US 2014/0236194 A1 · SPINAL DURAL REPAIR INSTRUMENTS AND METHODS FOR USING SAME

Abstract

Minimally invasive surgery for repairing a disruption in the spinal dura uses a pistol-grip forceps to permit the forceps to be used as a needle driver down a tubular cannula 14-20 mm in diameter and 40-120 mm long. The pistol grip permits one-handed use and provides an unobstructed view of the surgical site down the cannula. Jaws at the forceps' distal end are textured to frictionally engage the needle with sufficient force to enable the surgeon to drive the needle through tissue at the surgical site without damaging the needle. A bayoneted needle holder with a removable needle positioning tip having a unique configuration enables the surgeon to use the other hand to push a needle with an attached suture through the dura, after which the forceps are used to drive the needle and the suture through the edges of the disruption so the suture can be tied off.

Claims20

Dependent claims

A needle driving instrument for grasping a surgical needle at a surgical site accessible through a cannula extending from a proximal end to a distal end at the surgical site, the instrument comprising:

a pair of handles pivotally mounted relative to each other, wherein the handles include grips for enabling a surgeon to pivot one handle relative to the other using one hand;
a shaft portion to which the handles are mounted, wherein the handles extend laterally from a proximal portion of the shaft portion for providing a line of sight enabling the surgeon to view the surgical site when holding the grips while the shaft portion is within the cannula and the distal end is proximate to the surgical site;
and
a pair of jaws mounted at a distal end of the shaft portion for movement between an open position and a closed position, wherein facing surfaces of the jaws are forced together into the closed position for grasping the needle when one handle is pivoted relative to the other, the facing surfaces having a surface for frictionally engaging the needle with sufficient force to enable the surgeon to drive the needle through tissue at the surgical site without damaging the needle.

1 more element

A method for repairing a disruption in the spinal dura, the method comprising:

exposing a surgical site proximate to the spinal dura using a tubular retractor with a distal end proximate to the spinal dura, a proximal end, and a cannula connecting the distal and proximal ends;
providing a needle driving instrument having (i) a pair of handles pivotally mounted relative to each other, wherein the handles include grips for enabling a surgeon to pivot one handle relative to the other using one hand, (ii) a shaft portion to which the handles are mounted, wherein the handles extend laterally from a proximal portion of the shaft portion for providing a line of sight enabling the surgeon to view the surgical site when holding the grips while the shaft portion is within the cannula and the distal end is proximate to the surgical site, and (iii) a pair of jaws mounted at a distal end of the shaft portion for movement between an open position and a closed position, wherein facing surfaces of the jaws are forced together into the closed position for grasping a needle when one handle is pivoted relative to the other, the facing surfaces having a surface for frictionally engaging the needle with sufficient force to enable the surgeon to drive the needle through tissue at the surgical site without damaging the needle;
a needle pushing instrument having (i) a needle holder comprising a distal portion connected by an intermediate portion to a proximal handle portion, wherein the handle portion has an axis offset laterally from an axis of the distal portion to form a bayoneted instrument for providing a line of sight enabling the surgeon to view the surgical site while holding the handle portion with the other hand while the distal portion is within the cannula and the distal end of the holder is proximate to the surgical site, (ii) a needle positioning tip having a proximal end secured to the distal end of the needle holder, and (iii) a surgical needle removably held by the needle positioning tip;
pushing the needle shaft portion through the dura from one side of the disruption through the dura on another side of the disruption using the needle pushing instrument;
grasping the needle shaft portion on the other side of the disruption between the jaws of needle driving instrument;
manipulating the needle pushing instrument and the needle driving instrument to remove the needle from the needle positioning tip;
driving the needle and the suture through the edges of the dura using the needle driving instrument;
and
tying off the suture to bring the edges of the dura together.

6 more elements

Dependencies are inferred from the claim text.

Spinal dural repair instruments and methods for using same

Life of this patent

Spinal dural repair instruments and methods for using same

Life of this patent

Abstract

Claims20