrieval needle 102 having a proximal end 104, a distal end 106, and a needle body 108 extending therebetween. The needle body 108 defines a needle body axis 110 between the proximal end 104 and the distal end 106 of the suture retrieval needle 102. The needle body 108 has a proximal bore 112, a distal bore 114, and a needle lumen 116 extending therebetween along the needle body axis 110.

[0054] 1 for the first embodiment 1001, the suture retrieval needle 102 can be a hypodermic needle. For example, the suture retrieval needle 102 can be an introducer needle designed for introducing a guide wire into a blood vessel, herein referred to as the suture retrieval needle 102. Also, for example, the suture retrieval needle 102 can be a 24-gauge needle, a 21-gauge needle, an 18-gauge needle, a 17-gauge needle, a 16-gauge needle, or a 14-gauge needle.

[0055] Thus, in some embodiments, suture retrieval needle 102 is a hypodermic needle. In some embodiments, suture retrieval needle 102 is an introducer needle. In some embodiments, suture retrieval needle 102 is a 24 gauge needle, a 21 gauge needle, an 18 gauge needle, a 17 gauge needle, a 16 gauge needle, or a 14 gauge needle.

[0056] As shown in FIG. 1 for the first embodiment 1001, in some embodiments, the suture retrieval needle 102 is straight. According to these embodiments, the needle body shaft 110 is thus straight. Alternatively, in some embodiments, the suture retrieval needle 102 is curved. According to these embodiments, the needle body shaft 110 is thus curved. In some embodiments, one or more portions of the suture retrieval needle 102 may be straight, and one or more portions may be curved. For example, in some embodiments, the suture retrieval needle 102 includes a curve at or near its distal end 106, while remaining straight. According to these embodiments, the needle body shaft 110 also includes a curve at or near the distal end 106 of the suture retrieval needle 102, while remaining straight.

[0057] 1 and 9 for the first embodiment 1001, FIG. 14 for the second embodiment, and FIG. 18 for the third embodiment 1003, in some embodiments, the suture retrieval needle 102 has a sharp tip 118. This can be advantageous for piercing tissue during insertion of the suture retrieval needle 102 into the patient.

[0058] 1 for the first embodiment 1001, in some embodiments, the suture retrieval needle 102 further comprises a hub 119. The hub 119 may have an open lumen.

[0059] As shown in Figures 1, 12, 16, 20, and 21 for the first through fifth embodiments 1001-1005, respectively, the magnetic assisted suture grasper 100 also includes a retractor body 120. The retractor body 120 is disposed within the needle lumen 116 and is translatable therein along the needle body shaft 110. The retractor body 120 may be made from a polymer such as nylon, polyetheretherketone, polycarbonate, or acrylonitrile butadiene styrene, or a metal such as stainless steel or nitinol.

[0060] As shown in FIG. 2 for the first embodiment 1001, in some embodiments, the retriever body 120 includes a proximal end 122, a distal end 124, and a retriever tube 126 extending therebetween. In these embodiments, the retriever tube 126 defines a retriever tube axis 128 between the proximal end 122 and the distal end 124 of the retriever body 120, and the retriever tube 126 has a proximal bore, a distal bore, and a retriever tube lumen extending therebetween along the retriever tube axis 128. In these embodiments, the proximal bore of the retriever tube 126 is in fluid communication with the distal bore 114 of the needle body 108 through the retriever tube lumen and the needle lumen 116. In these embodiments, the retriever body 120 is preferably made from a polymer such as nylon to facilitate creating a retriever body 120 that includes a retriever tube lumen.

[0061] This can be advantageous by allowing the withdrawal of fluids and / or gases from a patient's surgical site and / or the delivery of contrast media to the surgical site through the retriever lumen of the retriever body 120. Providing the ability to exchange fluids through the retriever body 120, and thus through the magnet assisted suture grasper 100, broadens the applicability of the magnet assisted suture grasper 100 for use with interventional techniques that use fluid exchange to confirm the internal location of the distal end 106 of the suture retrieval needle 102 of the magnet assisted suture grasper 100. For example, in the field of interventional radiology, there is a need for the ability to confirm the location of a cannula inside a patient's gastric lumen during a gastropexy procedure. In magnet-assisted suture graspers 100 that include a retriever body 120 with a retriever lumen, after introduction of the suture retrieval needle 102 into the patient, aspiration of a small amount of gastric fluid or air can be used to confirm the intraluminal location of the distal end 106 of the suture retrieval needle 102. Alternatively, a small amount of liquid radiocontrast can be injected into the patient's gastric lumen through the retriever lumen of the retriever body 120, allowing the intraluminal location to be confirmed by radiographic imaging.

[0062] Also, in some embodiments, the retriever body 120 is more flexible than the needle body 108. This can be advantageous for suture retrieval needles 102 in which one or more portions of the suture retrieval needle 102 are curved, for example, a suture retrieval needle 102 that includes a curve at or near its distal end 106 but is otherwise straight. In this case, the retriever body 120 is preferentially made of a polymeric material or a metal with a high proportional limit, such as Nitinol, so that the retriever body 120 can elastically deform around the curve of the suture retrieval needle 102.

[0063] Also, in some embodiments, the collector body 120 can be transparent, which allows for the use of light-initiated adhesives, which can be advantageous for component assembly. Light-initiated adhesives require minimal fixture time due to their very fast cure profile, while providing more open time for component positioning.

[0064] As shown in FIGS. 1, 12, 16, 20, and 21 for the first through fifth embodiments 1001-1005, respectively, the magnet-assisted suture grasper 100 also includes a grasper arm 136. As shown in FIG. 5 for the first embodiment 1001, the grasper arm 136 includes a proximal end 138, a proximal-to-medial portion 140, a distal portion 142, and a distal end 144. Like the retriever body 120, the grasper arm 136 may be made from a polymer such as nylon, polyetheretherketone, polycarbonate, or acrylonitrile butadiene styrene, or a metal such as stainless steel or nitinol. The grasper arm 136 may also be, for example, a wire, although other structures, such as a tube or other elongated member, may also be suitable. With respect to the grasper arm 136 being a wire, the grasper arm 136 may be, for example, a metal wire such as a nitinol wire or a stainless steel wire, or a plastic wire, and may be formed, for example, as a solid wire, a stranded wire, or a braided wire, and may have a shape based, for example, on being a molded and / or stamped wire, and may comprise one or more wires that are held together at one or more common points, for example, by welding, soldering, braiding, crimping, adhesive, or other means.

[0065] As shown by a comparison of Figures 5 and 10 for the first embodiment 1001, the grasper arm 136 extends from the distal end 124 of the retriever body 120 and is reversibly movable between a first position 146 and a second position 148.

[0066] 5 for the first embodiment 1001, the retainer arms 136 may extend from the distal end 124 of the retriever body 120 by virtue of, among other things, the retainer arms 136 being unitary with the retriever body 120. This means that the retainer arms 136 and the retriever body 120 may be adjacent portions of a single segment of material, such as a wire, e.g., a solid, stranded, or braided wire segment, from which the retriever body 120 and the retainer arms 136 are formed. In such an example, the retainer arms 136 extend from the distal end 124 of the retriever body 120 by virtue of the retainer arms 136 and the retriever body 120 forming a continuous wire segment that passes through the distal end 124 of the retriever body 120.

[0067] Also, for example, the grasper arms 136 may extend directly from the distal end 124 of the retriever body 120 based on adhesively bonding or other direct attachment of the grasper arms 136 to the retriever body 120. In these examples, the grasper arms 136 may extend from the distal end 124 of the retriever body 120 based on the grasper arms 136 and the retriever body 120 forming a segment of material that is connected at the distal end 124 of the retriever body 120 by adhesively bonding.

[0068] Also, for example, the grasper arms 136 may extend indirectly from the distal end 124 of the retriever body 120 based on attachment through one, two, or more intermediate pieces, such as rings or sleeves, among other intermediate pieces. In these examples, the grasper arms 136 extend from the distal end 124 of the retriever body 120 based on the grasper arms 136 and the retriever body 120 forming a line segment that is connected at the distal end 124 of the retriever body 120 via the intermediate pieces.

[0069] As shown in Figures 5, 12, 16, 20, and 21 for first through fifth embodiments 1001-1005, respectively, magnet-assisted suture grasper 100 also includes a grasper magnet 150 disposed adjacent to a proximal-to-medial portion 140 of grasper arm 136. Magnet-assisted suture grasper 100 isolates grasper magnet 150 within needle lumen 116 when grasper arm 136 is in first position 146 and exposes grasper magnet 150 from needle lumen 116 at least when grasper arm 136 is in second position 148. Grasper magnet 150 may be, for example, a permanent dipole magnet.

[0070] 5 with respect to the first embodiment 1001, in some embodiments, the grasper magnet 150 is fixedly attached to the distal end 124 of the retriever body 120 either directly, e.g., based on an adhesive or other direct connection, or indirectly, e.g., based on attachment through one or more intermediate components such as a ferrule, ring, or sleeve, among other intermediate components. For example, the grasper magnet 150 may be fixedly attached to the distal end 124 of the retriever body 120 within a pocket in the distal end 124 of the retriever body 120 by adhesive. Fixedly attaching the grasper magnet 150 to the distal end 124 of the retriever body 120 may be advantageous by allowing the use of relatively short grasper arms 136.

[0071] Also, in some embodiments, the grasper magnet 150 is fixedly attached to the grasper arm 136, either directly or indirectly, at the proximal-medial portion 140 of the grasper arm 136.

[0072] 20 and 21 for fourth and fifth embodiments 1001 and 1005, respectively, in some embodiments, magnet-assisted suture grasper 100 further comprises a magnet wire 152 having a proximal end 154 and a distal end 156, wherein proximal end 154 of magnet wire 152 is fixedly disposed within retractor body 120 and grasper magnet 150 is fixedly attached to distal end 156 of magnet wire 152 either directly, e.g., via adhesive or other direct attachment, or indirectly, e.g., via attachment through one or more intermediate components such as a ferrule, ring, or sleeve, among other intermediate components. According to these embodiments, translation of retractor body 120 also results in translation of magnet wire 152, and thus grasper magnet 150.

[0073] The magnet wire 152 may be fixedly disposed within the retriever body 120 by inserting the proximal end 154 of the magnet wire 152 into the retriever body 120 and securing the magnet wire 152 to the retriever body 120 such that the magnet wire 152 is translatably and rotatably secured to the retriever body 120. The preferred method of assembly is to insert the magnet wire 152 into the lumen of the retriever body 120 and apply an adhesive to bond the magnet wire 152 to the retriever body 120, although other attachment means are suitable.

[0074] As shown in Figures 20 and 21 for the fourth embodiment 1001 and the fifth embodiment 1005, respectively, in some of these embodiments, the magnet wire 152 further comprises a magnet wire distal end point 158 ​​at the distal end 156 of the magnet wire 152, and the magnet-assisted suture grasper 100 further comprises a ferrule 160 attached to the magnet wire distal end point 158 ​​at the distal end 156 of the magnet wire 152, and the grasper magnet 150 is attached to the ferrule 160.

