# US 9,039,721 B2 · Instruments for delivering transfascial sutures and methods of transfascial suturing

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- Number: US 9,039,721 B2
- Document ID: US9039721B2
- Status: Granted
- Kind: B2
- Application number: 13/290,222
- Filed: 2011-11-07
- Published: 2013-05-09
- Granted: 2015-05-26
- Earliest claimed: 2011-11-07
- Assignees: C.R. Bard, Inc.
- Applicants: Donald E. Ziniti; Kevin J. Ranucci; Nathan Stewart Cauldwell; William F. Sincavage, Jr.; Roger E. Darois
- Inventors: Donald E. Ziniti; Kevin J. Ranucci; Nathan Stewart Cauldwell; William F. Sincavage, Jr.; Roger E. Darois
- Web page: https://patentgrep.com/patent/US9039721B2

## CPC

- A61B 17/0485: {Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet}
- A61B 17/0482: {Needle or suture guides (guides for drills, pins or wire A61B17/17; guides for puncturing needles A61B17/3403)}
- A61B 2017/0472: {Multiple-needled, e.g. double-needled, instruments}
- A61B 2017/2913: {cams or guiding means}
- A61B 2017/2923: {Toothed members, e.g. rack and pinion}
- A61B 2017/2925: {Pistol grips}
- A61B 2090/034: {abutting on parts of the device itself}
- A61B 2090/0801: {Prevention of accidental cutting or pricking}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

An instrument for delivering a suture transfascially may include a handle, a shaft extending from the handle, and at least one needle that is moveable to an extended position beyond the end of the shaft. A suture may be delivered transfascially with the instrument. The instrument may include a suture catch associated with each needle for retaining and releasing a suture segment. A shield may be provided to shield the sharp end of each needle when it is moved to the extended position. A method of delivering a transfascial suture may include inserting an instrument into an abdominal cavity and deploying, from within the abdominal cavity, each needle through a soft tissue repair patch and then through at least part of the abdominal wall. A suture or suture segment may be advanced across the fascia with the at least one needle.

## Claims

### Claim 1

An instrument for delivering a transfascial suture, the instrument comprising:
a handle;
an elongated shaft extending from the handle and including a distal end;
a single needle supported within the shaft, the needle being moveable to at least one extended position beyond the distal end of the shaft, the needle having a sharp end adapted to pierce a soft tissue repair prosthetic and abdominal wall tissue;
a suture catch movable to an extended position beyond the distal end of the shaft, the suture catch adapted to retain and release a suture segment;
a needle drive mechanism adapted to advance the needle to an extended position upon actuation of a needle actuator; and
a catch drive mechanism adapted to advance the suture catch to the extended position upon actuation of a catch actuator and to retract the suture catch upon release of the catch actuator.

### Claim 2 (depends on 1)

The instrument according to claim 1, wherein the suture catch is associated with the needle.

### Claim 3 (depends on 1)

The instrument according to claim 1, wherein the needle is hollow and the suture catch is movably supported within the needle.

### Claim 4 (depends on 3)

The instrument according to claim 3, wherein the suture catch is extendable from and retractable into the needle.

### Claim 5 (depends on 1)

The instrument according to claim 1, wherein the suture catch is collapsible to retain the suture segment and expandable to release the suture segment.

### Claim 6 (depends on 5)

The instrument according to claim 5, wherein the suture catch is adapted to collapse when retracted into the needle and to expand when extended from the needle.

### Claim 7 (depends on 6)

The instrument according to claim 6, wherein the suture catch includes a resilient frame that expands when extended from the needle.

### Claim 8 (depends on 1)

The instrument according to claim 1, wherein the at least one needle is movable a full stroke to a fully extended position, the drive mechanism including a needle drive mechanism adapted to move the at least one needle to the fully extended position in two or more partial strokes.

### Claim 9

An instrument for delivering a transfascial suture, the instrument comprising:
a handle;
an elongated shaft extending from the handle and including a distal end;
first and second needles moveable to at least one extended position beyond the distal end of the shaft, each needle being hollow and having a sharp end adapted to pierce a soft tissue repair prosthetic and abdominal wall tissue;
first and second suture catches movably supported within the first and second needles, each of the first and second suture catches extendable from and retractable into a corresponding one of the first and second needles, each suture catch adapted to retain and release a suture segment; and
a drive mechanism adapted to advance the first and second needles and/or the first and second suture catches to an extended position.

### Claim 10 (depends on 9)

The instrument according to claim 9, wherein each of the first and second needles is movable a full stroke to a fully extended position, the drive mechanism including a needle drive mechanism adapted to move each of the first and second needles to the fully extended position in two or more partial strokes.

### Claim 11 (depends on 9)

The instrument according to claim 9, wherein first and second segments of a suture are loadable into the first and second suture catches to be carried by the first and second needles as the needles move to one or more extended positions.

### Claim 12 (depends on 9)

The instrument according to claim 9, wherein the first and second needles are arranged to move along a diverging path.

### Claim 13

An instrument for delivering a transfascial suture, the instrument comprising:
a handle;
an elongated shaft extending from the handle and including a distal end;
at least one needle moveable to at least one extended position beyond the distal end of the shaft, the at least one needle having a sharp end adapted to pierce a soft tissue repair prosthetic and abdominal wall tissue, the at least one needle adapted to carry a suture segment through the abdominal wall tissue;
at least one suture catch located on an externally accessible portion of the at least one needle proximal to the sharp end, the at least one suture catch adapted to be opened and closed, the suture catch to receive and release the suture segment when opened, the suture catch to retain the suture segment when closed; and
a drive mechanism adapted to advance the at least one needle to an extended position.

