# US 9,750,495 B2 · Methods and devices for tissue suturing > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 9,750,495 B2 - Document ID: US9750495B2 - Status: Granted - Kind: B2 - Application number: 14/811,964 - Filed: 2015-07-29 - Published: 2016-03-31 - Granted: 2017-09-05 - Earliest claimed: 2014-09-30 - Assignees: Covidien LP - Applicants: Covidien LP - Inventors: Eric Kramer; Adam Carahalios; John Hammerland, III; Todd Scott - Web page: https://patentgrep.com/patent/US9750495B2 ## CPC - A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery} - A61B 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)} - A61B 17/0482: {Needle or suture guides (guides for drills, pins or wire A61B17/17; guides for puncturing needles A61B17/3403)} - A61B 17/11: for performing anastomosis; Buttons for anastomosis - A61B 2017/0409: {Instruments for applying suture anchors} - A61B 2017/0414: {having a suture-receiving opening, e.g. lateral opening} - A61B 2017/0459: {Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied} - A61B 2017/0464: {for soft tissue} - A61B 2017/1107: {for blood vessels} - A61B 2017/1135: {End-to-side connections, e.g. T- or Y-connections} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A suturing device is disclosed. The suturing device includes an end effector assembly disposed on a distal end of the suturing device. The end effector assembly includes at least one guide tube housing at least one elongated member, a clamshell, and a probe configured for disposal in a graft tubular tissue circumferentially offset from the clamshell. The probe includes at least one guide tube attached to a suture having a first end and a second end. The at least one elongated member is deployed to puncture graft tubular tissue and mate with the at least one aperture of the probe such that extraction of the at least one elongated member simultaneously draws out the suture through the punctured graft tubular tissue. ## Claims ### Claim 1 A suturing device for tubular tissue, comprising: a handle assembly, the handle assembly including a trigger assembly; an elongated shaft extending from the handle assembly; and an end effector assembly disposed on a distal end of the elongated shaft, the end effector assembly including: at least one first guide tube extending distally from the elongated shaft, the at least one first guide tube housing at least one elongated member; a mating plate extending distally from the elongated shaft; a hinge assembly including a hinge, the hinge assembly pivotably supported on the mating plate; a clamshell having at least one aperture configured for locating the at least one first guide tube, the clamshell including: a first clamshell portion operatively coupled to the hinge; and a second clamshell portion operatively coupled to the hinge, wherein the first and second clamshell portions are actuatable between a first configuration and a second configuration; and a probe configured for disposal in a graft tubular tissue circumferentially offset from the clamshell, the probe having: at least one aperture housing a second guide tube, the second guide tube attached to a suture having a first end and a second end; and a slot configured to locate the mating plate, wherein a first actuation of the trigger assembly approximates the first and second clamshell portions around the graft tubular tissue with the probe disposed therein such that the mating plate extending from the elongated shaft is inserted into the slot defined in the probe and a second actuation of the trigger assembly deploys the at least one elongated member to puncture the graft tubular tissue and mate with the at least one aperture of the probe such that extraction of the at least one elongated member simultaneously draws out the first end of the suture through the punctured graft tubular tissue. ### Claim 2 (depends on 1) The suturing device according to claim 1, wherein the end effector assembly further includes a guide plate having a plurality of apertures configured for guiding the at least one first guide tube. ### Claim 3 (depends on 1) The suturing device according to claim 1, wherein inserting the mating plate into the slot results in radial alignment between the at least one aperture of the clamshell and the at least one aperture of the probe. ### Claim 4 (depends on 1) The suturing device according to claim 1, wherein the probe includes an atraumatic tip. ### Claim 5 (depends on 1) The suturing device according to claim 1, wherein the at least one elongated member is a flexible needle configured for puncturing tissue. ### Claim 6 (depends on 1) The suturing device according to claim 1, wherein mating the at least one elongated member with the at least one aperture of the probe results in a press fit between the at least one elongated member and the at least one second guide tube of the probe. ### Claim 7 (depends on 1) The suturing device according to claim 1, further including an anchor configured for disposal in tubular tissue to extract the first end of the suture therefrom. ### Claim 8 A method of suturing tubular tissue, the method comprising: providing a suturing device for tubular tissue, the suturing device including: a handle assembly: an elongated shaft extending from the handle assembly; an end effector assembly disposed on a distal end of the elongated shaft, the end effector assembly having: at least one first guide tube extending distally from the elongated shaft, the at least one first guide tube housing at least one elongated member; a mating plate extending