Pivotable Jaw Surgical Suturing Instrument for TaTME
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Solution Overview
Problem
Performing purse string sutures in TaTME surgery is challenging due to the difficulty in maneuvering needles within the anal canal without damaging surrounding tissue, making it a time-consuming and skill-dependent task that often discourages surgeons from performing the procedure, resulting in patients being left with stomas.
Innovation Solution
A surgical suturing instrument with pivotable jaw members and an outer tube that allows for the use of larger needles, enabling the instrument to expand and accommodate larger sutures while maintaining a reduced profile for insertion, facilitated by a biasing mechanism that opens the jaws upon tube retraction, allowing for precise and efficient suturing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If smaller needles are used to navigate the anal canal, then the ease of operation improves, but the manufacturing precision and reliability of suturing deteriorate
Solution Approach 1:
The jaw members are designed to be movable relative to each other, transitioning between a closed configuration for insertion and an open configuration for suturing. This dynamic structure allows the instrument to adapt its shape for different operational phases, enabling larger needles to be used while maintaining ease of insertion and manipulation.
2Manufacturing precision
If larger needles are used for suturing, then the manufacturing precision and reliability improve, but the ease of operation and insertion difficulty worsen
Solution Approach 1:
The instrument is divided into separate movable jaw members that can be independently positioned. The first jaw member has a body portion and a movable distal end portion, while the second jaw member similarly separates proximal and distal portions. This segmentation allows the distal portions to be positioned for precise suturing with larger needles while the overall instrument maintains a compact profile for insertion.
Solution Approach 2:
The movable distal end portion of the first jaw member is disposed within the second jaw member when the jaws are in the closed configuration. This nested arrangement reduces the overall profile of the instrument for insertion while allowing the jaw members to be separated and positioned for suturing with larger needles once inserted.
3Device complexity
If a fixed jaw structure is used, then the device complexity is reduced, but the adaptability and versatility for different suturing configurations deteriorate
Solution Approach 1:
The jaw members incorporate movable distal end portions that can be positioned at different angles and configurations relative to the proximal portions. This dynamic capability allows the instrument to adapt to different suturing requirements and anatomical configurations while maintaining a relatively simple overall structure that does not require complex mechanical systems.
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
The instrument facilitates easier and more precise suturing by enabling the use of larger needles, reducing the risk of tissue damage and improving the efficiency of purse string formation, thereby making TaTME surgery more accessible and effective.
Implementation Method 1
The second jaw member may include a biasing member that resiliently biases the distal end portion of the second jaw member outwardly relative to the proximal end portion
Implementation Method 2
an outer tube disposed about the shaft and configured to move between a proximal position and a distal position
Implementation Method 3
an axially translatable cable having a distal end portion fixed to the distal end portion of the second jaw member. The cable may be configured to move the distal end portion of the second jaw member relative to the proximal end portion
Data Source
AI summary
Side bite surgical suturing instruments or portions thereof for endoscopic, laparoscopic, endoluminal, and/or transluminal suturing facilitate the use of larger needles to get a bigger bite while suturing.