[0075] The magnet wire 152 may be, for example, a metal wire such as a nitinol wire or a stainless steel wire, or a plastic wire, and may be formed, for example, as a solid wire, a stranded wire, or a braided wire, and may have a shape, for example, by being a molded and / or stamped wire, and may comprise one or more wires that are held together at one or more common points, for example, by welding, soldering, braiding, crimping, adhesive, or other means.

[0076] Considering the attachment of the grasper magnet 150 to the magnet wire 152 in more detail, the grasper magnet 150 may be attached to the magnet wire 152, for example, similar to that described in U.S. Publication No. 2021 / 0059667 for attaching magnets to sutures. This may be accomplished as follows: The grasper magnet 150 may be attached to a ferrule 160 that is attached to the magnet wire 152 having an enlarged magnet wire distal end 158. Referring to U.S. Publication No. 2021 / 0059667, the enlarged magnet wire distal end 158 replaces the knot tied within the suture. A ball end is the preferred shape for the magnet wire distal end 158, and a monofilament having a circular cross section is the preferred shape for the magnet wire 152. However, other configurations and final shapes are suitable as long as the magnet wire 152 and magnet wire distal end 158 are appropriately sized. The magnet wire distal end 158 can be formed into any shape, e.g., cube, cylinder, pyramid, organism, etc., and the magnet wire 152 can be of any cross-sectional shape, e.g., square, rectangle, cross, etc., and can be of mono- or multi-filament construction.

[0077] The magnet wire 152 must be sized small enough to fit through the small opening in the ferrule 160, but the magnet wire distal end 158 must be sized larger than the small opening in the ferrule 160 and smaller than the large opening in the ferrule 160. The magnet wire distal end 158 may be integrated into the magnet wire 152, e.g., the magnet wire distal end 158 may be melt formed, cast, bent, etc., or it may be a separate component. If a separate component, it may be attached by mechanical means, e.g., crimping, threading, interference fit, pinning, etc., by adhesive means, or by other means, e.g., welding, soldering, brazing, etc.

[0078] To assemble the gripper magnet 150, ferrule 160, and magnet wire 152, the magnet wire 152 is first threaded through the ferrule 160 from its distal end to its proximal end so that the magnet wire distal end 158 is positioned inside the ferrule. The gripper magnet 150 is then installed from the distal end and attached to the ferrule 160. The gripper magnet 150 may be attached by mechanical means, such as crimping, threading, interference fit, pinning, etc., or by adhesive or other means, such as welding, brazing, etc. Once the gripper magnet 150 is attached, the magnet wire distal end 158 is permanently captured between the gripper magnet 150 and the ferrule 160, and the subassembly is complete.

[0079] 20 and 21 for the fourth embodiment 1001 and the fifth embodiment 1005, respectively, in some embodiments of magnet-assisted suture grasper 100 further comprising magnet wire 152 to which grasper magnet 150 is fixedly attached as described, grasper magnet 150 is moved radially from needle body shaft 110 when grasper arm 136 is in second position 148. This can be advantageous by providing the operator of magnet-assisted suture grasper 100 with additional range of motion for moving grasper magnet 150 within a site on a patient by rotation of magnet-assisted suture grasper 100, and thus greater versatility in positioning grasper magnet 150 relative to magnetic suture 200 within a site.

[0080] 5, 12, 16, 20, and 21 for the first through fifth embodiments 1001-1005, respectively, distal end 144 of grasper arm 136 extends further distally than grasper magnet 150. This means that when grasper arm 136 is in first position 146, distal end 144 of grasper arm 136 extends further distally within needle lumen 116 than does any portion of grasper magnet 150. This also means that when grasper arm 136 is in second position 148, distal end 144 of grasper arm 136 extends further distally from suture retrieval needle 102 than does any portion of grasper magnet 150. This also means that when grasper arm 136 is in second position 148 , grasper magnet 150 is closer to distal end 106 of suture retrieval needle 102 than to distal end 144 of grasper arm 136 .

[0081] As shown by comparing FIG. 10 with FIG. 5 for the first embodiment 1001, FIG. 14 with FIG. 12 for the second embodiment 1002, and FIG. 18 with FIG. 16 for the third embodiment 1003, translation of the retriever body 120 within the needle lumen 116 in a first direction along the needle body axis 110 moves the grasper arms 136 from a first position 146 to a second position 148, thereby exposing the grasper magnets 150 and allowing contact between the grasper magnets 150 and the magnetic suture 200 attracted thereto. Translation of the retriever body 120 results in translation of the grasper arms 136. Translation of the retriever body 120 in the first direction can be translation of the retriever body 120 within the needle lumen 116 in a direction from the proximal end 104 of the suture retrieval needle 102 toward the distal end 106 of the suture retrieval needle 102. When the grasper arms 136 are in the first position 146, the grasper magnets 150 may be disposed completely inside the needle lumen 116 and therefore isolated within the needle lumen 116. According to these embodiments, such translation of the retriever body 120 within the needle lumen 116 in the first direction may move the grasper magnets 150 from inside the needle lumen 116 to outside the needle lumen 116, thereby exposing the grasper magnets 150.

[0082] The grasper arms 136 may be sufficiently rigid so that translation of the retriever body 120 within the needle lumen 116 in a first direction moves the grasper arms 136 from inside the needle lumen 116 to outside the needle lumen 116, thus exposing the grasper magnets 150. This can be achieved by making the grasper arms 136 sufficiently rigid so that they are movable with translation of the retriever body 120.

[0083] As shown by comparing Figure 5 with Figure 10 for the first embodiment 1001, Figure 12 with Figure 14 for the second embodiment 1002, and Figure 16 with Figure 18 for the third embodiment 1003, translation of the retriever body 120 within the needle lumen 116 in a second direction opposite the first direction along the needle body axis 110 moves the grasper arms 136 from the second position 148 to the first position 146, thereby isolating the grasper magnets 150 and grasping the magnetic suture 200 within the needle lumen 116. Translation of the retriever body 120 in the second direction can be translation of the retriever body 120 within the needle lumen 116 in a direction from the distal end 106 of the suture retrieval needle 102 toward the proximal end 104 of the suture retrieval needle 102. Such translation of the retriever body 120 within the needle lumen 116 in the second direction moves the grasper magnet 150 from outside the needle lumen 116 to inside the needle lumen 116, thus again isolating the grasper magnet 150 and grasping the magnetic suture 200 within the needle lumen 116.

[0084] This can be achieved as follows: while retainer arms 136 are in second position 148, retainer magnets 150 are closer to distal end 106 of suture retrieval needle 102 than distal ends 144 of retainer arms 136, so that suture magnets 202 of magnetic suture 200 contact retainer magnets 150, and when retriever body 120 is translated in the second direction to first position 146, retainer magnets 150 and suture magnets 202 of magnetic suture 200 enter needle lumen 116 before distal ends 144 of retainer arms 136. When the distal end 144 of the grasper arm 136 follows the suture magnet 202 into the needle lumen 116, the suture magnet 202 cannot exit the needle lumen 116 while the distal end 144 of the grasper arm 136 remains in the needle lumen 116. The grasper arm 136 blocks the exit of the suture magnet 202, thereby mechanically capturing the magnetic suture 200. The suture magnet 202 of the magnetic suture 200 can therefore be grasped by the grasper arm 136 when the magnet-assisted suture grasper 100 is used to pull the magnetic suture 200 through a patient's soft tissue. The grasper arm 136 is strong enough to counter the frictional resistance that results from pulling the magnetic suture 200 through soft tissue.

[0085] As described above, grasper arm 136 includes proximal end 138, proximal-mid portion 140, distal portion 142, and distal end 144. As described above, grasper magnet 150 is disposed adjacent proximal-mid portion 140 of grasper arm 136. Distal portion 142 of grasper arm 136 has a length and orientation sufficient to allow suture magnet 202 of magnetic suture 200 to fit between grasper magnet 150 and distal end 144 of grasper arm 136 when grasper arm 136 is in second position 148 so that suture magnet 202 of magnetic suture 200 can contact grasper magnet 150 by magnetic force, and when grasper arm 136 is returned to first position 146 so that suture magnet 202 of magnetic suture 200 can fit within needle lumen 116 together with grasper magnet 150 and grasper arm 136 by mechanical capture. The proximal-to-mid portion 140 of the grasper arm 136 adjacent to which the grasper magnet 150 is disposed can be any portion of the grasper arm 136 distal to the proximal end 138 and proximal to the distal portion 142, as long as sufficient space is provided for the suture magnet 202 to fit between the grasper magnet 150 and the distal end 144 of the grasper arm 136.

[0086] The grasper arms 136 may grasp the magnetic suture 200, for example, by acting as a mechanical stopper with the addition of the enlarged distal end 162. The enlarged distal end 162 may be sized to allow contact between the grasper magnets 150 and the suture magnets 202 of the magnetic suture 200 attracted thereto when the grasper arms 136 are in the second position 148 outside the needle lumen 116. The enlarged distal end 162 may also be sized such that when the grasper arms 136 are in the first position 146 inside the needle lumen 116, the suture 204 of the magnetic suture 200 can pass through the enlarged distal end 162 but cannot pass through the suture magnets 202 of the magnetic suture 200.

[0087] This may be achieved through the use of an enlarged distal end 162 corresponding to a partial spherical end with a hook, which can create an obstruction in the needle lumen 116 through which the suture magnet 202 of the magnetic suture 200 cannot pass. The enlarged partial spherical feature may have a size, e.g., a diameter or width across the needle body shaft 110, corresponding to, for example, about 10% to about 90% of the inner diameter of the needle lumen 116. This may also be achieved through various additional methods. For example, the enlarged distal end 162 may be an enlarged hook only or an enlarged sphere only. These offer the advantage of being simpler to manufacture than a partial spherical end with a hook. Enlarged hook only and enlarged sphere only may also have a size, e.g., a diameter or width across the needle body shaft 110, corresponding to, for example, about 10% to about 90% of the inner diameter of the needle lumen 116. Alternatively, two or more grasper arms 136 may be used. This provides the advantage that multiple gripper arms 136 with smaller cross sections can be used to achieve equivalent strength as a single gripper arm 136 with a larger cross section, but the multiple gripper arms 136 do not penetrate all the way into the needle lumen 116, allowing for maximizing the diameter of the gripper magnet 150. A similar effect can be achieved by using gripper arms 136 with non-circular profiles. The enlarged partial sphere with hook, the enlarged hook, and the mechanical plug corresponding to the enlarged sphere alone can be melt-formed from the gripper arms 136 or can be separate mechanical plug elements attached by crimping or using adhesives. The mechanical plug element also need not be spherical, as its shape is not essential to its function. Thus, the mechanical plug element could alternatively be shaped, for example, as an elongated cylinder, or a pyramid, or a toroid. Alternatively, the gripper arms 136 could simply terminate in a pigtail coil, forming a basket-like shape.

