Suture Management Device with Cantilever Blade and Expandable Actuator
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Solution Overview
Problem
Existing surgical procedures face challenges in securely tying and managing sutures, especially in regions with restricted access, where tying knots is difficult and trimming suture ends is cumbersome using standard instruments.
Innovation Solution
Development of suture management devices featuring elongate tubular members with cantilever blades, expandable members, and retractable guides, which allow for remote severing and manipulation of sutures using cutting assemblies with various actuation mechanisms, such as inflatable balloons, jaws, and magnets, enabling precise cutting and knot removal.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If standard instruments are used to trim suture ends in restricted access regions, then the surgical procedure can be completed, but the operation becomes cumbersome and difficult to perform
Solution Approach 1:
The cutting blade is nested within a protective housing that can slide along the delivery catheter. The blade assembly fits inside the catheter lumen, allowing the entire cutting mechanism to be delivered through the catheter to the remote site, then deployed when needed. This nesting approach enables complex functionality to be delivered through a relatively simple catheter structure.
Solution Approach 2:
A retractable guide wire or spiral loop is used as an intermediary to capture and guide the suture into the cutting position. The guide wire extends beyond the catheter tip, allows the suture to be engaged and retracted, and positions the suture against the cutting blade. This intermediary mechanism simplifies the complex task of positioning and cutting sutures in restricted access regions.
2Loss of time
If knots are tied outside the patient and pushed toward the region, then knot placement is achieved, but additional trimming operations become necessary and difficult
Solution Approach 1:
The cutting blade is pre-positioned at the distal end of the delivery catheter, ready to cut the suture immediately after knot placement. The blade remains retracted during delivery and knot tying, then is deployed to cut the suture in situ. This eliminates the need for separate trimming operations and reduces the time required to complete the procedure.
Solution Approach 2:
The knot placement and suture trimming functions are merged into a single integrated procedure. The cutting blade is positioned to cut the suture at the same location where the knot was just placed, combining what would traditionally be two separate steps (knot tying followed by trimming) into one continuous operation performed through the same catheter delivery system.
3Measurement precision
If remote suture severing is implemented, then surgical precision in hard-to-reach areas is improved, but device complexity increases
Solution Approach 1:
The cutting blade is positioned at the very distal tip of the delivery catheter, placing the cutting function exactly where it is needed - at the remote site within the patient. This localized positioning of the cutting function at the precise location of need eliminates the need for complex positioning mechanisms while achieving high precision in hard-to-reach areas.
Solution Approach 2:
The retractable guide wire or spiral loop automatically captures and positions the suture against the cutting blade through its own geometry and elasticity. The guide structure self-adjusts to engage the suture and bring it into the cutting position without requiring additional actuators or complex control mechanisms, thereby reducing device complexity while maintaining cutting 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 secure and efficient remote manipulation and severing of sutures, facilitating knot placement and removal in hard-to-reach areas, improving surgical precision and reducing tissue trauma.
Implementation Method 1
The expandable member may be any suitable expandable member. In some variations, the expandable member is inflatable (e.g., a balloon).
Implementation Method 2
In other variations, the retractable guide may comprise a spiral loop.
Data Source
Figure 1A~1B
Figure 2
Figure 3~4
AI summary
Described here are devices and methods for suture management. In some variations, the devices comprise an elongate tubular member having a proximal end, a distal end, a lumen therebetween, a cantilever blade positioned near the distal end of the elongate tubular member, and an expandable member positioned adjacent the cantilever blade for actuating the cantilever blade. Also described are devices comprising an elongate tubular member having a proximal end, a distal end, a lumen at least partially therebetween, and an aperture in a wall thereof for passage of a suture therethrough. These devices further comprise a blade connected to a blade housing disposed within the lumen, where the blade is oriented parallel to the longitudinal axis of the lumen. The blade and blade housing may be slidable within the lumen, or an inner shaft for may be slidable within the lumen. Methods of using the devices are also described.