Finger-guided suture device

Surgery – Body inserted urinary or colonic incontinent device or... – Implanted

Reexamination Certificate

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Details

C128S885000, C606S139000

Reexamination Certificate

active

06475135

ABSTRACT:

FIELD AND BACKGROUND OF THE INVENTION
The present invention relates to suture devices, and more particularly, to a finger-guided suture device for placing sutures especially in body locations of limited minimal-invasive accessibility. The present invention further relates to surgical procedures in which one or more finger-guided suture devices of the present invention are used to place one or more sutures, especially in body locations of limited minimal-invasive accessibility.
For years, there has been a discernible, clear tendency in surgery and invasive diagnosis, especially, but not exclusively, in abdominal, joint, vaginal, in-utero and brain, surgeries or diagnoses, to develop procedures that would reduce the need for major access-providing incisions with their concomitant requirements of general anesthesia, extended hospitalization and increased infection hazard. One step in this direction was the introduction of endoscopy and laparoscopy, which, through provision of minimal incision in, e.g., the abdominal wall of joint covering skin, permits the introduction into the abdominal cavity or joint of a miniature television camera including a light source, as well as of various surgical instruments, including suture devices.
PCT/US97/11494 teaches a number of surgical instruments which can be mounted directly on a surgeon's fingertip in a way that the surgeon can insert his or her hand into a natural cavity of the patient or through a minimal incision to perform surgical procedures, and also to use his or her fingers to manipulate tissues, thus enabling the surgeon to perform the procedures with the benefits of minimally invasive surgery, but with much greater tactile sense, control, and ease of manipulation. However, these surgical instruments (i) are carried by a finger and operated by the thumb, thereby are not applicable for procedures in which a single finger is employed for tactile sensing an operated intrabody location; (ii) include an operating head which permanently extends far beyond the fingertip on which the surgical instrument is mounted, which limits the tactile sensing of the surgeon; and/or (iii) prevent tactile sensing by the instrument carrying fingertip altogether.
According to the teachings of PCT/US97/11494 suturing can be performed while the surgeon uses tactile information collected by a single fingertip for tactile sensing the intrabody site to be stitched prior to the actual suturing. Several non-limiting examples of such suturing procedures are described in detail in the sections that follow. However, once the surgeon has collected the tactile information, surgery is conducted blindly within the body of the patient. According to the teachings of PCT/US97/11494, both the hands of the surgeon are engaged. Evidently, blindly operating surgical instruments intrabodily based on finger tip tactile information collected earlier may prove inconvenient, inaccurate and may increase the chance of inadvertently harming the patient.
PCT/IL99/00084 teaches design of finger-guided suture devices which can be used to perform extra- as well as intrabody suturing of tissue. This application does not teach construction and use of a device which causes a needle to penetrate a bodily tissue engage a piece of suture material and pull the suture material through the bodily tissue as the needle is retracted there through. In addition, this application fails to teach a construction which allows safe withdrawal of the needle in case of early detected misplacement other than pulling it via the hand or suture.
There is thus a widely recognized need for, and it would be highly advantageous to have, finger-guided suture devices devoid of the limitations associated with the prior art instruments and which enable a surgeon using a finger-guided surgical device to penetrate a bodily tissue with a suture needle, engage a piece of suture material with the needle and pull the suture material through the bodily tissue as the needle is retracted there through.
SUMMARY OF THE INVENTION
According to one aspect of the present invention there is provided a finger-guided suture device. The device comprises (a) a thimble-like element being adapted to surround a portion of a surgeon's finger; (b) a rotatably mounted substantially semi-circular surgical needle within a housing formed within, or connected to, a wall of the thimble-like element, the surgical needle being designed for collecting the surgical suture via a distal portion of the surgical needle upon contact therewith and for retaining and guiding the surgical suture while suturing; and (c) a mechanism for imparting to said surgical needle a rotary movement in one direction for ejecting the surgical needle from the thimble-like element and thereafter a rotary movement in the opposite direction for withdrawing the surgical needle into the thimble-like element, so as to place a suture.
According to another aspect of the present invention there is provided a surgical procedure for bladder-neck suspension for treatment of urinary incontinence, the procedure comprising the step of suspending a pelvic fascia and a vaginal wall lateral to a urethra of a patient to Cooper's ligament by a surgical suture applied by using a finger-guided suture device having a rotatably-driven substantially semi-circular surgical needle designed for collecting the surgical suture via a distal portion of the surgical needle upon contact therewith and for retaining and guiding the surgical suture while suturing.
According to yet another aspect of the present invention there is provided a surgical procedure for treatment of rectal prolapse, the procedure comprising the step of constricting an anal opening by a surgical suture applied by using a finger-guided suture device having a rotatably-driven, substantially semi-circular surgical needle designed for collecting the surgical suture via a distal portion of the surgical needle upon contact therewith and for retaining and guiding the surgical suture while suturing.
According to still another aspect of the present invention there is provided a surgical procedure for treatment of esophageal reflux, the procedure comprising the step of positioning a vessel loop around a esophagus of a patient by a surgical suture applied by using a finger-guided suture device having a rotatably-driven, substantially semi-circular surgical needle designed for collecting the surgical suture via a distal portion of the surgical needle upon contact therewith and for retaining and guiding the surgical suture while suturing.
According to an additional aspect of the present invention there is provided a surgical procedure for treatment of vaginal prolapse, the procedure comprising the step of tying an upper part of a vagina of a patient to a sacrospinous ligament of the patient by a surgical suture applied by using a finger-guided suture device having rotatably-driven, substantially semi-circular surgical needle designed for collecting the surgical suture via a distal portion of the surgical needle upon contact therewith and for retaining and guiding the surgical suture while suturing.
According to yet additional aspect of the present invention there is provided a surgical procedure for treatment of rupture of a rectum in large animals, the procedure comprising the step of suturing the rupture by a surgical suture applied by using a finger-guided suture device having a rotatably-driven, substantially semi-circular surgical needle designed for collecting the surgical suture via a distal portion of the surgical needle upon contact therewith and for retaining and guiding the surgical suture while suturing.
According to still additional aspect of the present invention there is provided a surgical procedure for treatment of rupture of a cervix in large animals, the procedure comprising the step of suturing the rupture by a surgical suture applied by using a finger-guided suture device having a rotatably-driven, substantially semi-circular surgical needle designed for collecting the surgical suture via a distal portion of the surg

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