[0088] The grasper arms 136 may also grasp the magnetic suture 200, for example, by forming a grasper arm loop. This may be accomplished, for example, by using a first grasper arm and a second grasper arm 136 connected at their distal ends 144, thereby forming a grasper arm loop. The grasper arm loop may have a length and shape such that when the grasper arm loop is in the second position 148, the grasper arm loop encloses an area large enough to allow contact between the grasper magnet 150 and the suture magnet 202 of the magnetic suture 200 attracted thereto. For example, the grasper arm loop has a length and shape such that the corresponding enclosed area is large enough to fit both the grasper magnet 150 and the suture magnet 202 when the grasper magnet 150 and the suture magnet 202 are in contact at their respective poles. The retainer arm loop may also be sized so that when the retainer arm loop is in the first position 146, the retainer arm loop has a thickness, e.g., an average diameter, that is sufficiently large to prevent the suture magnet 202 of the magnetic suture 200 from passing through the distal hole 114 of the suture retrieval needle 102 and exiting the needle lumen 116.

[0089] 5, 12, 16, and 20 and 21 for the first through fifth embodiments 1001-1005, respectively, in some embodiments, the grasper arm 136 further comprises an enlarged distal terminus 162 at the distal end 144 of the grasper arm 136. In these embodiments, the grasper arm 136 is reversibly movable between a first position 146 and a second position 148 based on translation of the grasper arm 136 from inside the needle lumen 116 to outside the needle lumen 116 through the distal bore 114 of the needle body 108. In these embodiments, enlarged distal terminus 162 at distal end 144 of grasper arm 136 has a size that is small enough to allow contact between grasper magnet 150 and suture magnet 202 of magnetic suture 200 attracted thereto when grasper arm 136 is in second position 148, is small enough to allow threading of suture 204 of magnetic suture 200 when grasper arm 136 is in first position 146, and is large enough to prevent suture magnet 202 of magnetic suture 200 from exiting needle lumen 116 through distal bore 114 of needle body 108 when grasper arm 136 is in first position 146. These embodiments may be advantageous in that they are relatively simple to manufacture, as compared to embodiments including multiple grasper arms 136, for example. In some examples of these embodiments, the size of the enlarged distal end 162 is about 10% to about 90% of the inner diameter of the needle lumen 116. For example, the enlarged distal end 162 can have a diameter or width across the needle body shaft 110 that is about 10% to about 90% of the inner diameter of the needle lumen 116.

[0090] 5 and 20 for the first and fourth embodiments 1001 and 1004, respectively, in some of these embodiments, the enlarged distal end 162 comprises a partial sphere 164 with a hook 166. Also, referring to FIG. 12 for the second embodiment 1002, in some of these embodiments, the enlarged distal end 162 comprises only a hook 166. As shown in FIGS. 22-24 for the first embodiment 1001, these embodiments that comprise a hook 136 may also be advantageous in enabling capture of a non-magnetic suture 600. Referring to FIGS. 16 and 21 for the third and fifth embodiments 1003 and 1005, in some of these embodiments, the enlarged distal end 162 comprises only a sphere 168. In some of these embodiments, such as a partial sphere 164 with a hook 166, only the hook 166, or only the sphere 168, the size of the enlarged distal end 162 is from about 10% to about 90% of the inner diameter of the needle lumen 116. For example, the enlarged distal end 162 can have a diameter or width across the needle body shaft 110 that is from about 10% to about 90% of the inner diameter of the needle lumen 116.

[0091] 21 for a fifth embodiment 1005, in some embodiments, the grasper arm 136 is a first grasper arm 136. In these embodiments, the magnet-assisted suture grasper 100 further includes a second grasper arm 136 having a proximal end 138, a proximal-to-intermediate portion 140, a distal portion 142, and a distal end 144, the second grasper arm 136 extending from the distal end 124 of the retriever body 120 and reversibly movable between a first position 146 and a second position 148. In these embodiments, the first grasper arm and the second grasper arm 136 are connected at their distal ends 144, thereby forming a grasper arm loop. In these embodiments, first and second grasper arms 136 further comprise enlarged distal terminal points 162 at distal ends 144 of first and second grasper arms 136. In these embodiments, grasper arm loops 136 are reversibly movable between first position 146 and second position 148 based on translation of the grasper arm loops from inside needle lumen 116 to outside needle lumen 116 through distal bore 114 of needle body 108. In these embodiments, when the grasper arm loops are in second position 148, the grasper arm loops encompass a sufficiently large area, and enlarged distal terminal points 162 at distal ends 144 of first and second grasper arms 136 have a sufficiently small size, to allow contact between grasper magnets 150 and magnetic sutures 202 of magnetic sutures 200 attracted thereto. In these embodiments, enlarged distal end 162 at distal end 144 of first and second grasper arms 136 has a size that is sufficiently small to allow threading of suture 204 of magnetic suture 200 when the grasper arm loops are in first position 146. In these embodiments, enlarged distal end 162 at distal end 144 of first and second grasper arms 136 has a size that is sufficiently large to prevent suture magnet 202 of magnetic suture 200 from passing through distal bore 114 of needle body 108 and exiting needle lumen 116 when the grasper arm loops are in first position 146.These embodiments are advantageous in that they allow for the use of grasper arms 126 having relatively smaller diameters. In some examples of these embodiments, the size of the enlarged distal end 162 is about 10% to about 90% of the inner diameter of the needle lumen 116. For example, the enlarged distal end 162 may have a diameter or width across the needle body shaft 110 that is about 10% to about 90% of the inner diameter of the needle lumen 116.

[0092] Also, in some embodiments, the grasper arm 136 is a first grasper arm 136. In these embodiments, the magnet-assisted suture grasper 100 further includes a second grasper arm 136 having a proximal end 138, a proximal-intermediate portion 140, a distal portion 142, and a distal end 144, the second grasper arm 136 extending from the distal end 124 of the retriever body 120 and reversibly movable between a first position 146 and a second position 148. In these embodiments, the first grasper arm 146 further includes an enlarged distal end 162 at the distal end 144 of the first grasper arm 136. In these embodiments, the second grasper arm 136 further includes an enlarged distal end 162 at the distal end of the second grasper arm 136. In these embodiments, the first and second gripper arms 136 are reversibly movable between a first position 146 and a second position 148 based on translation of the first and second gripper arms 136 from inside the needle lumen 116 to outside the needle lumen 116 through the distal hole 114 of the needle body 108. In these embodiments, enlarged distal end 162 of first and second gripper arms 136 has a size that is small enough to allow contact between gripper magnet 150 and suture magnet 202 of magnetic suture 200 attracted thereto when first and second gripper arms 136 are in second position 148, and to allow threading of suture 204 of suture magnet 200 when first and second gripper arms 136 are in first position 146, and large enough to prevent suture magnet 202 of magnetic suture 200 from exiting needle lumen 116 through distal bore 114 of needle body 108 when first and second gripper arms 136 are in first position 146. In some of these embodiments, the magnet-assisted suture grasper 100 may further include at least one additional grasper arm 136 extending distally from the retriever body 120. These embodiments may be advantageous by allowing for a larger grasper magnet 150 than an equivalent single grasper arm 136 having the same total cross-sectional area.This is because two or more grasper arms 136 can be positioned radially around the inner surface of the needle lumen 116, allowing the cross-sectional area of ​​the grasper arms 136 to be unevenly distributed. This leaves more usable space for the grasper magnets 150 to occupy. For example, a dual grasper arm design provides a 12% increase in usable space over a single grasper arm design, while a quadruple grasper arm design provides a 20% increase in usable space over a single grasper arm design. Furthermore, a similar effect can be achieved by using a non-circular profile for the grasper arms 136.

[0093] Also, in some embodiments, the grasper arm 136 is a first grasper arm 136. In these embodiments, the magnet-assisted suture grasper 100 further includes a second grasper arm 136 having a proximal end 138, a proximal-intermediate portion 140, a distal portion 142, and a distal end 144, the second grasper arm 136 extending from the distal end 124 of the retriever body 120 and reversibly movable between a first position 146 and a second position 148. In these embodiments, the first grasper arm and the second grasper arm 136 are connected at their distal ends 144, thereby forming a grasper arm loop. In these embodiments, retainer arm loop 136 is reversibly movable between first position 146 and second position 148 based on translation of retainer arm loop from inside needle lumen 116 to outside needle lumen 116 through distal bore 114 of needle body 108. In these embodiments, retainer arm loop encloses an area large enough to allow contact between retainer magnet 150 and suture magnet 202 of magnetic suture 200 attracted thereto when retainer arm loop is in second position 148. In some of these embodiments, retainer arm loop has a thickness large enough to prevent suture magnet 202 of magnetic suture 200 from exiting the needle lumen through distal bore 114 of needle body 108 when retainer arm loop is in first position 146. For those embodiments in which the grasper arms 136 do not include enlarged distal termini 162 at their distal ends 144, advantages include ease of manufacturing and the possibility of using larger grasper magnets 150.

[0094] Also, in some embodiments, the grasper arm 136 is a first grasper arm 136. In these embodiments, the magnet-assisted suture grasper 100 further comprises a second grasper arm 136 having a proximal end 138, a proximal-intermediate portion 140, a distal portion 142, and a distal end 144, the second grasper arm 136 extending from the distal end 124 of the retriever body 120 and reversibly movable between a first position 146 and a second position 148. In these embodiments, the first grasper arm 136 further comprises an enlarged distal end 162 at the distal end 144 of the first grasper arm 136. In these embodiments, the second grasper arm 136 further comprises an enlarged distal end 162 at the distal end 114 of the second grasper arm 136. In these embodiments, the first and second gripper arms 136 are reversibly movable between a first position 146 and a second position 148 based on translation of the first and second gripper arms 136 from inside the needle lumen 116 to outside the needle lumen 116 through the distal bore 114 of the needle body 108. In these embodiments, the proximal-to-intermediate portions 140 of the first and second gripper arms 136 are substantially parallel to the needle body axis 110 when the first and second gripper arms 136 are in the first position 146. In these embodiments, at least one of first or second gripper arms 136 reversibly pivots outwardly from needle body shaft 110 far enough to allow contact between gripper magnets 150 and suture magnets 202 of magnetic suture 200 attracted thereto when first gripper arm and second gripper arm 136 are in second position 148. In these embodiments, the enlarged distal end 162 of the first and second gripper arms 136 is small enough to allow the suture 204 of the magnetic suture 200 to pass through when the first and second gripper arms 136 are in the first position 146, and is large enough to prevent the suture magnet 202 of the magnetic suture 200 from passing through the distal hole 114 of the needle body 108 and exiting the needle lumen 116 when the first and second gripper arms 136 are in the first position 146.In these embodiments, the two grasper arms 136 may function as tweezers including a bifurcation. In such embodiments, a grasper magnet 150 may advantageously be attached to the bifurcation of the tweezers to attract and hold the magnetic suture 200 in place, thereby facilitating capture by the tweezers. In some instances of these embodiments, when the first grasper arm and the second grasper arm 136 are in the second position 148, both the first grasper arm and the second grasper arm 136 reversibly pivot outward from the needle body shaft 110.