distally from the elongated shaft; a hinge assembly having a hinge, the hinge assembly pivotably supported on the mating plate; a clamshell having at least one aperture configured for locating the at least one first guide tube, the clamshell including: a first clamshell portion operatively coupled to the hinge; and a second clamshell portion operatively coupled to the hinge, wherein the first and second clamshell portions are actuatable between a first configuration and a second configuration; and a probe configured for disposal in a graft tubular tissue circumferentially offset from the clamshell, the probe having: at least one aperture including a second guide tube, the second guide tube attached to a suture having a first end and a second end; and a slot configured to locate the mating plate; disposing the probe into the graft tubular tissue; approximating the first and second clamshell portions such that the graft tubular tissue is captured between the clamshell and the probe; puncturing the graft tubular tissue with the at least one elongated member; mating the at least one elongated member with the at least on aperture of the probe; extracting the at least one elongated member; and extracting the suture through the punctured graft tubular tissue. ### Claim 9 (depends on 8) The method according to claim 8, wherein providing a suturing device includes a trigger assembly coupled to the handle assembly and actuating the trigger assembly approximates the first and second clamshell portions around graft tubular tissue. ### Claim 10 (depends on 8) The method according to claim 8, further comprising: inserting the mating plate into the slot such that the at least one aperture of the clamshell is in radial alignment with the at least one aperture of the probe. ### Claim 11 (depends on 8) The method according to claim 8, further comprising: extending the at least one guide tube; and seating the at least one guide tube into the at least one second aperture of the clamshell. ### Claim 12 (depends on 8) The method according to claim 8, further comprising: translating the at least one elongated member through and along the at least one guide tube. ### Claim 13 (depends on 8) The method according to claim 8, further comprising: frictionally engaging the at least one elongated member with the second guide tube. ### Claim 14 (depends on 8) The method according to claim 8, further comprising: tying the suture such that the tubular tissue and the graft tubular tissue are connected at a junction. ### Claim 15 An end effector for suturing tissue comprising: an elongated shaft; and an assembly attachable to an end of the elongated shaft, assembly including: at least one first guide tube extending distally from the elongated shaft, the at least one first guide tube housing at least one elongated member; a mating plate extending distally from the elongated shaft; a hinge assembly having a hinge pivotably supported on the mating plate; a clamshell having at least one aperture configured for locating the at least one first guide tube, the clamshell having: a first clamshell portion operatively coupled to the hinge; and a second clamshell portion operatively coupled to the hinge, wherein the first and second clamshell portions are transitionable between a first configuration and a second configuration; and a probe configured for disposal in a graft tubular tissue, the probe having: at least one aperture housing a second guide tube, the second guide tube attached to a suture having a first end and a second end; and a slot configured to locate the mating plate, wherein the mating plate is extendable from the elongated shaft into the slot defined in the probe and the at least one elongated member is deployable to puncture the graft tubular tissue and mate with the at least one aperture of the probe such that extraction of the at least one elongated member simultaneously draws out the first end of the suture through the punctured graft tubular tissue. ### Claim 16 (depends on 15) The end effector according to claim 15, wherein the probe is configured for disposal in the graft tubular tissue circumferentially offset from the clamshell. ### Claim 17 (depends on 15) The end effector according to claim 15, wherein the first and second clamshell portions are adapted to be approximated around the graft tubular tissue. ### Claim 18 (depends on 15) The end effector according to claim 15, wherein the assembly further includes a guide plate having a plurality of apertures configured for guiding the at least one first guide tube. ### Claim 19 (depends on 15) The end effector according to claim 15, wherein inserting the mating plate into the slot results in radial alignment between the at least one aperture of the clamshell and the at least one aperture of the probe. ### Claim 20 (depends on 15) The end effector according to claim 15, wherein the probe includes an atraumatic tip. ### Claim 21 (depends on 15) The end effector according to claim 15, wherein the at least one elongated member is a flexible needle configured for puncturing tissue. ### Claim 22 (depends on 15) The end effector according to claim 15, wherein mating the at least one elongated member with the at least one aperture of the probe results in a press fit between the at least one elongated member and the at least one second guide tube of the probe. ### Claim 23 (depends on 15) The end effector according to claim 15, further including an anchor configured for disposal in tubular tissue to extract the first end of the suture therefrom.