GB2437368A

GB2437368A - Suturing device having hollow pincer-style needle

Info

Publication number: GB2437368A
Application number: GB0607888A
Authority: GB
Inventors: Khaled Afifi Arafa
Original assignee: Individual
Current assignee: Individual
Priority date: 2006-04-21
Filing date: 2006-04-21
Publication date: 2007-10-24
Anticipated expiration: 2026-04-21
Also published as: GB2437368B; GB0607888D0

Abstract

A suturing device has an elongate shaft 1 with a needle 4 mounted at its distal end. The needle comprises two hollow arms 6, 9 having open ends. The arms pivot between a closed position in which one extends inside the other and an open position in which the ends are separated. The needle is operated by a handle 14 mounted at the proximal end of the shaft, which may include a disposable distal end portion 2. A latch 16 may secure the handles in the closed position. In use, closure of the needles pierces tissue and forms a channel through which suture thread 13 is passed to form a stitch. A resilient retainer (17, figure 4) may prevent the thread from passing back through the needle.

Description

1 2437368

SURGICAL DEVICE

This invention relates to a surgical device for threading surgical thread through soft tissue. The invention has particular, but not exclusive application, for inserting and retrieving surgical thread where there is a poor view and difficult access, for example when operating through an opening in the body such as the vagina.

During vaginal surgery ii is sometimes necessary to thread suture material through soft tissue. Insertion and retrieval of the suture material can be difficult due to limited access to and a poor view of the tissue being stitched. It is also possible that the thread can be placed too deep within the tissue.

According to a first aspect of the invention there is provided a surgical device comprising a shaft having at one end a needle for piercing tissue, the needle comprising two hollow arms arranged to be remotely operated for relative movement between a closed position and an open position wherein, in the closed position, an open end of a first one of the hollow arms extends into an open end of the other, second hollow arm and, in the open position, these ends of the hollow arms are spaced apart.

In this way, the arms of the needle can be operated in a pincer like fashion to pierce tissue when moved to the closed position and, in the closed position, provide a passageway for surgical thread, facilitating the insertion of thread into the tissue. Furthermore, the arms for the needle can be arranged to enable the surgeon to pierce the tissue at an adequate depth while preventing the thread being placed too deep within the tissue as the depth of the piercing by the arms is dictated by the path the arms take during movement of the needle to the closed position.

The device may be arranged such that, in use, thread is passed through the needle in the closed position from the first arm having an end that extends into the second arm to that second arm. In this way, insertion of the thread through the passageway formed by the arms in the closed position is not impeded by the lip of the end of the second arm. The end of the first arm may have a diameter smaller than the diameter of an end of that second arm. This ensures a smooth transition of the arms to the closed position.

In one arrangement, one of the hollow arms of the needle may be (immovably) fixed to the shaft and the other hollow arm attached to the shaft for movement relative to the fixed hollow arm. This may simplify the mechanics for remotely operating the needle, as only one of the arms needs to be actuated. Preferably, the second arm is fixed and the first arm is movable to open and close the needle.

In the closed position, the two arms may form a continuous arc, preferably forming 2/3 or more of a circle. In this way, the needle can be rotated during the piercing as needed by the surgeon. In a preferred embodiment, the two arms make-up different proportions of the arc.

Preferably, the movable arm forms the larger portion of the arc. This maximises the depth that can be achieved by this needle arrangement.

Means may be provided to prevent the thread from passing back through the needle after the thread has been passed therethrough. In one embodiment, the terminal end of the needle is an open end and the surgical thread is attached to a thread introducer having a retainer portion that projects from the open end and is prevented from passing back through the needle.

In this way, surgical thread connected to the introducer can be inserted through the hollow arms of the needle in the closed position and is prevented from being pulled back through the needle by the retainer portion of the introducer. Accordingly, a needle terminating in an open end used in conjunction with the thread introducer retains the surgical thread in the needle facilitating retrieval of the thread during surgery.

In one arrangement, the thread introducer comprises an elongate flexible member that can conform to the arcuate shape of the needle in the closed position so as to pass through the needle and the retainer portion comprises a formation having a tapered shape that is compressible to pass through the needle in the threading direction and expands on exiting the open end of the needle to prevent the introducer being pulled back through the needle.

