Surgical instrument for manipulating and passing suture
An instrument for manipulating and passing suture through a tissue is disclosed. The instrument includes a handle and a needle. The needle includes a lumen and terminates with a distal opening and a sharp edge surface for piercing tissue. The instrument also includes a hook, axially slideable within the needle lumen and through the needle distal opening. The hook may axially slide between a suture-locking configuration, a suture-sliding configuration and a suture release and capture configuration. The instrument may include improvements that better protect smaller and more fragile sutures.
1 . An instrument for manipulating and passing a suture through a tissue, said instrument comprising:
a proximal end including a handle and a distal end including a needle, the needle defining a lumen extending up to and including a distal opening; and
a hook axially moveable along the lumen between an extended configuration wherein the hook is external to the lumen configured to capture or release the suture and a retracted configuration wherein the hook is disposed within the lumen configured to hold the suture within the needle and;
wherein the hook includes three legs continuous with each other and orientated so as to define a three sided cavity to capture the suture in, the three legs including a first leg of the three legs defining a proximal-most side of the three sided cavity, extending from a first surface of the lumen and across a center axis of the lumen, a second leg of the three legs extending distally and directly from the first leg and along the center axis of the lumen and a distal-most leg extending angularly from the second leg across the center axis of the lumen defining a distal-most side of the three sided cavity, the distal-most leg having a length and angular orientation relative to a diameter of the lumen when in the retracted configuration, the distal-most leg proximally spaced from the distal opening when in the retracted configuration and wherein tension from the suture captured within the three sided cavity is configured to rotate the distal-most leg about a point (B) located along the second leg so that opposing ends of the distal-most leg interfere with at least the first surface and a second opposing surface of the lumen, to resist rotation of the distal-most leg and thereby resist release of the suture held within the hook.
2 . The instrument of claim 1 wherein the hook first leg extends distally from a base portion, the base portion have a preformed bend that biases a distal-most end of the distal-most leg to engage the lumen second opposing surface when in the retracted configuration.
3 . The instrument of claim 2 wherein the distal-most side of the three sided cavity is a proximal facing planar surface that extends across the center axis of the lumen, the proximal facing planar surface configured to limited cleating or recessing of the suture within the three sided cavity, and therefore easing release of suture from the three sided cavity.
4 . The instrument of claim 1 wherein the hook distal-most leg defines a width that forms a lateral gap between the distal-most leg and the lumen, the lateral gap configured to bind the suture between the distal-most leg and the lumen when in the retracted configuration, and therein deter sliding of the suture through the hook.
5 . The instrument of claim 4 wherein the lateral gap is 0.015 inches on each side of the hook.
6 . The instrument of claim 1 wherein the needle distal lumen includes a graduated portion, including a first diameter portion that extends along the distal opening, and a second diameter portion that is smaller than the first diameter portion and extends proximally from the first diameter portion and is located at a proximal end of the distal opening, the graduated portion configured to reduce fraying of the suture, as the suture is drawn into the lumen.
7 . The instrument of claim 6 wherein an outer diameter of the needle is uniform along both the first and second diameter portion.
8 . The instrument of claim 6 wherein the graduated portion is also configured to reduce forces required to move the suture and hook to the retracted configuration.
9 . An instrument for manipulating and passing suture through a tissue, said instrument comprising:
a handle end and a needle defining a distal end of the instrument, the needle comprising a lumen having a distal opening, the distal opening having a proximal-most edge; and
a hook axially moveable within the lumen and through the distal opening;
wherein the needle lumen includes a first diameter portion that extends from the distal opening, and a second diameter portion that is smaller than the first diameter portion, and extends proximally from the proximal-most edge and first diameter portion, the first diameter portion configured to funnel the hook with a suture captured therein into the lumen with a low compression force on the suture, and the second diameter portion configured to house the suture and hook distal end within the needle, an outer diameter of the needle uniform along the first and second diameter portion.
10 . The instrument of claim 9 wherein the first diameter portion transitions to the second diameter portion with a curved counterbore portion, the curved counterbore at a proximal end of the distal opening.
11 . The instrument of claim 9 further comprising a tapered or rounded transition between the first and second diameter portion.
12 . The instrument of claim 9 wherein the first diameter portion extends up until a proximal edge of the lumen distal opening.
13 . The instrument of claim 9 wherein the second diameter portion is configured to lockingly hold the suture within the needle.
14 . An instrument for manipulating and passing a suture through a tissue, said instrument comprising:
a proximal end including a handle and a distal end that defines a needle, the needle defining a lumen extending up to and including a distal opening; and
a hook axially moveable along the lumen between an extended configuration wherein the hook is external to the lumen configured to capture or release the suture and a retracted configuration wherein the hook is disposed within the lumen configured to hold the suture within the needle; and
wherein the hook includes three legs continuous with each other and orientated so as to define a three sided cavity to capture the suture in, the three legs including a first leg of the three legs defining a proximal-most side of the three sided cavity, extending from a first surface of the lumen and across a center axis of the lumen, a second leg of the three legs extending distally and directly from the first leg and along the center axis of the lumen and a distal-most leg extending angularly from the second leg and back across the center axis of the lumen defining a distal-most side of the three sided cavity, the distal-most side of the three sided cavity defining a planar surface that is proximally facing and extends across the center axis of the lumen, configured to engage the suture with limited cleating, and wherein the distal-most leg has a length that, when within the lumen and proximally spaced from the needle distal opening, extends from the first surface of the lumen to a second opposing surface of the lumen, at axially spaced locations along the lumen and wherein the first and second surfaces are on opposing sides of a longitudinal axis of the lumen, wherein the length is greater than a diameter of the lumen, and configured to prevent rotation of the distal-most leg via tension from the suture and thereby prevent release of the suture from the needle when in the retracted configuration.
15 . The instrument of claim 14 wherein the hook distal-most leg defines a free end that is proximally spaced relative to a distal-most end of hook.
16 . The instrument of claim 14 wherein the needle distal opening includes a counterbore located at a proximal end of the distal opening, configured to reduce fraying of the suture as the suture is funneled through the distal opening, past the counterbore and into the lumen.
17 . The instrument of claim 16 wherein the counterbore is disposed between a first inner diameter portion that is distal to the counterbore and a second inner diameter portion that is proximal of the counterbore, the second inner diameter portion smaller than the first inner diameter portion, an outer diameter of the needle uniform along both the first and second inner diameter portions.
18 . The instrument of claim 14 wherein the hook has a lateral width configured to cooperate with an inner diameter of the lumen coextensive with the hook to define a mode of a holding configuration on the suture, the mode being either a locking or a sliding hold configuration.