[0095] Considering further the first embodiment 1001 of the magnet assisted suture grasper 100, in some embodiments, the magnet assisted suture grasper 100 further comprises a suture retriever needle handle that is attached to the hub 119 of the suture retriever needle 102 and to the retriever body 120. This advantageously improves the ergonomics of the magnet assisted suture grasper 100 by allowing for one-handed operation. The suture retriever needle handle preferentially comprises a non-axisymmetric design to rotationally secure the suture retriever needle handle and the retriever body 120.

[0096] Also, in some embodiments, the magnet-assisted suture grasper 100 further comprises a return mechanism, such as a spring. In these embodiments, the retriever body 120 may be attached directly to the suture retriever needle handle so that when the suture retriever needle handle is depressed, the retriever body 120 is advanced, which in turn advances the grasper arms 136 and grasper magnet 150 from the needle lumen 116. When the suture retriever needle handle is released, the spring returns the suture retriever needle handle to its original position, thereby returning the grasper arms 136 and grasper magnet 150 to the needle lumen 116.

[0097] The magnetic assisted suture grasper 100 embodiment 1001 can be operated as follows.

[0098] After magnetic suture 200 is disposed inside the patient, suture retrieval needle 102 is introduced into the patient to gain access to the suture site. Retriever body 120 is used to advance grasper arms 136 and grasper magnets 150 through needle lumen 116 of suture retrieval needle 102 until grasper arms 136 and grasper magnets 150 exit needle lumen 116 and extend past distal bore 114 of suture retrieval needle 102. Grasper arms 136 and grasper magnets 150 are brought close to suture magnets 202 of magnetic suture 200 so that the magnetic fields of grasper magnets 150 and suture magnets 202 can interact. The attractive force between grasper magnets 150 and suture magnets 202 pulls suture magnets 202 toward grasper magnets 150, bringing them into contact and axial alignment.

[0099] The retriever body 120 is then used to pull the grasper arms 136 and grasper magnets 150 back inside the needle lumen 116 of the suture retrieval needle 102. The attractive force between the grasper magnets 150 and the suture magnets 202 allows the grasper magnets 150 to pull the suture magnets 202, and the attached suture 204, with it. The retriever body 120 is pulled back until the grasper magnets 150 and suture magnets 202 are brought completely inside the needle lumen 116. At this point, the magnetic suture 200 cannot escape from the suture retrieval needle 102 because the distal ends 144 of the grasper arms 136 block the exit path. Because the proximal ends 138 of the grasper arms 136 are attached to the retriever body 120, the grasper arms 136 are not moved by the suture 204.

[0100] Once magnetic suture 200 is captured, magnet-assisted suture grasper 100 can be used to pull or push magnetic suture 200 to a new location. Grasper arms 136 enable magnet-assisted suture grasper 100 to hold magnetic suture 200 securely, even when magnetic suture 200 is heavily loaded to the point where the load exceeds the attractive force between grasper magnets 150 and suture magnets 202. Grasper arms 136 prevent suture magnets 202 of magnetic suture 200 from being pulled out of needle lumen 116, even when the applied force exceeds the strength of the attractive force between grasper magnets 150 and suture magnets 202.

[0101] Once magnetic suture 200 has been threaded to the desired location, magnetic suture 200 may be released from magnet-assisted suture grasper 100. To release magnetic suture 200, retriever body 120 is used to advance grasper arms 136, grasper magnets 150, and suture magnets 202 out of needle lumen 116, and suture 204 may then be pulled to separate grasper magnets 150 and suture magnets 202.

[0102] 24-32 illustrate a first embodiment 3001 of a magnet-assisted suture grasper 300 including (a) a handle, (b) a shaft, (c) a first grasper jaw, (d) a second grasper jaw, (e) a grasper magnet, and (f) an actuator body as disclosed herein. FIGS. 33 and 34 illustrate a second embodiment 3002. FIGS. 35 and 36 illustrate a third embodiment 3003. FIGS. 37 and 38 illustrate a fourth embodiment 3004. FIGS. 39 and 40 illustrate a fifth embodiment 3005. FIGS. 41 and 42 illustrate a sixth embodiment 3006. The magnet-assisted suture grasper 300 will be discussed primarily with respect to the first embodiment 3001. Differences between the second through sixth embodiments 3002-3006 and the first embodiment 3001 are also discussed. Except where differences are indicated or apparent, the discussion regarding the first embodiment 3001 also applies to the second through sixth embodiments 3002-3006.

[0103] 25-27 for the first embodiment 3001, the magnetic assisted suture grasper 300 includes a handle 302. The handle 302 is used by an operator to operate the magnetic assisted suture grasper 300. The handle 302 may be made of a metal, such as stainless steel or titanium, or plastic, or other material suitable for use as a handle 302 in operating the magnetic assisted suture grasper 300.

[0104] As shown in FIGS. 25, 33, 35, 37, 39, and 41 for the first through sixth embodiments 3001-3006, respectively, the magnetically assisted suture grasper 300 also includes a handle 304. As shown in FIG. 25 for the first embodiment, the handle 304 includes a proximal end 306, a distal end 308, and a handle body 310 extending therebetween. The handle 304 is connected to a handle 302 adjacent the proximal end of the handle 304. The handle body 304 defines a handle body axis 312 and includes a handle lumen 314 extending along the handle 304. The handle 304 may have a diameter small enough to allow the handle 304 to fit through a port for accessing a site within a patient. The handle 304 may be made of a metal, such as stainless steel or titanium, or plastic, or other material suitable for providing structural support.

[0105] 30, 33, 35, 37, 39, and 41 for first through sixth embodiments 3001-3006, respectively, magnetic assisted suture grasper 300 also includes first grasper jaw 316 having proximal end 318, proximal-to-intermediate portion 320, distal portion 322, and distal end 324. First grasper jaw 316 may be made of a metal, such as stainless steel or titanium, or plastic, or other suitable material for grasping magnetic suture 200.

[0106] A first grasper jaw 316 extends from the handle 304 adjacent the distal end 308 of the handle 304 and is reversibly movable between a first position 326 and a second position 328 .

[0107] As shown in Figures 30, 33, 35, 37, 39, and 41 for the first through sixth embodiments 3001 through 3006, respectively, the first grasper jaw 316 may extend from the handle 304 adjacent to the distal end 308 of the handle 304 by, among other ways, being pivotally connected to the handle 304 adjacent to the distal end 308 of the handle 304.

[0108] 30, 33, 35, 37, 39, and 41 for the first through sixth embodiments 3001-3006, respectively, magnetic assisted suture grasper 300 also includes second grasper jaw 330 including proximal end 332, proximal-intermediate portion 334, distal portion 336, and distal end 338. Second grasper jaw 330 may be made of a metal, such as stainless steel or titanium, or plastic, or other suitable material for grasping magnetic suture 200.

[0109] Like first gripper jaw 316, first gripper jaw 330 extends from handle 304 adjacent the distal end 308 of handle 304. As discussed below, in some embodiments, second gripper jaw 330 is also reversibly movable, while in other embodiments, second gripper jaw 330 is not reversibly movable. Second gripper jaw 330 may extend from handle 304 adjacent the distal end 308 of handle 304 by, among other ways, being pivotally connected to handle 304 adjacent the distal end 308 of handle 304.

[0110] 30, 33, 39, and 41 for the first embodiment 3001, the second embodiment 3002, the fifth embodiment 3005, and the sixth embodiment 3006, respectively, in some embodiments, the first gripper jaw 316 is straight from the proximal end 318 of the first gripper jaw 316 to the distal end 324 of the first gripper jaw 316 relative to the handle body axis 312. Also, as shown in FIGS. 35 and 37 for the third embodiment 3003 and the fourth embodiment 3004, respectively, in some embodiments, the first gripper jaw 316 is curved from the proximal end 318 of the first gripper jaw 316 to the distal end 324 of the first gripper jaw 316 relative to the handle body axis 312. The second gripper jaw 330 may also be straight or curved. Preferably, both the first gripper jaw 316 and the second gripper jaw 330 are straight or both are curved.

[0111] As shown in Figures 30, 33, 35, 37, 39, and 41 for the first through sixth embodiments 3001 through 3006, respectively, the magnet-assisted suture grasper 300 also includes a grasper magnet 340 disposed adjacent to the proximal-to-medial portion 320 of the first grasper jaw 316. 32 for the first embodiment 3001, magnet-assisted suture grasper 100 isolates grasper magnet 340 between first grasper jaw 316 and second grasper jaw 330 within a recess formed in at least one of first grasper jaw 316 or second grasper jaw 316, 330 when first grasper jaw 316 is in first position 326, and exposes grasper magnet 340 from recess 342 when first grasper jaw 316 is in second position 328. Grasper magnet 340 may be, for example, a permanent dipole magnet.

[0112] As shown in FIGS. 30, 33, 35, 37, 39, and 41 for the first through sixth embodiments 3001-3006, respectively, in some embodiments, the grasper magnet 340 is fixedly disposed in the proximal-to-intermediate portion 320 of the first grasper jaw 316. Alternatively, in some embodiments, the grasper magnet 340 is fixedly attached to the proximal-to-intermediate portion 334 of the second grasper jaw 330. Also, in some embodiments, the grasper magnet 340 is fixedly attached to the shank 304 between the proximal-to-intermediate portions 320, 334 of the first grasper jaw 316 and the second grasper jaw 330.

[0113] 32 for the first embodiment 3001, the magnet-assisted suture grasper 300 isolates the grasper magnet 340 between the first grasper jaw 316 and the second grasper jaw 330 within a recess 342 formed in at least one of the first grasper jaw 316 or the second grasper jaw 316, 330 when the first grasper jaw 316 is in the first position 326. As shown in FIG. 29 for the first embodiment 3001, in some embodiments, the first grasper jaw 316 defines a first grasper jaw axis 344, and a proximal-medial portion 320 of the first grasper jaw 316 includes a recessed portion 346 along the first grasper jaw axis 344 that defines at least a portion of the recess 342. Also, as shown, in some embodiments, second gripper jaw 330 defines second gripper jaw axis 348, and proximal to intermediate portion 334 of second gripper jaw 330 includes a recessed portion 350 along second gripper jaw axis 348 that defines at least a portion of recess 342. Also, as shown, in some embodiments, the first gripper jaw 316 defines a first gripper jaw axis 344, the second gripper jaw 330 defines a second gripper jaw axis 348, and the proximal to intermediate portions 320, 334 of the first gripper jaw 316 and the second gripper jaw 330 include recessed portions 346, 350 along the first gripper jaw axis 344 and the second gripper jaw axis 348, respectively, which define the recess 342.

