Apparatus and method for fascial closure device for laparoscopic trocar port site and surgery

A method of placing a suture and closing a tissue defect created by an endoscopic trocar port having an outer diameter, the method comprising

• inserting a suture placement device into a trocar port, the suture placement device comprising
• a cannular housing comprising a proximal portion, a distal portion and a longitudinal axis,
• an extension mechanism comprising a first receptor port, a second receptor port, and a distal suture passage extending from the first receptor port to the second receptor port,
• a first stylet guide comprising a first suture path segment between a proximal end and a distal end of the first stylet guide, and
• a second stylet guide comprising a second suture path segment between a proximal end and a distal end of the second stylet guide;
• moving the extension mechanism from a folded position to an extended position;
• removing the trocar port;
• deploying the first stylet guide from a retracted orientation to a deployed orientation where the distal end of the first stylet guide is extended to the first receptor port;
• deploying the second stylet guide from a retracted orientation to a deployed orientation where the distal end of the second stylet guide is extended to the second receptor port;
• creating a suture path through the first stylet guide suture path segment, the distal suture path segment, and the second stylet guide suture path segment;
• routing a suture through the suture path segments;
• removing the suture placement device while keeping the suture in place around the periphery of the tissue defect site;
• and
• tying the suture.

A method of placing a suture and closing a tissue defect created by an endoscopic trocar port, the method comprising

• placing a the distal end of a guide wire through a trocar;
• removing the trocar;
• providing a suture placement device comprising
• a cannular housing comprising a proximal portion, a distal portion and a longitudinal axis,
• an extension mechanism comprising a first receptor port, a second receptor port, and a distal suture passage extending from the first receptor port to the second receptor port,
• a first stylet guide comprising a first suture path segment between a proximal end and a distal end of the first stylet guide, and
• a second stylet guide comprising a second suture path segment between a proximal end and a distal end of the second stylet guide;
• threading the proximal end of the guide wire through the distal end of the first stylet guide;
• grasping the proximal end portion of the guide wire after it emerges from the proximal end of the first stylet guide;
• guiding the suture placement device along the guide wire into the port site;
• pulling the proximal end of the guide wire until the distal end of the guide wire is drawn past the distal end of the first stylet guide;
• moving the extension mechanism from a folded position to an extended position;
• removing the trocar port;
• deploying the first stylet guide from a retracted orientation to a deployed orientation where the distal end of the first stylet guide is extended to the first receptor port;
• deploying the second stylet guide from a retracted orientation to a deployed orientation where the distal end of the second stylet guide is extended to the second receptor port;
• creating a suture path through the first stylet guide suture path segment, the distal suture path segment, and the second stylet guide suture path segment;
• routing a suture through the suture path segments;
• removing the suture placement device while keeping the suture in place around the periphery of the tissue defect site;
• and
• tying the suture.