# US 10,869,662 B2 · Methods, systems, and devices for surgical suturing

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- Number: US 10,869,662 B2
- Document ID: US10869662B2
- Status: Granted
- Kind: B2
- Application number: 16/106,719
- Filed: 2018-08-21
- Published: 2019-01-03
- Granted: 2020-12-22
- Earliest claimed: 2015-08-06
- Assignees: DePuy Synthes Products, Inc.
- Applicants: DePuy Synthes Products, Inc.
- Inventors: Brian Otrando; Kevin Zylka; Jonathan Bellas; James T. Spivey; Peter Colby
- Web page: https://patentgrep.com/patent/US10869662B2

## CPC

- A61B 17/0491: {Sewing machines for surgery}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/0483: {Hand-held instruments for holding sutures (A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30)}
- A61B 17/062: Needle manipulators
- A61B 50/30: Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments (for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40)
- A61B 2017/0023: {disposable}
- A61B 2017/0053: {Loading magazines or sutures into applying tools}
- A61B 2017/0479: {Packages or dispensers for MIS suturing instruments}
- A61B 2017/06095: {pliable}
- A61B 2090/0808: {for indicating correct assembly of components, e.g. of the surgical apparatus}
- A61B 2090/0811: {for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Various exemplary methods, systems, and devices for surgical suturing are provided. In general, a loading element can be configured to facilitate loading of a plate into a surgical instrument configured to facilitate passage of a suture through tissue. The surgical instrument can be configured to advance the suture through a tissue of a patient, to capture a free end or looped end of the suture after the suture's advancement through the tissue, and to pull the captured suture out of the patient's body with a portion of the suture remaining passed through the tissue within the patient's body.

## Claims

### Claim 1

A surgical method, comprising:
inserting a distal end of a surgical instrument into a bore formed in a proximal end of an inner housing of a loading element, the inner housing removably and replaceably seating a plate, and the surgical instrument being configured to pass a suture through tissue; and
moving at least one of the inner housing and an outer housing of the loading element relative to the other, thereby causing the plate to move from being seated in the inner housing to being seated in the distal end of the surgical instrument.

### Claim 2 (depends on 1)

The method of claim 1, wherein the surgical instrument includes an elongate shaft extending distally from a proximal handle of the surgical instrument, the elongate shaft defining a first longitudinal axis;
the bore of the inner housing defines a second longitudinal axis; and
the distal end of the surgical instrument is inserted into the bore with the first and second longitudinal axes being substantially parallel to one another.

### Claim 3 (depends on 1)

The method of claim 1, further comprising engaging the tissue with the distal end of the surgical instrument; and
actuating the surgical instrument so as to cause the surgical instrument to pass the suture through the engaged tissue, thereby causing deflection of the plate seated in the distal end of the surgical instrument.

### Claim 4

A surgical method, comprising:
seating a loading element having a plate seated therein onto a distal end of a surgical instrument by advancing the loading element in a first direction relative to the distal end of the surgical instrument, the surgical instrument being configured to pass a suture through tissue;
advancing in a second direction the loading element seated on the distal end of the surgical instrument, thereby causing the plate to move from a seated condition in the loading element to a seated condition in the distal end of the surgical instrument, the second direction being substantially perpendicular to the first direction; and
removing the loading element from the surgical instrument, the plate remaining seated in the distal end of the surgical instrument.

### Claim 5 (depends on 4)

The method of claim 4, wherein the second direction is a direction toward a handle at a proximal end of the surgical instrument.

### Claim 6 (depends on 4)

The method of claim 4, wherein the distal end of the surgical instrument includes a pair of jaws, the plate being seated in the distal end of the surgical instrument includes the plate being seated in one of the jaws, and the method further comprises:
grasping tissue with the pair of jaws, and
actuating the surgical instrument so as to cause the surgical instrument to pass the suture through the grasped tissue, thereby causing deflection of the plate seated in the surgical instrument.