[0114] 29 for the first embodiment 3001, in some embodiments, the grasper magnet 340 is a permanent dipole magnet. Also shown in FIG. 29, in some of these embodiments, the grasper magnet 340 is fixedly mounted to the proximal-to-intermediate portion 320 of the first grasper jaw 316 such that the pole of the grasper magnet 340 is positioned along the first grasper jaw axis 344. In other examples of these embodiments, the grasper magnet 340 is fixedly mounted to the proximal-to-intermediate portion 334 of the second grasper jaw 330 such that the pole of the grasper magnet 340 is positioned along the second grasper jaw axis 348. In still other examples of these embodiments, the grasper magnet 340 is fixedly mounted to the handle 304 at the distal end 308 such that the pole of the grasper magnet 340 is positioned along the handle body axis 312.

[0115] As shown in FIGS. 27-29 for the first embodiment 3001, the magnet-assisted suture grasper 300 also includes an actuator body 352 disposed within the handle lumen 314 and translatable therein along the handle body axis 312. The actuator body 352 is connected to the handle 302 and the first grasper jaw 316 and is configured for pivotal movement of the first grasper jaw with movement of the handle 302. The actuator body 352 can be configured, for example, such that, at rest, the first grasper jaw 316 is in the second position 328. According to this example, when the operator squeezes the handle 302, squeezing the handle 302 translates the actuator body 352 proximally, thereby pivotally actuating the first grasper jaw 316 to move from the second position 328 to the first position 326. Also according to this example, when the operator releases the handle 302, the release of the handle 302 translates the actuator body 352 distally, thereby pivotally actuating the first grasper jaw 316 from the first position 326 to the second position 328. This is a typical configuration for actuating the grasper jaws of a suture threader with articulating grasper jaws. Other configurations may also be suitable. The actuator body 352 may be made of a metal, such as stainless steel or titanium, or plastic, or other suitable material for achieving actuation of the first grasper jaw 316.

[0116] 28, in some embodiments, the actuator body 352 comprises multiple elongated parts. This can be advantageous, for example, in a magnet-assisted suture grasper 300 that includes a rotation collar 353 that allows rotation of the first grasper jaw 316 and the second grasper jaw 330 without requiring rotation of the handle 302.

[0117] As shown in Figures 30, 33, 35, 37, 39, and 41 for the first through sixth embodiments 3001-3006, respectively, the distal ends 324, 338 of the first and second gripper jaws 316, 330 extend further distally than the gripper magnet 340. This means that the distal ends 324, 338 of the first and second gripper jaws 316, 330 extend further distally from the handle 304 than does any portion of the gripper magnet 340. Thus, the gripper magnet 340 is closer to the distal end 308 of the handle 304 than the distal ends 324, 338 of the first and second gripper jaws 316, 330.

[0118] As shown by comparing Figure 31 with Figure 30 for the first embodiment 3001, Figure 34 with Figure 33 for the second embodiment 3002, Figure 36 with Figure 35 for the third embodiment 3003, Figure 38 with Figure 37 for the fourth embodiment 3004, Figure 40 with Figure 39 for the fifth embodiment 3002, and Figure 42 with Figure 41 for the sixth embodiment 3006, translation of the actuator body 352 within the handle lumen 314 in a first direction along the handle body axis 312 pivots the first grasper jaw 316 from the first position 326 to the second position 328, thereby exposing the grasper magnet 340 and enabling contact between the grasper magnet 340 and the magnetic suture 300 attracted thereto. Translation of the actuator body 352 results in pivoting of the first grasper jaw 316. Translation of the actuator body 352 in the first direction may be translation of the actuator body 352 within the handle lumen 314 in a direction from the proximal end 306 of the handle 304 toward the distal end 308 of the handle 304. When the first gripper jaw 316 is in the first position 326, the gripper magnet 340 may be disposed completely within the recess 342 and thus isolated within the first gripper jaw 316 and the second gripper jaw 330. According to these embodiments, such translation of the actuator body 352 within the handle lumen 314 in the first direction may pivot the first gripper jaw 316 away from the second gripper jaw 330, thereby exposing the gripper magnet 340.

[0119] As shown by comparing FIG. 30 with FIG. 31 for the first embodiment 3001, FIG. 33 with FIG. 34 for the second embodiment 3002, FIG. 35 with FIG. 36 for the third embodiment 3003, FIG. 37 with FIG. 38 for the fourth embodiment 3004, FIG. 39 with FIG. 40 for the fifth embodiment 3002, and FIG. 41 with FIG. 42 for the sixth embodiment 3006, translation of the actuator body 352 within the handle lumen 314 in a second direction opposite to the first direction along the handle body axis 312 pivots the first grasper jaw 316 from the second position 328 to the first position 326, thereby isolating the grasper magnet 340 and grasping the magnetic suture 200 within the recess 342. Translation of actuator body 352 in the second direction can be translation of actuator body 352 within handle 304 in a direction from distal end 108 of handle 304 toward proximal end 106 of handle 304. Such translation of actuator body 352 within handle lumen 314 in the second direction can pivot first grasper jaw 316 toward second grasper jaw 330, thereby again isolating grasper magnets 340 and grasping magnetic suture 200 within first grasper jaw 316 and second grasper jaw 330.

[0120] This can be achieved as follows: Because grasper magnet 340 is closer to distal end 308 of shank 304 than to distal ends 324, 338 of first grasper jaw 316 and second grasper jaw 330, when suture magnet 202 of magnetic suture 200 contacts grasper magnet 340 and actuator body 352 is translated in the second direction to first position 326, grasper magnet 340 and magnetic suture 200 are moved together. Suture magnet 202 of magnetic suture grasper 100 fits within recess 342 before first grasper jaw 316 closes on second grasper jaw 330, so that when magnet-assisted suture grasper 100 is used to pull magnetic suture 200 through a patient's soft tissue, suture magnet 202 of magnetic suture 200 is grasped by first grasper jaw 316 and second grasper jaw 330. First grasper jaw 316 and second grasper jaw 330 are strong enough to counter the frictional resistance that results from pulling magnetic suture 200 through soft tissue.

[0121] As described above, first grasper jaw 316 includes proximal end 318, proximal-mid portion 320, distal portion 322, and distal end 324. Also, as described above, grasper magnet 340 is disposed adjacent proximal-mid portion 320 of first grasper jaw 316. Recess 342 formed in at least one of first gripper jaw 316 or second gripper jaw 330 when first gripper jaw 316 is in first position 326 has a length and orientation sufficient to allow suture magnet 202 of magnetic suture 200 to fit between gripper magnet 340 and distal end 324 of first gripper jaw 316 when first gripper jaw 316 is in second position 328 and when first gripper jaw 316 is returned to first position 326 such that suture magnet 202 of magnetic suture 200 can contact gripper magnet 340 by magnetic force. The proximal-to-middle portion 320 of the first grasper jaw 316 adjacent to which the grasper magnet 340 is disposed can be any portion of the first grasper jaw 316 distal to the proximal end 318 and proximal to the distal portion 322, as long as sufficient space is provided for the suture magnet 202 to fit within the recess 342 between the grasper magnet 340 and the distal end 324 of the first grasper jaw 316.

[0122] As described above and shown in FIGS. 30, 35, and 39 for the first embodiment 3001, the third embodiment 3003, and the fifth embodiment 3005, respectively, in some embodiments, the second gripper jaw 330 is reversibly movable. In these embodiments, the actuator body 352 is further connected to the second gripper jaw 330 and configured for pivotal movement of the second gripper jaw 330 with movement of the handle 302. For example, the actuator body 352 may be configured with respect to the second gripper jaw 330 as described above for the first gripper jaw 316. Other configurations may also be suitable. In these embodiments, translation of actuator body 352 within shank lumen 314 in a first direction pivots second grasper jaw 330 away from first grasper jaw 316, thereby further exposing grasper magnet 340 and allowing contact between grasper magnet 340 and magnetic suture 200 attracted thereto. Also, in these embodiments, translation of actuator body 352 within shank lumen 314 in a second direction pivots second grasper jaw 330 toward first grasper jaw 316, thereby contributing to isolating grasper magnet 340 and grasping magnetic suture 200 within recess 342. These embodiments may be advantageous by providing a greater range of motion for first grasper jaw 316 and second grasper jaw 330 during operation of magnet-assisted suture grasper 300, and therefore more space for suture magnet 202 of magnetic suture 200 to contact grasper magnet 340 when first grasper jaw 316 is in second position 328.

[0123] 30, in some embodiments, the distal ends 308, 338 of the first grasper jaw 316 and the second grasper jaw 330 have sharp tips 354, 356. This can be advantageous for piercing tissue during insertion of the magnet-assisted suture grasper 300 into the patient.

[0124] The magnetically assisted suture grasper embodiment 3001 can be operated as follows.

[0125] After the magnetic suture 200 is disposed inside the patient, the handle 302 of the magnet-assisted suture grasper 300 is moved, e.g., squeezed, to pivotally actuate the first grasper jaw 316 and the second grasper jaw 330 via the actuator body 352 such that the first grasper jaw 316 pivots from the second position 328 to the first position 326 and the second grasper jaw 330 pivots toward the first grasper jaw 316, closing the first grasper jaw 316 on the second grasper jaw 330. The distal end of the magnet-assisted suture grasper 300, including the first grasper jaw 316 and the second grasper jaw 330, and the distal end 308 of the handle 304 are introduced into the patient to gain access to the suture site.

[0126] The handle is then moved, e.g., released, to pivotally actuate first and second grasper jaws 316, 330 such that first grasper jaw 316 is pivoted from first position 326 to second position 328 and second grasper jaw 330 is pivoted away from first grasper jaw 316, thereby exposing grasper magnet 340 from recess 342 formed between first grasper jaw 316 and second grasper jaw 330. First and second grasper jaws 316, 330 and grasper magnet 340 are brought near suture magnet 202 of magnetic suture 200 so that the magnetic fields of grasper magnet 340 and suture magnet 202 can interact. The attractive force between the grasper magnet 340 and the suture magnet 202 pulls the suture magnet 202 towards the grasper magnet 340, bringing them into contact and axial alignment.

[0127] Handle 302 is then moved, e.g., squeezed, again to pivot first grasper jaw 316 back to first position 326 from second position 328 and to pivot second grasper jaw 330 toward first grasper jaw 316. As first grasper jaw 316 and second grasper jaw 330 pivot toward each other, grasper magnet 340 and suture magnet 202 of magnetic suture 200 fit within recess 342 before first grasper jaw 316 fully closes on second grasper jaw 330. At this point, magnetic suture 200 cannot escape recess 342 formed between first grasper jaw 316 and second grasper jaw 330.

