Expandable needle suture apparatus and associated handle assembly with rotational suture manipulation system

A method for placing suture across a body wall of a patient, comprising the steps of:

• providing a suture device including a hollow shaft with a proximal end and a distal end, a longitudinal handle assembly connected to the proximal end of the hollow shaft, an actuating rod disposed in the hollow shaft, a needle assembly carried by the actuating rod between a deployed position and a retracted position, and a thumb actuator assembly operatively connected to a proximal end of the actuating rod, the thumb actuator assembly located on and extending from a side of the longitudinal handle assembly, near a distal end of the longitudinal handle assembly, and movable longitudinally on the side of the longitudinal handle assembly between a distal position and a proximal position and between a first lateral position and a second lateral position, and wherein the thumb actuator assembly comprises a thumb wheel that slides axially along a longitudinal axis of the longitudinal handle assembly and rotates angularly about the longitudinal axis;
• providing the needle assembly with a needle having a sharp distal tip;
• bifurcating the needle to form at least one pair of arms defining a suture slot, the arms being movable between a proximate position associated with a first slot size and a spaced position associated with a second slot size greater than the first slot size;
• penetrating the body wall with the needle assembly in the retracted position and the arms in the proximate position;
• advancing the needle assembly to the deployed position to move the arms to the spaced position associated with the second slot size;
• and
• rotating the needle assembly with the thumb wheel between the first lateral position and the second lateral position to vary the orientation of the suture slot.