Surgery – Instruments – Suture – ligature – elastic band or clip applier
Patent
1995-04-07
1997-02-11
Schmidt, Jeffrey A.
Surgery
Instruments
Suture, ligature, elastic band or clip applier
606139, 606207, A61B 1700
Patent
active
056015780
DESCRIPTION:
BRIEF SUMMARY
This invention relates to endoscopic suturing and in particular a device or instrument for forming knots to tie tissue together in cavities within animal (human) bodies to complete internal surgical procedures.
It has become practice with certain surgical procedures within cavities in the human body to avoid over intrusive surgical techniques, involving large incisions to gain access to body cavities, to now use a surgical technique known as endoscopy where relatively small incisions are made through to the body cavity and surgical procedures are carried out using an endoscope being an elongate device or instrument in the nature of a telescope inserted thorough the incision to view the area where surgery is being carried out, whilst a similar elongate device or instrument is used to sever internal body tissue during various types of tissue removal or repair operations. By using such a less intrusive surgical technique involving small incisions, patient tram is kept to a minimum resulting in a lesser tern of hospitalisation and keeping scarring to a minimum.
However one of the major difficulties with such a surgical technique arises when it is necessary to suture internal body tissue by stitching the tissue together using thread like material, which requires the formation of knots within the body cavity as distinct from externally accessible areas where suturing external body tissue is involved.
One presently used technique involves the use of clips or clamps which clamp the body tissue together and which are applied within the body cavity using an elongate clip applicator inserted through one of the external incisions whilst the viewing the application of the clip with the endoscope through another external incision. However, some such clips are not designed to be dissolved over a period of time whilst the joined body tissue heals and as a result are relatively expensive adding significantly to the cost of the surgical procedure.
One other known intracorporal suturing technique involves the use of a pair of instruments one being in the form a pair suture grasping forceps and a separate knotting device, and involves inserting the suture (thread) through the tissue to be joined using a needle holder and thereafter holding one free end of the thread with the needle holder whilst through a separate incision the knotting device is inserted to catch the thread between the needle holder and the tissue whereby by rotating the knotting device through one or more rotations of 180.degree., one or more loops are formed in the thread, whereafter either through the same incision by withdrawing the knotting device, or thorough a separate incision, the suture grasping forceps are inserted to grasp the other end of the thread and draw it through the loop or loops to form a single or multiple knot.
It is therefore an object of present invention to provide an endoscopic suturing device which will suture together body tissue in an internal body cavity and which is not subject to the same problems and difficulties as the aforementioned suturing techniques.
In accordance with the present invention there is provided an endoscopic suturing device, comprising an elongate hollow tube one end of which carries a combination of a thread engaging and loop forming member and a thread or needle clamping member, and means operable at the other end of the tube for actuating the thread or needle clamping member, wherein said means for actuating the thread clamping member comprises an actuating member engaging an elongate actuating rod extending through said tube and coupled to said thread or needle clamping member, whereby axial movement of the actuating member causes said actuating rod to actuate said thread or needle clamping member.
Such a device enables the instrument to complete a knotting function in one operation and whilst inserted through the same incision, to grasp the short end of the thread by the thread clamping member on the needle side of the tissue to be joined, whereafter rotation of the device through one or more rotations
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Miranic Investments Pty. Ltd.
Schmidt Jeffrey A.
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