[0128] Once magnetic suture 200 is captured, magnet-assisted suture grasper 300 can be used to pull or push magnetic suture 200 to a new location. First grasper jaw 316 and second grasper jaw 330 enable magnet-assisted suture grasper 300 to hold magnetic suture 200 securely, even when magnetic suture 200 is heavily loaded to the point where the load exceeds the attractive force between grasper magnet 340 and suture magnet 202.

[0129] Once magnetic suture 200 has been threaded to the desired location, magnetic suture 200 may be released from magnet-assisted suture grasper 300. To release magnetic suture 200, handle 302 is again moved, e.g., released, to pivot first grasper jaw 316 and second grasper jaw 330, thereby exposing grasper magnets 340 and suture magnets 202 of magnetic suture 200 from recesses 342. Suture 204 may then be pulled to separate grasper magnets 340 and suture magnets 202.

[0130] 43-47, there is also disclosed a magnetic suture loop 400. The magnetic suture loop 400 includes a suture magnet 402 and a bifurcated suture 404 extending from the suture magnet 402 and forming a suture loop 406.

[0131] Magnetic suture loop 400 may be fabricated similarly to that described in U.S. Publication No. 2021 / 0059667, as discussed above. Thus, in some embodiments, magnetic suture loop 400 further comprises a ferrule 408 with a tapered region 410 to which bifurcated suture 404 is tied and secured with adhesive, and a straight region 412 in which suture magnet 402 is provided.

[0132] The magnetic suture loop 400 advantageously provides a means for snare- ing a second suture for the purpose of pulling the second suture through the suture loop 406 created by the first suture. A surgeon may accomplish this as follows: The magnetic suture loop 400 is first passed through the patient's tissue, so that the magnetic suture loop 400 has an entry point and an exit point from the patient. The entry point and exit point may be separate points or the same point. A length of second suture is then threaded through the suture loop 406 of the magnetic suture loop 400. The magnetic suture loop 400 is then pulled through the tissue from the opposite end. As the magnetic suture loop 400 is pulled through the tissue entry point, the suture loop 406 is closed by the tissue around the second suture, effectively snare- ing the second suture. This snare action allows the magnetic suture loop to pull the second suture through the tissue and out of the exit point, so that the second suture now occupies the path previously occupied by magnetic suture loop 400. This is advantageous because it allows for limited substitution of suture sizes, materials, and configurations without limiting the choices regarding the type of suture used. For example, if a surgeon desires to use a different style of suture than magnetic suture loop 400, the surgeon can use magnetic suture loop 400 to establish the path, and then quickly and easily exchange magnetic suture loop 400 for a different second suture using the techniques described above.

[0133] 48-52, a pre-loaded magnetic suture cartridge 500 is also disclosed. Pre-loaded magnetic suture cartridge 500 includes magnetic suture loop 400 and cartridge tube 502. Magnetic suture loop 400 may be as described above. Cartridge tube 502 includes cartridge tube proximal opening 504, cartridge tube distal opening 506, and cartridge tube lumen 508 therebetween.

[0134] The magnetic suture loop 400 may be pre-loaded into the cartridge tube 502 during manufacture such that the suture loop 406 of the magnetic suture loop 400 traverses the cartridge tube lumen 508, which is sized such that the suture loop 406 can freely enter the cartridge tube lumen 508 but the suture magnet 402 of the suture loop 406 cannot enter the cartridge tube lumen 508, such that the suture loop 406 can pass freely through the cartridge tube lumen 508 in one direction but is trapped in the opposite direction. The wall thickness of the cartridge tube 502 and the modulus of the material used in its construction are such that the cartridge tube 502 has greater column strength than the suture loop 406, allowing the pre-loaded magnetic suture cartridge 500 containing the magnetic suture loop 400 to be easily inserted into and advanced through a cannula by being pushed from one end.

[0135] This is advantageous because the suture loop 406 itself does not have sufficient column strength to allow the suture loop 406 to be pushed through a cannula from one end. Thus, the cartridge tube 502 facilitates advancing the suture loop 406 through the cannula and into the internal working space. The cannula and cartridge tube 502 may then be removed, leaving only the suture loop 406. Alternatively, the cannula may be removed, leaving the cartridge tube 502 with the captured suture loop 406. Leaving the cartridge tube 502 in this manner may provide some benefit during the procedure, as the rigidity of the cartridge tube 502 provides the operator with a means to directly manipulate the suture magnet 402 of the magnetic suture loop 400 from outside the body at the distal end of the suture loop 406. To this effect, a curved portion may be added to the distal end of cartridge tube 502, which further enhances the operator's ability to directly manipulate suture magnet 402 of magnetic suture loop 400 within the body space.

[0136] Also disclosed is a system for threading a magnetic suture. The system includes a magnet-assisted suture grasper including (a) a suture retrieval needle, (b) a retriever body, (c) a grasper arm, and (d) a grasper magnet, as described above. The system also includes a magnetic suture, as described above, including a suture magnet and a suture extending from the suture magnet.

[0137] Another system for threading a magnetic suture is also disclosed. The system includes a magnet-assisted suture grasper comprising (a) a handle, (b) a shaft, (c) a first grasper jaw, (d) a second grasper jaw, (e) a grasper magnet, and (f) an actuator body, as described above. The system also includes a magnetic suture, as described above, comprising a suture magnet and a suture extending from the suture magnet.

[0138] Another system for threading a magnetic suture is also disclosed. The system includes a magnet-assisted suture grasper including (a) a suture retrieval needle, (b) a retriever body, (c) a grasper arm, and (d) a grasper magnet, as described above. The system also includes a magnetic suture loop, as described above, including a suture magnet and a bifurcated suture extending from the suture magnet to form a suture loop. In some embodiments, the system further includes a cartridge tube, as described above. The cartridge tube includes a cartridge tube proximal opening, a cartridge tube distal opening, and a cartridge tube lumen therebetween. The suture loop traverses the cartridge tube lumen upon insertion through the cartridge tube distal opening. The suture magnet is disposed outside the cartridge tube lumen adjacent to the cartridge tube distal opening.

[0139] Another system for threading a magnetic suture is also disclosed. The system includes a magnet-assisted suture grasper including (a) a handle, (b) a shaft, (c) a first grasper jaw, (d) a second grasper jaw, (e) a grasper magnet, and (f) an actuator body, as described above. The system also includes a magnetic suture loop, as described above, including a suture magnet and a bifurcated suture extending from the suture magnet to form the suture loop. In some embodiments, the system further includes a cartridge tube, as described above. The cartridge tube includes a cartridge tube proximal opening, a cartridge tube distal opening, and a cartridge tube lumen therebetween. The suture loop traverses the cartridge tube lumen upon insertion through the cartridge tube distal opening. The suture magnet is disposed outside the cartridge tube lumen adjacent to the cartridge tube distal opening.

[0140] The magnet-assisted suture graspers disclosed herein can be used to thread magnetic sutures that include a suture magnet at the end of the suture. Such magnetic sutures can be made, for example, as described in U.S. Publication No. 2021 / 0059667. The magnet-assisted suture graspers disclosed herein can also be used to thread magnetic sutures that are magnetic by virtue of the inclusion of a magnetic metal within the suture.

[0141] The magnetically assisted suture graspers disclosed herein may be useful in procedures including, among others, (1) inguinal herniotomy via high ligation of the patent processus vaginalis as described above, (2) laparoscopic port closure (typical suture size 2-0 or larger), (3) microsurgical surgery (typical suture size 7-0 or smaller), (4) general surgery (typical suture size 2-0 to 0), and (5) orthopedic surgery (typical suture size 0 or larger).

[0142] The magnet-assisted suture grasper may also be modified for use in ultrasound-guided surgical techniques. The magnet-assisted suture grasper is modified by making the distal end of the suture retrieval needle echogenic. This may be done, for example, by applying an echogenic treatment to the distal tip of the suture retrieval needle or to the grasper jaws. The modified magnet-assisted suture grasper is then used with a hypodermic needle for introducing the suture, the hypodermic needle also being echogenic at its distal end. Optionally, the magnet of the magnet-assisted suture grasper and magnetic suture, and / or the ferrule attaching the magnet to the wire and suture of the magnet-assisted suture grasper, may also be made echogenic, for example, by applying an echogenic treatment to the magnet and / or ferrule.

[0143] The use of modified magnet-assisted suture graspers in ultrasound-guided surgical techniques may result in reduced surgical time and complexity by eliminating the need for suction equipment, which is currently required to thread the suture through the needle.

[0144] A modified magnet-assisted suture grasper could also enable an alternative technique in which sutures are delivered and retrieved from inside the abdominal cavity. This would allow the repair to be completed entirely through a single needle access point, resulting in improved cosmesis and less postoperative pain. In the current laparoscopic approach (called the PEAR / PIRS technique), a needle is introduced through the skin, centered around the defect, and exits below the defect through the peritoneum into the abdominal cavity. Suture delivery and retrieval occur within this space inside the abdominal cavity. This is currently not possible under ultrasound guidance because sutures are not echogenic, so the surgeon must retrieve the suture from inside the abdominal cavity without any vision. This is nearly impossible with the current state of suture threading device technology (i.e., snares, graspers, etc.). In contrast, a modified magnet-assisted suture grasper could enable this to work, especially if the needle point and ferrule are echogenic.

[0145] The mechanical grasper arm technology described herein can be integrated into the magnetic U-stitch suturing device disclosed in U.S. Patent No. 10,245,021 to provide a more secure means of holding the magnetic suture during retrieval. In addition, this allows the operation of the device to be modified so that the suture does not have to be pulled completely out of the body through a second cannula but can simply be captured, and then the entire device removed, pulling the suture directly through the skin. This would allow the magnetic U-stitch suturing device to be used to place multiple sutures with a single device.

[0146] Additionally, the magnetically assisted suture graspers described herein can be integrated as end-of-arm tooling for robotic-assisted surgery or into the end of an endoscope for direct endoscopic manipulation of sutures.

[0147] Although magnet-assisted suture graspers are described for grasping magnetic sutures, the magnet-assisted suture graspers may also be used to grasp sutures that do not necessarily include a suture magnet but that include ferromagnetic elements that are attracted by a magnet.

[0148] While the present invention has been described in conjunction with the specific embodiments outlined above, it is evident that many alternatives, modifications, and variations will be apparent to those skilled in the art. Accordingly, the preferred embodiments of the invention as set forth above are intended to be illustrative rather than limiting. Various changes may be made without departing from the spirit and scope of the invention.

