US 5,425,737 A · Surgical purse string suturing instrument and method

Abstract

A purse string suturing instrument is provided for quickly and effectively forming a purse string suture in tubular tissue through relatively small cannulas placed in the body. The instrument includes a pair of elongated jaws, each having a row of spaced-apart uniform-size teeth. The jaws are hinged together at one end to clamp the tubular tissue therebetween. The two rows of teeth are offset with respect to each other so that they mesh when the jaws are closed. A single operating mechanism is provided to articulate the pair of jaws with respect to a longitudinal axis of the suturing instrument and actuate the jaws between an open position and a clamping position. The jaws are inserted through a cannula and positioned to close around the tissue to be sutured. The rows of teeth bend the tissue therebetween into a wavelike configuration. A pair of needles, the ends of each being connected to a single length of suture, is then inserted through passageways provided through the teeth. An encircling series of stitches are thus formed in the wall of the tubular tissue to create a purse string suture. The needles and the suturing instrument are then withdrawn through the cannula. The tubular tissue can be snugly fitted over an anastomosis ring or the like by drawing and tying the purse string suture.

Claims23

Dependent claims

A method of placing a purse string suture in a section of tubular tissue inside a body cavity of a patient without fully opening the patient, said method comprising the steps of:

inserting a cannula into the body cavity;
inserting, through the cannula, an instrument comprising a pair of relatively movable jaws hinged together at one end for pivotal movement about a first axis, each jaw having a row of spaced-apart, uniform-size teeth, each tooth having a base and a crest, the two rows being opposed and offset with respect to each other so that the rows of teeth mesh when the jaws are closed, the crest of each tooth having a channel therein running parallel to the direction of the row, all of the channels in each row being aligned so as to define at their bases a substantially straight needle passageway through all of the teeth in the rows, the pair of jaws being closed;
actuating an operating mechanism to first articulate the pair of jaws about a second pivot axis transverse to the first pivot axis and then actuate the first and second jaws to pivot about the first axis to an open position;
positioning the first and second jaws adjacent and transverse to the section of tubular tissue;
actuating the operating mechanism to pivot the first and second jaws to pivot about the first axis to clamp around the tissue and bend the clamped tissue into a wavelike configuration with a two-wall thickness of the tissue overlying the crest of each tooth, the tissue being forced deep enough into the spaces between the teeth that a first wall thickness of tissue, but not the second wall thickness thereof, protrudes into the needle passageway;
sliding a suturing cartridge having two needles attached to opposite ends of a length of bioabsorbable thread and loaded into a needle cartridge through a pathway in one of the jaws;
forcing the two needles completely through the needle passageways and the tissue, one needle for each passageway, thereby creating an encircling series of stitches in the wall of the tubular tissue;
and
detaching the needles from the thread and removing the needles from the body, thereby leaving a purse string suture in the tubular tissue, ready to be drawn snug and tied.

6 more elements

A surgical suturing instrument for placing a purse string suture in a tubular tissue, said instrument comprising:

a pair of relatively movable jaws for clamping the tubular tissue therebetween, a first jaw of said pair of jaws being pivotable with respect to a second jaw about a first pivot axis defined in said pair of jaws, each jaw having a row of spaced-part, uniform-size teeth;
actuating means, operably connected to said pair of jaws, for actuating said pair of jaws between an open position for receiving the tubular tissue and a clamping position where the row of teeth of said first jaw meshes with the row of teeth of said second jaw, wherein the clamping position is achieved by pivoting said pair of jaws about a second axis defined in one of said jaws and parallel to the first axis, wherein said actuating means includes a lost motion linkage having a lever pivotally connected to one of said jaws about the second pivot axis parallel to said first pivot axis, a link pivotally connected to said lever and a driving rod pivotally connected to said link, wherein said operating means slides said driving rod to actuate said pair of jaws about the first pivot axis and one of said jaws about the second pivot axis;
a camming rod slidably disposed between said pair of jaws and said actuating means to operate on at least one of said jaws and pivot said pair of laws about a third pivot axis transverse to the first pivot axis;
and
operating means, connected to said actuating means and said camming rod, for sliding said camming rod to articulate said pair of jaws about the third pivot axis and sliding said actuating means to actuate said pair of laws about the first pivot axis and one of said jaws about the second pivot axis.

2 more elements

A surgical suturing instrument for placing a purse string suture in a tubular tissue, said instrument comprising:

a pair of relatively movable jaws for clamping the tubular tissue therebetween, a first jaw of said pair of jaws being pivotable with respect to a second jaw about a first pivot axis, each jaw having a row of spaced-apart, uniform-size teeth;
actuating means, operably connected to said pair of jaws, for actuating said pair of jaws between an open position for receiving the tubular tissue and a clamping position where the row of teeth of said first jaw meshes with the row of teeth of said second jaw;
a camming rod slidably disposed between said pair of jaws and said actuating means to operate on at least one of said jaws and pivot said pair of jaws about a second pivot axis transverse to the first pivot axis;
and
operating means, connected to said actuating means and said camming rod, for sliding said camming rod to articulate said pair of jaws about the second pivot axis and sliding said actuating means to actuate said pair of jaws about the first pivot axis, wherein
said operating means includes a rotatable knob and motion imparting means for imparting rotational movement of said knob into linear movement of said camming rod and said driving rod.

3 more elements

A surgical suturing instrument for placing a purse string suture in a tubular tissue, said instrument comprising:

a pair of relatively movable jaws for clamping the tubular tissue therebetween, a first jaw of said pair of jaws being pivotable with respect to a second law about a first pivot axis defined in said pair of jaws, each jaw having a row of spaced-apart, uniform-size teeth;
an actuating mechanism operably connected to said pair of jaws, actuating said pair of jaws between an open position for receiving the tubular tissue and a clamping position where the row of teeth of said first jaw meshes with the row of teeth of said second jaw, said actuating mechanism including a lost motion linkage having a lever pivotally connected to one of said jaws about a second pivot axis defined in one of said jaws and parallel to said first pivot axis, a link pivotally connected to said lever and a driving rod pivotally connected to said link;
a camming rod slidably disposed between said pair of jaws and said actuating mechanism to engage one of said jaws and pivot said pair of jaws about a third pivot axis transverse to the first pivot axis pin;
and
an operating mechanism operably connected to said actuating mechanism and said camming rod, said operating mechanism being actuated to slide said camming rod and articulate said pair of jaws about the third pivot axis transverse to the first pivot axis and to actuate said actuating mechanism to open and close said pair of jaws about the first pivot axis and to pivot one of said jaws about the second pivot axis to the clamping position, wherein
said operating mechanism includes a rotatable knob and an axially slidable actuating sleeve connected to said rotatable knob by mutually engagable threads.

3 more elements

Dependencies are inferred from the claim text.

Surgical purse string suturing instrument and method

Life of this patent

Surgical purse string suturing instrument and method

Life of this patent

Abstract

Claims23