Surgery – Instruments – Suturing needle
Reexamination Certificate
1999-02-19
2001-06-12
Recia, Henry J. (Department: 3731)
Surgery
Instruments
Suturing needle
Reexamination Certificate
active
06245091
ABSTRACT:
BACKGROUND OF THE INVENTION
This invention concerns surgical needles and procedures for their use. In particular the invention relates to a needle which can be vibrated to aid in passing through tissue and which, in some embodiments, has provision for attaching to a suture to pull the suture through tissue as the needle is retracted.
Application Ser. No. 859,887, now U.S. Pat. No. 5,931,855, discloses a one-way surgical suture and methods for its use. The sutures have barbs enabling passage through tissue in one direction, but not the other, so that wounds can be closed by a pair of such one-way sutures oriented oppositely on opposed sides of a wound and connected together, or, as the pending application discloses, by a double armed suture with barbs in opposite directions, both ends implanted into opposite sides of the wound. The copending application discloses several methods for use of such one-way sutures. This invention is concerned with a surgical needle apparatus particularly useful with such one-way sutures, and also with a cooperating feature which helps avoid blood vessels and nerves as the needle is pushed through the patient's tissue.
The following patents have some relevance to the subject matter of this invention: U.S. Pat. Nos. 4,103,689, 4,356,823, 4,493,694, 4,708,717, 4,730,635, 4,886,491, 5,199,943, 5,254,082, 5,380,273, 5,514,086, 5,484,398, 5,549,119, 5,562,609, 5,562,610, 5,645,537. Most of these patents are concerned with medical devices involving suction, or ultrasonic vibration, or both. The suction is generally applied to the medical instrument for the purpose of drawing fragments of tissue out of the body, often after portions of tissue have been shattered using ultrasonic energy transmitted from the tip of the tool.
Of the above patents, U.S. Pat. No. 5,549,119 describes a vibrating tip catheter or guidewire which is vibrated for the purpose of passing through tortuous anatomical pathways, the vibration being intended to enhance the ability of the catheter or guidewire to pass through the narrow pathways or to cross lesions or stenoses. In that patent the vibrations can be achieved with a microvibrating motor integral with the catheter or guidewire, the frequency and amplitude of vibration being adjustable via an external control device. The instrument seems primarily concerned with movement through a blood vessel, particularly for angioplasty and atharectomy.
Medical devices of the prior art have not been effective for the purposes of the present invention, and have not included a surgical suturing needle which vibrates at a sub-ultrasonic frequency to aid in passing the needle through tissue, or a surgical needle which is hollow, with means for gripping the end of a suture.
SUMMARY OF THE INVENTION
In a principal embodiment of the present invention, a surgical needle is attached at its base end to a hollow handle having provision for vibrating the needle. This vibration could be via an internal electric motor, but in a preferred form the vibration is induced by a suction-operated device served by a suction line connected to the handle. When the surgical needle, vibrating at a frequency well below ultrasonic (usually in very low audible range, e.g. a range of about 20 to 30 per second) is pushed through subcutaneous patient tissue, the vibratory force permits the needle to be passed smoothly through the tissue, avoiding damage to major blood vessels and nerves. In tendon surgery, the needle tends to slide down the core of the tendon as it follows the longitudinal fibers of the tendon.
One type of suction-operated vibration inducer which can be included in the handle is a wheel with vanes, caused to rotate by the passage of air via the suction. The wheel has eccentric weighting, so as to cause vibration, and the handle is vented appropriately to allow the suction passage of air at sufficient velocity through the vaned wheel. Another type of vibratory device can be a flutter valve, such as a rubber duckbill valve which vibrates as air pulses through.
Once the needle, which may be a lengthy needle in the case of a face-lift operation, has been passed through the desired path and its sharp end exposed, the needle has provision for attaching to a suture, to enable the surgeon to pull the suture through the same path that has been occupied by the needle. The suture attachment device could be at either end of the needle, but in a specific embodiment it is at the distal, sharp end of the needle so that the surgeon can attach a one-way suture with barbs along its length and retract the needle by its handle, pulling the one-way suture in a reverse direction along the same path where the needle was inserted.
One arrangement for retaining the suture end to the needle includes the use of a hollow needle, with suction applied to the needle from the proximal end, thus enabling the needle to draw the suture end firmly into the needle to hold the suture for pulling it back through the tissue. This procedure is particularly useful in face-lifts, where a one-way suture is drawn back through the tissue in the permitted direction, then tension can later be applied to the distal end of the suture to pull and maintain tension in the skin tissue.
In one embodiment of the invention the tubular needle has an angled distal end, only the tip portion of which is sharpened. This, in conjunction with the vibration, helps avoid damage to vessels and nerves. The needle preferably is capable of disconnection from the handle and replaceable with a new needle.
The invention also encompasses methods for use of the vibrating needle, with or without the suction feature for retaining suture ends to the needle. These methods include the implantation and use of double-armed sutures having barbs extending in opposite directions on opposed sides of a midpoint of the suture. By one procedure, the needle of the invention is inserted through a lengthy path of subcutaneous tissue, from which it emerges at its distal end, an end of a double-armed suture is drawn into the hollow needle by suction from the handle, and the needle is retracted out from the tissue, drawing the one-way suture into the same path, in the direction permitted by the barbs. Then the procedure is repeated from the opposite direction to the same distal emerging point, where the other end of the suture, with the oppositely-directed barbs, is pulled through tissue in the opposite direction until the suture is fully implanted. Tension can then be applied to the tissue by drawing the double-armed suture tight.
It is among the objects of the invention to improve on surgical techniques, including face-lifts and plastic surgery, by use of a surgical needle useful in avoiding damage when passed through subcutaneous tissue and useful particularly for implanting one-way sutures. These and other objects, advantages and features of the invention will be apparent from the following description of preferred embodiments, considered along with the accompanying drawings.
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Freiburger Thomas M.
Ho Tan-Uyen T.
Hoffman Frank
Recia Henry J.
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