[0149] Terms Clause 1. A magnet-assisted suture grasper for grasping a magnetic suture, comprising: (a) a suture retrieval needle having a proximal end, a distal end, and a needle body extending therebetween, the needle body defining a needle body axis between the proximal and distal ends of the suture retrieval needle, the needle body having a proximal bore, a distal bore, and a needle lumen extending therebetween along the needle body axis; (b) a retriever body disposed within the needle lumen and translatable therein along the needle body axis; (c) a grasper arm having a proximal end, a proximal-intermediate portion, a distal portion, and a distal end, the grasper arm extending from the distal end of the retriever body and reversibly movable between a first position and a second position; and (d) a grasper magnet disposed adjacent the proximal-medial portion of the grasper arm, the magnetic assisted suture grasper comprising a grasper magnet that isolates the grasper magnet within the needle lumen when the grasper arm is in the first position and exposes the grasper magnet from the needle lumen when the grasper arm is in the second position; the distal ends of the grasper arms extend further distally than the grasper magnets; translation of the retriever body within the needle lumen in a first direction along the needle body axis moves the grasper arms from the first position to the second position, thereby exposing the grasper magnets and allowing contact between the grasper magnets and a magnetic suture attracted thereto; A magnet-assisted suture grasper, wherein translation of the retriever body within the needle lumen in a second direction opposite the first direction along the needle body axis moves the grasper arms from the second position to the first position, thereby isolating the grasper magnet and grasping the magnetic suture within the needle lumen.

[0150] Clause 2. The magnet-assisted suture grasper of clause 1, wherein the suture retrieval needle is straight and the needle body shaft is thereby straight.

[0151] Clause 3. The magnet-assisted suture grasper of clause 1, wherein the suture retrieval needle is curved and the needle body shaft is thereby curved.

[0152] Clause 4. A magnet-assisted suture grasper as described in any one of clauses 1 to 3, wherein the suture retrieval needle has a sharp tip.

[0153] Clause 5. A magnet-assisted suture grasper according to any one of clauses 1 to 4, wherein the grasper arms are integral with the retriever body.

[0154] Clause 6. A magnet-assisted suture grasper as described in any one of clauses 1 to 5, wherein the grasper magnet is fixedly attached, either directly or indirectly, to the distal end of the retriever body.

[0155] Clause 7. A magnet-assisted suture grasper as described in any one of clauses 1 to 6, wherein the grasper magnet is fixedly attached to the grasper arm, either directly or indirectly, at the proximal to medial portion of the grasper arm.

[0156] Clause 8. A magnet-assisted suture grasper as described in any one of clauses 1 to 6, further comprising a magnet wire having a proximal end and a distal end, the proximal end of the magnet wire being fixedly disposed within the retriever body, and the grasper magnet being fixedly attached, either directly or indirectly, to the distal end of the magnet wire.

[0157] Clause 9. The grasper arm further comprises an enlarged distal terminus at the distal end of the grasper arm; the grasper arm is reversibly movable between the first position and the second position based on translation of the grasper arm from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; 9. A magnet-assisted suture grasper according to any one of clauses 1 to 8, wherein the enlarged distal terminal point at the distal end of the grasper arm is small enough to allow contact between the grasper magnet and a suture magnet of a magnetic suture attracted thereto when the grasper arm is in the second position, and is sized to allow threading of the suture of the magnetic suture when the grasper arm is in the first position, and large enough to prevent the suture magnet of the magnetic suture from exiting the needle lumen through the distal hole of the needle body when the grasper arm is in the first position.

[0158] Clause 10. The magnet-assisted suture grasper of clause 9, wherein the enlarged distal end comprises a hook.

[0159] Clause 11. The gripper arm is a first gripper arm; the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-midsection, a distal section, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between the first position and the second position; the first grasper arm further comprising an enlarged distal terminus at the distal end of the first grasper arm; the second grasper arm further comprising an enlarged distal terminus at the distal end of the second grasper arm; the first and second gripper arms are reversibly movable between the first and second positions based on translation of the first and second gripper arms from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; 9. A magnet-assisted suture grasper according to any one of clauses 1 to 8, wherein the enlarged distal end points of the first and second grasper arms have a size that allows contact between the grasper magnet and a suture magnet of a magnetic suture attracted thereto when the first and second grasper arms are in the second position, is small enough to allow threading of a suture of the magnetic suture when the first and second grasper arms are in the first position, and is large enough to prevent the suture magnet of the magnetic suture from passing through the needle lumen and out the distal hole of the needle body when the first and second grasper arms are in the first position.

[0160] Clause 12. The magnet-assisted suture grasper of clause 11, further comprising at least one additional grasper arm extending distally from said retriever body.

[0161] Clause 13. The gripper arm is a first gripper arm; the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-midsection, a distal section, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between the first position and the second position; the first grasper arm and the second grasper arm are connected at their distal ends to form a grasper arm loop; the grasper arm loop is reversibly movable between the first position and the second position based on translation of the grasper arm loop from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; the grasper arm loop encompasses an area large enough to allow contact between the grasper magnet and a suture of a magnetic suture attracted thereto when the grasper arm loop is in the second position; 9. A magnet-assisted suture grasper as described in any one of clauses 1 to 8, wherein the grasper arm loop has a thickness that is sufficiently large to prevent the suture magnet of the magnetic suture from passing through the distal hole of the needle body and exiting the needle lumen when the grasper arm loop is in the first position.

[0162] Clause 14. The gripper arm is a first gripper arm; the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-midsection, a distal section, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between the first position and the second position; the first grasper arm and the second grasper arm are connected at their distal ends to form a grasper arm loop; the first and second grasper arms further comprising enlarged distal termini at the distal ends of the first and second grasper arms; the grasper arm loop is reversibly movable between the first position and the second position based on translation of the grasper arm loop from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; the grasper arm loop encompasses an area large enough, and the enlarged distal endpoints at the distal ends of the first and second grasper arms have a small enough size, to allow contact between the grasper magnet and a suture magnet of a magnetic suture attracted thereto when the grasper arm loop is in the second position; the enlarged distal endpoints at the distal ends of the first and second grasper arms have a size sufficiently small to allow threading of a suture of the magnetic suture when the grasper arm loops are in the first position; A magnet-assisted suture grasper as described in any one of clauses 1 to 8, wherein the enlarged distal end points at the distal ends of the first grasper arm and the second grasper arm have a size sufficiently large to prevent the suture magnet of the magnetic suture from passing through the distal hole of the needle body and exiting the needle lumen when the grasper arm loop is in the first position.

[0163] Clause 15. The gripper arm is a first gripper arm; the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-midsection, a distal section, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between the first position and the second position; the first grasper arm further comprising an enlarged distal terminus at the distal end of the first grasper arm; the second grasper arm further comprising an enlarged distal terminus at the distal end of the second grasper arm; the first and second gripper arms are reversibly movable between the first and second positions based on translation of the first and second gripper arms from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; the proximal to intermediate portions of the first and second gripper arms are substantially parallel to the needle body axis when the first and second gripper arms are in the first position; at least one of the first or second gripper arms reversibly pivots outwardly from the needle body shaft sufficiently far to permit contact between the gripper magnet and a suture magnet of a magnetic suture attracted thereto when the first and second gripper arms are in the second position; 9. A magnet-assisted suture grasper according to any one of clauses 1 to 8, wherein the enlarged distal end points of the first and second grasper arms are small enough to allow threading of the suture of the magnetic suture when the first and second grasper arms are in the first position, and large enough to prevent the suture magnet of the magnetic suture from passing through the distal hole of the needle body and exiting the needle lumen when the first and second grasper arms are in the first position.

[0164] Clause 16. A system for threading magnetic sutures, comprising: 16. A magnetic assisted suture grasper according to any one of clauses 1 to 15; and a magnetic suture comprising a suture magnet and a suture extending from the suture magnet; A system comprising:

[0165] Clause 17. A system for threading magnetic sutures, comprising: 16. A magnetic assisted suture grasper according to any one of clauses 1 to 15; and a magnetic suture loop comprising a suture magnet and a bifurcated suture extending from the suture magnet to form a suture loop; A system comprising:

[0166] Clause 18. Further comprising a cartridge tube; the cartridge tube comprising a cartridge tube proximal opening, a cartridge tube distal opening, and a cartridge tube lumen therebetween; the suture loop traverses the cartridge tube lumen upon being inserted through the cartridge tube distal opening; 18. The system of claim 17, wherein the suture magnet is disposed outside the cartridge tube lumen adjacent the cartridge tube distal opening.

[0167] Clause 19. A magnetically assisted suture grasper for grasping a magnetic suture, comprising: (a) Handle, (b) a handle having a proximal end, a distal end, and a handle body extending therebetween, the handle connected to the handle adjacent the proximal end of the handle, the handle body defining a handle body axis and including a handle lumen extending along the handle; (c) a first grasper jaw having a proximal end, a proximal-intermediate portion, a distal portion, and a distal end, the first grasper jaw extending from the handle adjacent the distal end of the handle and reversibly movable between a first position and a second position; (d) a second grasper jaw having a proximal end, a proximal-intermediate portion, a distal portion, and a distal end, the second grasper jaw extending from the handle adjacent the distal end of the handle; (e) a grasper magnet disposed adjacent the proximal-medial portion of the first grasper jaw, wherein the magnet-assisted suture grasper isolates the grasper magnet between the first grasper jaw and the second grasper jaw within a recess formed in at least one of the first grasper jaw or the second grasper jaw when the first grasper jaw is in the first position, and exposes the grasper magnet from the recess when the first grasper jaw is in the second position; and (f) an actuator body disposed within the handle lumen and translatable therein along the handle body axis, the actuator body connected to the handle and the first grasper jaw and configured for pivotal movement of the first grasper jaw with movement of the handle; the distal ends of the first and second grasper jaws extend further distally than the grasper magnet; translation of the actuator body within the handle lumen in a first direction along the handle body axis pivots the first grasper jaw from the first position to the second position, thereby exposing the grasper magnet and allowing contact between the grasper magnet and a magnetic suture attracted thereto; A magnet-assisted suture grasper, wherein translation of the actuator body within the handle lumen in a second direction opposite the first direction along the handle body axis pivots the first grasper jaw from the second position to the first position, thereby isolating the grasper magnet and grasping the magnetic suture within the recess.

[0168] Clause 20. A magnet-assisted suture grasper as described in Clause 19, wherein the first grasper jaw is straight from the proximal end of the first grasper jaw to the distal end of the first grasper jaw relative to the handle body axis.

[0169] Clause 21. A magnet-assisted suture grasper as described in Clause 19, wherein the first grasper jaw is curved relative to the handle body axis from the proximal end of the first grasper jaw to the distal end of the first grasper jaw.

[0170] Clause 22. A magnet-assisted suture grasper as described in any one of clauses 19 to 21, wherein the first grasper jaw defines a first grasper jaw axis, and the proximal to intermediate portion of the first grasper jaw includes a recessed portion along the first grasper jaw axis that defines at least a portion of the recess.