Means may be provided to allow the surgeon to detach the thread introducer from the needle with the surgical thread still attached to the thread introducer. In this way, the thread can be retrieved after passing through the tissue to allow the surgeon to make more than one stitch.

In one arrangement, the arm from which the thread introducer projects are formed with an elongate slot that is wider than the surgical thread but narrower than the thread introducer. In this way, the thread introducer is retained in the arm and, when it is desired to detach the thread introducer with the thread still attached, the surgeon can pull the thread introducer clear of the arm and pass the thinner thread through the slot to detach the thread introducer from the needle.

Means may be provided for feeding surgical thread to the needle where access to the needle is restricted, for example in key-hole surgery where the shaft carrying the needle is inserted through a small opening in the body. In one arrangement, the needle is mounted at one end of the shaft and a hollow conducting rod is provided that extends longitudinally within the shaft for feeding the thread into the needle from the other end of the shaft. Alternatively or additionally, where the needle can be accessed within the patient, the needle may be adapted to enable the surgeon to thread the needle directly without using the feeding means.

The device may be provided with means to lock the needle in the closed position. This is advantageous in order to prevent the needle accidentally opening while passing the surgical thread through the needle.

The needle may comprise a disposable section of the device so that it can be thrown away after use and replaced by a new, clean needle. In this way, the risk of cross-infection due to inadequate cleaning and/or sterilising of re-usable needles is reduced.

In one arrangement, the shaft and, where provided, conducting rod may be formed in two or more separable sections. In this way, the sections carrying the needle that are contaminated during surgery may be disposed of and replaced after use. The separable sections of the shaft and, where provided, conducting rod may be releasably secured together by any suitable means, for example by threaded engagement or snap fit.

According to a second aspect of the invention there is provided a method comprising using the device of the first aspect of the invention to insert surgical thread into tissue.

The device can be used for vaginal sacrospinous fixation, repairs of pravaginal defects, laparoscopic surgery and other such surgeries in which surgical thread has to be inserted into tissue through openings in the body, for example key-hole surgery.

According to a third aspect of the invention there is provided a surgical device comprising a shaft having a proximal end and a distal end, a needle for piercing tissue at the distal end of the shaft, and means for rotating the shaft to adjust the position of the needle.

According to a fourth aspect of the invention there is provided a surgical device comprising a shaft having at one end a needle for threading suture material through tissue, and means for detaching the thread from the needle after the thread has been passed through the tissue.

An embodiment of the invention will now be described, by example only, with reference to the following drawings, in which:-Figure 1 shows a surgical device according to the invention and surgical thread extending through the device; Figure 2 shows a re-usable section of the device shown in Figure 1; Figure 3 shows a disposable section of the device shown in Figure 1; Figure 4 shows an end of surgical thread suitable for use with a device according to the invention; and Figure 5 shows a modification to the surgical device shown in Figures 1 to 3; and Figure 6 shows a further modification to the surgical device shown in Figures ito 3.

Referring to Figures 1 to 3, the surgical device comprises an elongate hollow shaft comprising a re-usable tail section 1 and a disposable head section 2 releasably secured together. The disposable head section 2 has at its distal end a needle 4 for piercing soft tissue of a patient and at its proximal end a screw thread (not shown) for engagement with a threaded coupler 5 at the distal end of the tail section ito connect the sections 1,2 together. Any other suitable releasable connector means may be employed to connect the sections together, for example a push or snap fit connector.

The needle 4 comprises two hollow arms 6 and 9. Hollow arm 6 has a curved portion 7 and a straight portion 8 extending along and fixed to the side of disposable section 2. The straight part 8 of the hollow fixed arm 6 of the needle 4 terminates in an opening 13. Hollow arm 9 has a reduced diameter portion 10 and is pivotally connected to the end of disposable section 2.

The arm 9 can be moved between a closed position (shown in the Figures) in which an open end of a reduced diameter portion 10 of the arm 9 extends by a few millimetres into an end of hollow arm 6 and an open position (not shown) in which these ends of the hollow arms 6,9 are spaced apart. In the closed position, the hollow arm 9 and curved portion 7 of hollow arm 6 form approximately 5/6 of a circle with slightly more than " of the circle made up by hollow arm 9.

