US 6,183,485 B2 · Insertable suture passing grasping probe and methodology for using same

Abstract

A surgical instrument, guide, and method capable of being used for closure of peritoneum fascia, occlusion of bleeding vessels such as inferior epigastric, and for all uses related to accurately passing suture material through a guide into tissue. A tip of a surgical instrument in a standard suture-/needle-driving position with a sharp tip that opens and closes with the surgeon grasping suture material with the sharp tip is provided. Insertion of the tip/suture through tissue until the tip is seen through the peritoneum by direct vision begins the wound-closing procedure. The suture is released by opening and withdrawing the tip from the guide. The suture is recovered by using the guide to redirect the tip and puncturing the tissue opposite the first point of insertion. The tip grasps the suture and pulls the suture through the guide. The suture is pulled outside the wound, providing for rapid closure of the surgical incision. The guide is insertable within the wound to be closed and guides the surgical instrument at a predetermined angle from the longitudinal axis of the guide for optimum wound closure. Alternative embodiments of the guide include providing a slot through which non-linear surgical instruments may pass through an open or enclosed passageway.

Claims18

Dependent claims

A device for accurately guiding and positioning a surgical instrument bearing suture material to a predetermined area within the body for closing an open wound, comprising:

a guide means having a longitudinal axis and distal and proximal ends, and further having a first wing including a depth-limiting extending lip near said proximal end of said guide means being generally perpendicular to said longitudinal axis and a gripping area radially-disposed surface being generally parallel to said longitudinal axis, wherein said distal end is for insertion into the wound to a depth limited and determined by said extending lip;
and
said guide means defining first and second generally linear passageways therethrough at first and second diverging angles less than 90° from said longitudinal axis, said first and second passageways terminating below said lip, said second passageway positioned oppositely adjacent said first passageway, said first and second passageways sharing a common entrance;
whereby
said distal end of said guide is positionable within said wound with said lip portion above the wound to be closed, said guide positioning the surgical instrument carrying suture material for passing through said first and second passageways at said angles to the predetermined area within the body to assist in closing the open wound and the suture material can be left at a predetermined point within the body and the surgical tool may be inserted into and through said second passageway through said common entrance to retrieve the suture material from the area within the body.

2 more elements

A method of suturing an open wound comprising the steps of:

(a) providing a guide, comprising:
a longitudinal axis and distal and proximal ends, and further having a first wing including a depth-limiting extending lip near said proximal end of said guide means being generally perpendicular to said longitudinal axis and a gripping area radially-disposed surface being generally parallel to said longitudinal axis, wherein said distal end is for insertion into a wound to a depth limited and determined by said extending lip, said guide means defining therein a first generally linear passageway therethrough at a first diverging angle less than 90° from said longitudinal axis, and providing for at least one exit hole below said lip, wherein said distal end of said guide is tapered and positionable within said wound with the lip portion above the wound to be closed, said guide positioning the surgical instrument carrying suture material for passing through said passageway at said angle to the predetermined area within the body to assist in closing the open wound;
(b) grasping and inserting a tip means for passing suture material through said first passageway in said guide until reaching tissue and until said tip means is seen through the peritoneum by way of a surgical camera;
(c) releasing said suture material, withdrawing said tip means from said guide, and leaving the suture material in place;
(d) inserting said tip means in a second passageway defined within said guide and appositely adjacent said first passageway, said second passageway directing said tip means to a point where the suture material may first leave the body to provide wound closure, said second passageway through said guide means forming a second angle less than 90° from said longitudinal axis, and positioned appositely adjacent said first passageway, said first and second passageways sharing a common entrance, and further having a second exit hole below said lip, wherein the suture material can be left at the predetermined point within the body and the surgical tool may be inserted into and through said second passageway through said common entrance to retrieve the suture material from the area within the body;
(e) grasping said suture material with said tip means;
(f) retrieving said suture material with said tip means through said guide outside the wound;
and
(g) removing said guide means from the wound and tying ends of said suture material together to provide closure of the wound.

6 more elements