[0171] Clause 23. A magnet-assisted suture grasper as described in any one of clauses 19 to 21, wherein the second grasper jaw defines a second grasper jaw axis, and the proximal to intermediate portion of the second grasper jaw includes a recessed portion along the second grasper jaw axis that defines at least a portion of the recess.

[0172] Clause 24. A magnet-assisted suture grasper as described in any one of clauses 19 to 21, wherein the first grasper jaw defines a first grasper jaw axis, the second grasper jaw defines a second grasper jaw axis, and the proximal to intermediate portions of the first grasper jaw and the second grasper jaw include recessed portions along the first grasper jaw axis and the second grasper jaw axis, respectively, that define the recess.

[0173] Clause 25. A magnet-assisted suture grasper as described in any one of clauses 19 to 24, wherein the grasper magnet is fixedly mounted to the proximal to medial portion of the first grasper jaw.

[0174] Clause 26. A magnet-assisted suture grasper as described in any one of clauses 19 to 24, wherein the grasper magnet is fixedly attached to the proximal to medial portion of the second grasper jaw.

[0175] Clause 27. A magnet-assisted suture grasper as described in any one of clauses 19 to 24, wherein the grasper magnet is fixedly attached to the handle between the proximal and intermediate portions of the first grasper jaw and the second grasper jaw.

[0176] Clause 28. The second gripper jaw is reversibly movable; the actuator body is further connected to the second gripper jaw and configured for pivotal movement of the second gripper jaw by movement of the handle; translation of the actuator body within the handle lumen in the first direction pivots the second grasper jaw away from the first grasper jaw, thereby further exposing the grasper magnet and enabling contact between the grasper magnet and a magnetic suture attracted thereto; 28. A magnet-assisted suture grasper as described in any one of clauses 19 to 27, wherein translation of the actuator body within the handle lumen in the second direction pivots the second grasper jaw toward the first grasper jaw, thereby contributing to isolating the grasper magnet and grasping the magnetic suture within the recess.

[0177] Clause 29. A magnet-assisted suture grasper as described in any one of clauses 19 to 28, wherein the distal ends of the first grasper jaw and the second grasper jaw have sharp tips.

[0178] Clause 30. A system for threading magnetic sutures, comprising: 30. A magnetic assisted suture grasper according to any one of clauses 19 to 29; and a magnetic suture comprising a suture magnet and a suture extending from the suture magnet; A system comprising:

[0179] Clause 31. A system for threading magnetic sutures, comprising: 30. A magnetic assisted suture grasper according to any one of clauses 19 to 29; and a magnetic suture loop comprising a suture magnet and a bifurcated suture extending from the suture magnet to form a suture loop; A system comprising:

[0180] Clause 32. Further comprising a cartridge tube; the cartridge tube comprising a cartridge tube proximal opening, a cartridge tube distal opening, and a cartridge tube lumen therebetween; the suture loop traverses the cartridge tube lumen upon being inserted through the cartridge tube distal opening; 32. The system of claim 31, wherein the suture magnet is disposed outside the cartridge tube lumen adjacent the cartridge tube distal opening.

Claims

1. 1. A magnetically assisted suture grasper for grasping a magnetic suture, comprising: (a) a suture retrieval needle comprising a proximal end, a distal end, and a needle body extending therebetween, the needle body defining a needle body axis between the proximal and distal ends of the suture retrieval needle, the needle body having a proximal bore, a distal bore, and a needle lumen extending therebetween along the needle body axis; (b) a retriever body disposed within the needle lumen and translatable therein along the needle body axis; (c) a grasper arm having a proximal end, a proximal-intermediate portion, a distal portion, and a distal end, the grasper arm extending from the distal end of the retriever body and reversibly movable between a first position and a second position; and (d) a grasper magnet disposed adjacent the proximal-medial portion of the grasper arm, the grasper magnet isolating the grasper magnet within the needle lumen when the grasper arm is in the first position and exposing the grasper magnet from the needle lumen when the grasper arm is in the second position; the distal ends of the grasper arms extend further distally than the grasper magnets; translation of the retriever body within the needle lumen in a first direction along the needle body axis moves the grasper arms from the first position to the second position, thereby exposing the grasper magnets and allowing contact between the grasper magnets and a magnetic suture attracted thereto; a magnet-assisted suture grasper, wherein translation of the retriever body within the needle lumen in a second direction opposite the first direction along the needle body axis moves the grasper arms from the second position to the first position, thereby isolating the grasper magnet and grasping the magnetic suture within the needle lumen.

2. the suture retrieval needle is straight and the needle body shaft is thus straight; or 10. The magnet assisted suture grasper of claim 1, wherein the suture retrieval needle is curved and the needle body shaft is thereby curved.

3. The magnet-assisted suture grasper of claim 1 , wherein the suture retrieval needle has a sharp tip.

4. The magnet assisted suture grasper of claim 1 , wherein the grasper arms are integral with the retriever body.

5. the grasper magnet is fixedly attached, either directly or indirectly, to the distal end of the retriever body; or 10. The magnet assisted suture grasper of claim 1, wherein the grasper magnet is fixedly attached to the grasper arm, either directly or indirectly, at the proximal to medial portion of the grasper arm.

6. 10. The magnet-assisted suture grasper of claim 1, further comprising a magnet wire having a proximal end and a distal end, the proximal end of the magnet wire fixedly disposed within the retriever body, and the grasper magnet fixedly attached, either directly or indirectly, to the distal end of the magnet wire.

7. the grasper arms further comprising enlarged distal termini at the distal ends of the grasper arms; the grasper arm is reversibly movable between the first position and the second position based on translation of the grasper arm from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; 2. The magnet-assisted suture grasper of claim 1, wherein the enlarged distal terminus at the distal end of the grasper arm is small enough to allow contact between the grasper magnet and a suture magnet of a magnetic suture attracted thereto when the grasper arm is in the second position, and is sized to allow threading of a suture of the magnetic suture when the grasper arm is in the first position, and large enough to prevent the suture magnet of the magnetic suture from exiting the needle lumen through the distal aperture of the needle body when the grasper arm is in the first position.

8. The magnet-assisted suture grasper of claim 7 , wherein the enlarged distal end comprises a hook.

9. the grasper arm is a first grasper arm; the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-intermediate portion, a distal portion, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between the first position and the second position; the first grasper arm further comprising an enlarged distal terminus at the distal end of the first grasper arm; the second grasper arm further comprising an enlarged distal terminus at the distal end of the second grasper arm; the first and second grasper arms are reversibly movable between the first and second positions based on translation of the first and second grasper arms from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; 2. The magnet-assisted suture grasper of claim 1, wherein the enlarged distal end points of the first and second grasper arms have a size that is small enough to allow contact between the grasper magnet and a suture magnet of a magnetic suture attracted thereto when the first and second grasper arms are in the second position and to allow threading of a suture of the magnetic suture when the first and second grasper arms are in the first position, and large enough to prevent the suture magnet of the magnetic suture from exiting the needle lumen through the distal bore of the needle body when the first and second grasper arms are in the first position.

10. The magnet assisted suture grasper of claim 9, further comprising at least one additional grasper arm extending distally from the retriever body.

11. the grasper arm is a first grasper arm; the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-intermediate portion, a distal portion, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between the first position and the second position; the first grasper arm and the second grasper arm are connected at their distal ends to form a grasper arm loop; the grasper arm loop is reversibly movable between the first position and the second position based on translation of the grasper arm loop from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; the grasper arm loop encompasses an area large enough to allow contact between the grasper magnet and a suture of a magnetic suture attracted thereto when the grasper arm loop is in the second position; 2. The magnet-assisted suture grasper of claim 1, wherein the grasper arm loop has a thickness that is sufficiently great to prevent a suture magnet of the magnetic suture from passing through the distal aperture of the needle body and exiting the needle lumen when the grasper arm loop is in the first position.

12. the grasper arm is a first grasper arm; the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-intermediate portion, a distal portion, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between the first position and the second position; the first grasper arm and the second grasper arm are connected at their distal ends to form a grasper arm loop; the first and second grasper arms further comprising enlarged distal termini at the distal ends of the first and second grasper arms; the grasper arm loop is reversibly movable between the first position and the second position based on translation of the grasper arm loop from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; the grasper arm loop encompasses a sufficiently large area and the enlarged distal endpoints at the distal ends of the first grasper arm and the second grasper arm have a sufficiently small size to allow contact between the grasper magnet and a suture magnet of a magnetic suture attracted thereto when the grasper arm loop is in the second position; the enlarged distal endpoints at the distal ends of the first and second grasper arms have a size sufficiently small to allow threading of a suture of the magnetic suture when the grasper arm loops are in the first position; 2. The magnet-assisted suture grasper of claim 1, wherein the enlarged distal terminus at the distal end of the first grasper arm and the second grasper arm has a size large enough to prevent the suture magnet of the magnetic suture from passing through the distal aperture of the needle body and exiting the needle lumen when the grasper arm loop is in the first position.

13. the grasper arm is a first grasper arm; the magnet assisted suture grasper further comprises a second grasper arm having a proximal end, a proximal-intermediate portion, a distal portion, and a distal end, the second grasper arm extending from the distal end of the retriever body and being reversibly movable between the first position and the second position; the first grasper arm further comprising an enlarged distal terminus at the distal end of the first grasper arm; the second grasper arm further comprising an enlarged distal terminus at the distal end of the second grasper arm; the first and second grasper arms are reversibly movable between the first and second positions based on translation of the first and second grasper arms from inside the needle lumen to outside the needle lumen through the distal aperture of the needle body; the proximal-medial portions of the first and second gripper arms are substantially parallel to the needle body axis when the first and second gripper arms are in the first position; at least one of the first or second grasper arms reversibly pivots outwardly from the needle body shaft sufficiently far to permit contact between the grasper magnet and a suture magnet of a magnetic suture attracted thereto when the first grasper arm and the second grasper arm are in the second position; 2. The magnet-assisted suture grasper of claim 1, wherein the enlarged distal end points of the first and second grasper arms are sized small enough to allow threading of a suture of the magnetic suture when the first and second grasper arms are in the first position, and large enough to obstruct the suture magnet of the magnetic suture from exiting the needle lumen through the distal aperture of the needle body when the first and second grasper arms are in the first position.

14. 1. A system for threading a magnetic suture, comprising: a magnetically assisted suture grasper according to claim 1; a magnetic suture comprising a suture magnet and a suture extending from the suture magnet; A system comprising:

15. 1. A system for threading a magnetic suture, comprising: a magnetically assisted suture grasper according to claim 1; a magnetic suture loop comprising a suture magnet and a bifurcated suture extending from the suture magnet to form a suture loop; Cartridge tube and Equipped with the cartridge tube comprising a cartridge tube proximal opening, a cartridge tube distal opening, and a cartridge tube lumen therebetween; the suture loop traverses the cartridge tube lumen upon being inserted through the cartridge tube distal opening; The suture magnet is disposed outside the cartridge tube lumen adjacent the cartridge tube distal opening.

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