The end of the movable hollow arm 9 proximate to the pivot 11 is attached to a flexible, hollow conducting rod 12 that extends through the entire shaft and is formed by head and tail sections 12a,12b releasably secured together within the coupler 5. In this embodiment, the sections 12a,12b have mating threaded end portions and the tail section 12b is rotatable by means of an attachment member 15 at the proximal end to engage/disengage the sections 12a,12b when the shaft sections 1,2 are engaged/disengaged. It will be understood that any suitable releasable connector means may be provided to secure releasably the sections 12a,12b of the conductor rod 12 to each other.

The tail section 1 of the shaft includes a handle 14 for remotely operating the needle 4 comprising a fixed handgrip 14a and a movable thumb grip 14b. The movable thumb grip 14b is pivotally mounted on the handgrip 14a and has an end attached to the conducting rod 12 via the attachment member 15. With this arrangement, closing the handle 14 by pivoting the thumb grip 14b towards the handgrip 14a pulls the conducting rod 12 in the direction of arrow A to move the needle 4 to the closed position shown in Figures 1 and 3. Opening the handle 14 by pivoting the thumb grip 14b away from the handgrip 14a pushes the conducting rod 12 in the direction of arrow B to move the needle 4 to the open position (not shown). The thumb grip 14b can be releasably secured to the handgrip 14a in the closed position by placing a tie 16 around the handgrip 14a when the thumb grip 14b is held against the handgrip 14a to lock the needle 4 in the closed position (Figures 1 and 3).

In use, the surgical device is inserted through an opening in the body to a position proximate the tissue to be stitched. The surgeon then squeezes the handle 14 to close the arms 6,9 of the needle 4 piercing the tissue with the movable portion 9 of the needle 4. The tie 16 is then secured to lock the needle 4 in this closed position before the surgeon feeds surgical thread (suture material) along the conducting rod 12 from the outer end, through both arms 6 and 9 of the closed needle 4 and out through opening 13 as shown in Figure 1.

The leading end of the thread is attached to a thread introducer 17 (shown in Figure 4) made of a flexible material capable of following the arcuate shape of the closed needle 4. The thread introducer 17 has a tapered retainer formation 17a that compressible to allow the thread introducer 17 to be pushed through the device in the threading direction until it exits the open end 13 of the needle 4 whereupon it expands and prevents the thread introducer 17 from being pulled back through the needle 4. In this way, when the needle 4 is opened and the device is removed from the body, the end of the thread is retained by the arm 6 of needle 4 and can be easily and quickly retrieved.

In a modification (not shown), the arm 6 of the needle 4 is provided with a longitudinally extending slot that is wider than the surgical thread but narrower than the thread introducer 17 allowing the surgeon to detach the thread introducer 17 from the device with the thread still attached to the thread introducer 17 by pulling the thread introducer 17 out of the arm 6 and passing the thread through the slot. In this way, the thread can be re-inserted through the device during a subsequent piercing operation allowing a surgeon to stitch the patient with a single, continuous thread rather than having to cut the thread after each piercing operation and stitch the patent with multiple, separate loops of thread.

Once stitching of the patient has been completed, the head section 2 of the shaft that has been inserted into the opening in the patient can be detached from the tail section 1 of the shaft and thrown away. The tail section 1 of the shaft can be cleaned/sterilised and provided with a new disposable head section 2. In this way, the risk of cross-contamination due to inadequate cleaning/sterilisation of a re-usable head section 2 can be reduced or eliminated. The disposable head section 2 may be made of any suitable materials such as plastics or metal or alloy. Alternatively, the head section 2 may be sterilised and re-used.

Figure 5 shows a modification to the device shown in Figures 1 to 3 in which like reference numerals are used to indicate corresponding parts.

In this modification, the needle 4 can be threaded remotely by feeding surgical thread through the conducting rod 12 as described above or locally by feeding surgical thread through open end 18a of a guide section 18 provided on the distal end of the head section 2 of the shaft.

Remote threading is useful for key-hole surgery or other operations where access to the needle at the distal end of the shaft is restricted when inserted into the patient's body. Local threading may be used where the surgeon has ready access to the needle at the distal end of the shaft when inserted in the patient's body.