### Claim 14 (depends on 13)

The instrument according to claim 13, further comprising an outer sleeve that is movable relative to the shaft and the at least one needle to open and close the at least one suture catch.

### Claim 15 (depends on 14)

The instrument according to claim 14, wherein the outer sleeve has an opening in a sidewall thereof that is positionable relative to the at least one suture catch to open and close the suture catch.

### Claim 16

An instrument for delivering a transfascial suture, the instrument comprising:
a handle;
an elongated shaft extending from the handle and including a distal end;
first and second suture guides moveable to at least one extended position beyond the distal end of the shaft, each of the first and second suture guides adapted to guide a suture therealong, each of the first and second suture guides having a sharp distal end adapted to pierce a soft tissue repair prosthetic and abdominal wall tissue;
a suture guide support coupling proximal ends of the first and second suture guides together, the suture guide support including a continuous suture guide channel adapted to guide the suture from the proximal end of the first suture guide to the proximal end of the second suture guide; and
a drive mechanism adapted to advance the first and second suture guides to the at least one extended position.

### Claim 17 (depends on 16)

The instrument according to claim 16, wherein the suture guide channel extends from the proximal end of the first suture guide to the proximal end of the second suture guide.

### Claim 18 (depends on 17)

The instrument according to claim 17, wherein the suture guide channel extends along a rounded path.

### Claim 19 (depends on 16)

The instrument according to claim 16, wherein each of the first and second suture guides is hollow and adapted to guide the suture therethrough.

### Claim 20 (depends on 16)

The instrument according to claim 16, wherein the first and second suture guides diverge away from each other in a distal direction.

### Claim 21

An instrument for delivering a transfascial suture, the instrument comprising:
a handle;
an elongated shaft extending from the handle and including a distal end;
first and second suture guides moveable to at least one extended position beyond the distal end of the shaft, each of the first and second suture guides being hollow and adapted to guide a suture therealong, each of the first and second suture guides having a sharp distal end adapted to pierce a soft tissue repair prosthetic and abdominal wall tissue;
a suture guide support including a continuous channel adapted to guide the suture from the first suture guide to the second suture guide; and
a drive mechanism adapted to advance the first and second suture guides to the at least one extended position;
each of the first and second suture guides including an elongated slot that extends from the sharp distal end thereof to the suture guide support and that is adapted to release the suture therefrom.

### Claim 22 (depends on 21)

The instrument according to claim 21, wherein the slot in the first suture guide faces the slot in the second suture guide.

### Claim 23

An instrument for delivering a transfascial suture, the instrument comprising:
a handle;
an elongated shaft extending from the handle and including a distal end;
at least one needle moveable to a plurality of discrete extended positions beyond the distal end of the shaft that differ from each other, the at least one needle having a sharp end adapted to pierce a soft tissue repair prosthetic and abdominal wall tissue;
at least one suture catch associated with the at least one needle that is adapted to catch and release a suture segment; and
a needle drive mechanism adapted to advance the at least one needle to the plurality of discrete extended positions in response to multiple actuations of the needle drive mechanism.

### Claim 24 (depends on 23)

The instrument according to claim 23, wherein the at least one suture catch is movable to an extended position beyond the distal end of the shaft.

### Claim 25 (depends on 24)

The instrument according to claim 24, wherein the at least one needle is hollow and the at least one suture catch is movably supported within the at least one needle.

### Claim 26 (depends on 25)

The instrument according to claim 25, wherein the at least one suture catch is extendable from and retractable into the at least one needle.

### Claim 27 (depends on 24)

The instrument according to claim 24, wherein the at least one suture catch is collapsible to retain the suture segment and expandable to release the suture segment.

### Claim 28 (depends on 27)

The instrument according to claim 27, wherein the at least one suture catch is adapted to collapse when retracted into the at least one needle and to expand when extended from the at least one needle.

### Claim 29 (depends on 28)

The instrument according to claim 28, wherein the at least one suture catch includes a resilient frame that expands when extended from the at least one needle.

### Claim 30 (depends on 24)

The instrument according to claim 24, further comprising a catch drive mechanism adapted to extend and retract the at least one suture catch.

### Claim 31 (depends on 23)

The instrument according to claim 23, wherein the at least one needle includes first and second needles and the at least one suture catch includes first and second suture catches.

### Claim 32 (depends on 31)

The instrument according to claim 31, wherein the first and second needles are arranged to move along a diverging path.

### Claim 33 (depends on 23)

The instrument according to claim 23, wherein the at least one needle is adapted to carry the suture segment through the abdominal wall.

### Claim 34 (depends on 33)

The instrument according to claim 33, wherein the at least one suture catch is located on an externally accessible portion of the needle proximal to the sharp end.

### Claim 35 (depends on 34)

The instrument according to claim 34, wherein the suture catch is adapted to be opened to receive and/or release the suture segment and closed to retain the suture segment.

### Claim 36 (depends on 35)

The instrument according to claim 35, further comprising an outer sleeve that is movable relative to the shaft and the needle to open and close the suture catch.

### Claim 37 (depends on 36)

The instrument according to claim 36, wherein the outer sleeve has an opening in a sidewall thereof that is positionable relative to the suture catch to open and close the suture catch.