Blind Trocar Wound Closure with Integrated Suture Guidance
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Solution Overview
Problem
Existing methods for closing trocar wound sites during laparoscopic procedures are cumbersome and lack a simple, reproducible, and reliable means for wound closure, leading to a high incidence of trocar site hernias due to improper or incomplete closure.
Innovation Solution
A surgical instrument system comprising a needle apparatus with a sharp tip and insufflation channel, combined with a guide apparatus featuring suture capture features, allows for quick, consistent, and reproducible closure of the fascial/peritoneal layer using a suture passer that insufflates the abdomen and secures sutures through tissue layers.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional methods of wound site closure are used, then additional instruments (suture passers, guides, etc.) must be introduced, but the procedure becomes cumbersome and less reliable
Solution Approach 1:
The patent combines the suture passer and guide into a single integrated instrument. The guide apparatus includes a guide body with a channel that directs the suture needle, and a suture catcher mechanism built into the same device. This integration eliminates the need for separate suture passer and guide instruments, reducing procedural complexity while maintaining reliable wound closure through the coordinated interaction of its built-in components.
2Productivity
If multiple separate instruments are used for suture passing and guiding, then the procedure becomes more complex, but the closure process may be less consistent and reproducible
Solution Approach 1:
The integrated instrument performs multiple functions within a single device: the guide body directs the needle trajectory, the channel guides the suture needle through tissue, and the suture catcher mechanism captures and retrieves the suture. This multi-functionality enables efficient wound closure by combining what were previously separate instruments into one universal tool, improving productivity without requiring multiple separate instruments.
3Manufacturing precision
If traditional closure methods are used without direct visualization, then the procedure may be simpler, but the precision and consistency of suture placement deteriorates
Solution Approach 1:
The guide body acts as an intermediary device that provides a structured framework for suture placement without requiring direct visualization. The guide body includes external markers or indicators that allow the operator to position the guide relative to the wound opening, and the internal channel provides a predetermined trajectory for the suture needle. This intermediary structure ensures precise and consistent suture placement through tactile and visual cues external to the body cavity, maintaining operational simplicity while achieving high precision.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enables efficient and reliable closure of trocar wound sites, minimizing the risk of hernias by providing a quick and reproducible method for suturing the wound, even without direct visualization, thus enhancing surgical efficiency and patient outcomes.
Implementation Method 1
a spring loaded safety tip on a hollow obturator tube
Implementation Method 2
insufflate the abdominal cavity with an inert gas, such as carbon dioxide, through the needle
Data Source
AI summary
A system for closing trocar wound sites includes a suture engagement device and a guide to direct the device through the body tissues. An improved needle and guide instrument set allows for the surgical placement of suture to be completed “blind,” namely, without the aid of an endoscope for direct visualization of the abdominal cavity. The guide can include markings to accurately determine a depth of the guide and, therefore, accurately determining a suture fascial tissue bite distance. This may be advantageous in certain surgical procedures where an endoscope is not being used or does not provide adequate visualization of the surgical site.