Suture for use in endoscopic surgery

#The present invention relates to sutures for use in laparoscopic/pelviscopic surgery, and more particularly to the provision of sutures which are more easily tied and secured in a body cavity using graspers extending through trocars in the body wall.

#The present invention relates to suture tying or suture fastening in laparoscopic/pelviscopic surgery which is a rapidly growing field of surgery in this and other countries. Typically, a patient is anesthetized and placed on a surgery table for surgery. An initial very small opening, perhaps 12 mm in diameter, is made in the body wall for insertion of a scope or optic probe which will facilitate viewing inside the body cavity. In the case of the abdominal cavity, for instance, the cavity may be expanded by an insufflation process using carbon dioxide under pressure. This type of surgery is beginning to be well known as Minimally Invasive Surgery (MIS) or Less Invasive Surgery (LIS).

#One of the well known problems with MIS or LIS is that the use of sutures is a very difficult task for many surgeons. The surgeon has to be able to tie a suture inside the body cavity using graspers which extend through trocars in the body wall. The surgeon has to do this tying while viewing the suture and the body tissue with which the suture is used on a television camera picking up the image through the scope or optic probe.

#FIG. 1 is a view of a suture showing gripping means formed on the opposite ends of the length of suture;

#FIG. 2 is a suture showing a needle attached one end of the suture length and a gripping means attached to the opposite end of the suture length;

#FIG. 3 is a fragmentary view showing an elongated gripping means attached to one end of a suture;

#Turning first to FIG. 1, it will be seen that a suture 10 is shown comprising a length 12 of suture material, the length 12 having opposite end portions 14, 16. Gripping means 18, 20 may be attached to each end portion 14, 16, respectively, to facilitate the gripping of the suture 10 ends by the typical jaw-like graspers conventionally used in MIS or LIS surgery. The illustrative gripping means 18, 20 may be formed in a variety of shapes and from a variety of materials to facilitate the gripping of the suture end portions 14, 16 by a conventional grasper. The illustrative gripping means 18, 20 may be, for example, formed from a wax-like or deformable material which may, for some surgery applications, be dissolvable or absorbable into the body if left in the body cavity. This type of material may even be impregnated with a medicant such as an antibiotic agent.

#The gripping means 18, 20 shapes illustrated in FIG. 1 are somewhat elongated elliptical shapes, elongated in the direction of the length 12. Preferably, these gripping means 18, 20 will be of a cross sectional size such that they may be dropped into the body cavity through a 5 mm cannula extending into the body cavity through a trocar. It will be appreciated that, in a MIS procedure, access may be obtained to an abdominal body cavity through cannula extending through the body wall and having internal diameters ranging from, for instance, 5 mm up to about 12 mm. It is believed that an effective gripping means 18, 20 may be elongated even beyond that shown in FIG. 1 such that each gripping means is, perhaps, three to five times or even longer than its cross sectional dimension. Since the suture 10 will be used in MIS, and the gripping means 18, 20 will be viewed on a television screen or through a scope, the gripping means may preferably be fabricated from a material which will provide significant color contrast to the body tissues being observed so that they will be easily seen and used.

#The object of the suture 10 shown in FIG. 1 is to provide the gripping means 18, 20 which can be easily seen and easily gripped and controlled and manipulated by the conventional graspers used in MIS surgery. The suture 10 may be used, for example, as a ligation suture to tie off a conduit such as the cystic duct in a gallbladder MIS procedure, referred to as a laparoscopic cholecystectomy. Most surgeons should be able to use conventional graspers and the gripping means 18, 20 to tie the suture 10 (tie a knot) after it is wrapped around a body conduit and to save the rather expensive cost of a clip applicator gun. The illustrated elliptical shape gripping means 18, 20 in FIGS. 1 and 2 is merely illustrative, and the shape may be varied to fit the applications. For instance, simple elongated cylinders or rectangular blocks may be used. Further, the nature of the suture is immaterial to the present invention. The gripping means of the present invention may be used with any type or size suture material. The length, diameter and characteristics will be selected by the surgeon.