Figure 6 shows another modification to the device shown in Figures 1 to 3 in which like reference numerals are used to indicate corresponding parts. In this modification, the tail section 1 comprises a rotary member 18 that allows rotation and change of direction of the needle 4 remotely as appropriate. This facilitates the use of the device for insertion of thread.

It will be understood that the invention is not limited to the above-described embodiment and includes modifications and alterations that fall within the scope of the invention as described herein. For example, part or all of the device may be disposable and designed for single use to be thrown away after use. Alternatively, part or all of the device may be re-useable and designed for multiple use to be cleaned/sterilised after each use.

Although the shaft of the above-described embodiment is formed in two sections that are separable to allow the head section to be thrown away after use, this is not essential and the shaft could be formed in one section that is cleaned/sterilised after use and can then be re-used. For some applications, the shaft may be formed in more than two sections that are releasably connected together allowing the length of the shaft to be adapted to the surgical operation being carried out. Multi-section shafts may include single use sections that are disposable and can be thrown away after use and/or sections that are re-usable and can be cleaned/sterilised after use.

The embodiment of the surgical device according to the invention is for vaginal sacrospinious fixation and repairs of paravaginal defects.

However, it will be understood that surgical devices according to the invention are envisaged that are suitable for laparoscopic surgery, keyhole surgery or other suitable surgeries where there is limited access and/or a poor view of the tissue to be stitched.

Claims

CLAIMS

1. A surgical device comprising a shaft having at one end a needle for piercing tissue, the needle comprising two hollow arms arranged to be remotely operated for relative movement between a closed position and an open position wherein, in the closed position, an open end of a first one of the hollow arms extends into an open end of the other, second hollow arm and, in the open position, these ends of the hollow arms are spaced apart.

2. A surgical device according to claim 1 wherein, in the closed position, the arms form a passageway for insertion of surgical thread through the passageway.

3. A surgical device according to claim 1 or claim 2 wherein, one of the hollow arms of the needle is fixed to the shaft and the other hollow arm is attached to the shaft for movement relative to the fixed hollow arm.

4. A surgical device according to claim 3 wherein, the second arm is fixed and the first arm is movable to open and close the needle.

5. A surgical device according to any preceding claim wherein, in the closed position, the two arms form a continuous arc.

6. A surgical device according to claim 5 wherein, the arc forms 2/3 or more of a circle.

7. A surgical device according to claim 5 or claim 6 wherein, the movable arm forms a larger portion of the arc.

8. A surgical device according to any preceding claim wherein, means is provided to prevent surgical thread from passing back through the needle after it has been passed therethrough.

9. A surgical device according to claim 8 wherein, a terminal end of the needle is an open end and surgical thread is attached to a thread introducer having a retainer portion that projects from the open end and is prevented from passing back through the needle.

10. A surgical device according to claim 9 wherein, the thread introducer comprises an elongate flexible member that can conform to the shape of the needle in the closed position so as to pass through the needle, and the retainer portion comprises a formation having a tapered shape that is compressible to pass through the needle in the threading direction and expands on exiting the open end of the needle to prevent the introducer being pulled back through the needle.

11. A surgical device according to 9 or claim 10 wherein, means is provided to allow the thread introducer to be detached from the needle with surgical thread still attached to the thread introducer.

12. A surgical device according to claim 11 wherein, the arm from which the thread introducer projects is formed with an elongate slot that is wider than surgical thread but narrower than the thread introducer.

13. A surgical device according to any preceding claim wherein, means is provided for feeding surgical thread to the needle.

14. A surgical device according to claim 13 wherein, the needle is mounted at one end of the shaft and a hollow conducting rod is provided that extends longitudinally within the shaft for feeding surgical thread into the needle from the other end of the shaft.

15. A surgical device according to any preceding claim wherein, means is provided to lock the needle in the closed position.

16. A surgical device according to any preceding claim wherein, the needle comprises a disposable section of the device.

17. A surgical device according to any preceding claim wherein, the shaft is formed in two or more separable sections.

18. A surgical device according to claim 17 wherein, the separable sections of the shaft are releasably secured together.

19. A surgical device according to any preceding claim wherein, means is provided for rotating the shaft to adjust the position of the needle.

20. A surgical device substantially as hereinbefore described with reference to the accompanying drawings.

21. A method comprising using the device according to any preceding claim to insert surgical thread into tissue.