Suturing device, system, and method
Improved medical suturing devices, systems, and methods may hold a suture needle at a fixed location relative to a handle of the device, allowing the surgeon to grasp and manipulate the handle of the suturing device to insert the needle through tissues in a manner analogous to use of a standard needle gripper. Cycling the handle from a closed position to an open position and back to the closed position may alternate the device between gripping the needle with a first clamp (for example, along a proximal portion of the needle) to gripping the needle with a second clamp (for example, along a distal portion of the needle) and optionally back to gripping with the first clamp, with the needle often staying at a substantially fixed location relative to the suturing device body. Related single-clamp needle grasping devices can be bent plastically by a surgeon, and/or have bodies that are grasped by a hand while a portion of the hand actuates a handle.
1. A suturing method comprising:
inserting a distal portion of a suturing needle distally through a tissue by moving a body of a suturing device while a first clamp of the suturing device holds the needle at a fixed location relative to the body;
grasping the distal portion of the needle with a second clamp of the suturing device;
releasing the proximal portion of the needle from the first clamp; and
pulling the proximal portion of the needle through the tissue by moving the body while the second clamp holds the needle; wherein the first and second clamps are alternatingly latched by an alternatable latch, and further comprising moving the alternatable latch laterally between a first configuration and a second configuration in response to movement of a drive element, wherein the alternatable latch in the first configuration inhibits axial movement of the first clamp, and wherein the alternatable latch in the second configuration inhibits axial movement of the second clamp.
2. The suturing method of claim 1 , the tissue being included on a first patient, further comprising replacing the first and second clamps with third and fourth clamps, disposing of the first and second clamps so as to avoid sterilizing the first and second clamps, and suturing tissue of a second patient with the third and fourth clamps.
3. The suturing method of claim 1 , further comprising securing the suture to the tissue by tying a knot in the suture without releasing the body from a hand of a surgeon.
4. The suturing method of claim 1 , wherein an actuation axis extends between each clamp and the body, each clamp comprising a pair of opposed driven surfaces which angle laterally outwardly along the axis, wherein the driven surfaces of each clamp are moved axially by pushing engagement of corresponding driving surfaces so that the clamp moves along the axis, and are driven laterally by sliding engagement between the driving surfaces and the driven surfaces so that the clamp articulates.
5. The suturing method of claim 1 , wherein the body is moved by manually grasping and manipulating the body with a hand of a surgeon, and wherein the grasping and releasing of the needle are effected by articulating a handle with fingers of the hand while the hand grasps the body.
6. The suturing method of claim 1 , wherein the tissue is from a first patient, further comprising detaching the first and second clamps from the body after suturing of the first patient and disposing of the first and second clamps, attaching third and fourth clamps to the body, suturing tissue of the second tissue, detaching the third and fourth clamps from the body and disposing of the third and fourth clamps so that each clamps is used to suture tissue of only a single patient.
7. The suturing method of claim 1 , further comprising forming a plurality of stitches by repeatedly and alternatingly grasping the suturing needle with the first and second clamps, wherein the first clamp has a first clamp position when the first clamp holds the needle at the fixed location, wherein the second clamp holds the needle at a second clamp position for pulling of the proximal portion of the needle, and wherein gradual displacement of the needle relative to the body during the alternatingly grasping of the clamps is inhibited by:
each grasping of the needle with the first clamp comprising extending the first clamp slightly beyond the fixed location, closing the extended first clamp on the needle, and withdrawing the needle with the first clamp to the fixed location; and
each grasping of the needle with the second clamp comprising extending the second clamp slightly beyond the second clamp position, closing the extended second clamp on the needle, and withdrawing the second clamp to the second clamp position.
8. The suturing method of claim 1 , further comprising manually establishing an oblique angle between a distal tip of the needle and the first clamp for proximal or distal suturing, and wherein cycling of the suturing device between grasping of the needle with the first and second clamps substantially maintains the oblique angle.