Biological tissue access and closure apparatus, systems and methods
A system for piercing through biological tissue and providing access to internal structures; particularly, intra-abdominal structures, and closing an opening in the tissue. The system includes a suture guide sub-system having a tissue positioning sub-system for engaging segments of tissue disposed proximate the tissue opening and a suture passer sub-system that slideably engages the suture guide sub-system. The suture passer sub-system includes suture deployment and capture means that is configured to removably secure a suture thereto and deliver the suture to the segments of tissue disposed proximate the tissue opening.
1. A suture guide apparatus, comprising:
an elongated housing comprising a first proximal end, a distal region and an open internal region disposed in said distal region, said distal region being configured to transition into and through a tissue structure,
said housing further comprising a first suture passer lumen receiving a suture passer system therein, said suture passer system comprising a suture passer cannula and suture deployment shaft, said suture deployment shaft comprising a distal end that is configured to capture a suture therewith and releasably secure said suture therefrom,
said housing further comprising an open tissue positioning region proximate said distal region of said housing, said open tissue positioning region comprising second proximal and distal ends, said first suture passer lumen extending from said proximal end of said housing to said proximal end of said open tissue positioning region,
said housing further comprising a second suture passer lumen that extends from said distal end of said open tissue positioning region to said distal region of said housing, said second suture passer lumen comprising a longitudinal axis, said first and second suture passer lumens being in an aligned relationship, wherein said suture deployment shaft is capable of transitioning unobstructably from said first suture passer lumen into and through said open tissue positioning region and into and through said second suture passer lumen,
said distal region of said housing further comprising a suture retention clip having a flexible extended door region, said suture retention clip being disposed in said internal region of said distal region proximate said open tissue positioning region, wherein said flexible extended door region intersects said longitudinal axis of said second suture passer lumen, wherein said extended door region forms a suture capture door that obstructs passage of said suture passer cannula and, thereby said suture deployment shaft through said second suture passer lumen, when said suture capture door is in a closed position,
said suture capture door being further configured to transition from said closed position to an open position, wherein said extended door region allows passage of said suture passer cannula and, thereby said suture deployment shaft through said second suture passer lumen,
said suture capture door being further configured to engage and retain a first suture that is releasably secured to said distal end of said suture deployment shaft when said suture deployment shaft and engaged first suture are disposed in said suture passer cannula and said suture passer cannula and engaged first suture are inserted into and through said second suture passer lumen and through said suture capture door and, thereafter, said suture passer cannula is withdrawn through said suture capture door,
whereby, when said suture passer cannula and engaged first suture are inserted into and through first tissue disposed in said tissue positioning region, into and through said second suture passer lumen and through said suture capture door and, thereafter, said suture passer cannula is withdrawn through said suture capture door, said first suture is engaged to said first tissue and retained by said capture door,
said suture capture door being further configured to provide a closure force in the range of 0.1-5.0 lbs f when said suture capture door is in said closed position.
2. The suture guide apparatus of claim 1 , wherein said housing further comprises a third continuous lumen that extends from said proximal end of said housing through said distal region of said housing, said third lumen being sized and configured to receive surgical instruments therein.