Push-Twist Laparoscopic Knot Tying Instrument
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Solution Overview
Problem
Tying knots intra-corporeally in laparoscopic surgery is difficult and time-consuming, requiring significant skill and manual dexterity, with existing instruments either being cumbersome or relying on external knot pushers and staples.
Innovation Solution
A laparoscopic instrument with two integrated graspers, one stationary and one rotatable and slideable, allows the head end of a suture to be passed behind the tail end between the graspers, utilizing manual thumb control and automatic rotation to simplify the knot-tying process, employing standard 45-degree jaws and compression springs for secure holding.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If manual manipulation of suture with two laparoscopic graspers is used, then knot tying can be performed intra-corporeally, but the process becomes slow and cumbersome requiring considerable skill
Solution Approach 1:
The patent combines two separate laparoscopic graspers into a single integrated instrument with a common external sheath and handle. The donor grasper and recipient grasper are merged into one operable unit, allowing both grasping functions to be controlled simultaneously through a single handle mechanism, thereby simplifying the knot-tying process and reducing the time required.
Solution Approach 2:
The donor grasper is designed to be rotatable and slideable relative to the recipient grasper within the common sheath. This dynamic mechanism allows the head end of the suture to be automatically passed behind the tail end through rotational and sliding motions, eliminating the need for complex manual manipulation and reducing the skill level required while saving time.
2Ease of operation
If extra-corporeal knot tying with knot pusher is used, then knot tying is simpler, but it requires pushing the knot inside the body which adds complexity
Solution Approach 1:
The patent merges the functions of creating a knot extra-corporeally with pushing it intra-corporeally into a single integrated instrument. The donor and recipient graspers work together to form the knot within the body cavity, eliminating the need for separate knot-pushing operations and reducing overall device complexity while maintaining ease of operation.
3Adaptability or versatility
If two separate graspers are used for knot tying, then flexibility is maintained, but the instrument becomes cumbersome
Solution Approach 1:
The patent combines two separate graspers into one integrated instrument with a common external sheath and handle, reducing the number of separate instruments needed while maintaining the functional flexibility of having both donor and recipient grasping capabilities within a single operable unit.
Solution Approach 2:
The donor grasper is nested within the common external sheath that also contains the recipient grasper. The rotatable and slideable donor grasper can move within the confines of the shared sheath, allowing flexible manipulation while maintaining a compact, non-cumbersome overall instrument structure.
Data Source
AI summary
This is a laparoscopic instrument for facilitating intra-corporeal tying of knots. The shafts of two small diameter laparoscopic graspers are combined within a common external sheath. One grasper has a regular scissors handle, is stationary, and acts as a recipient grasper, while the other has no handle, but is rotatable and slidable, and acts as a donor grasper. It enables the head end of a suture to be actively passed from the jaws of the donor grasper to the jaws of the adjacent recipient grasper, after passing behind and around the tail strand, thus forming a knot. The current version of this instrument introduces two additional features, one being the passive production of the rotation by the straight sliding mechanism, the other being the use of free-wheeling levers allowing rotation of the shaft of the donor grasper, without rotating the attached levers in the slots.