Devices and methods for minimally invasive suturing
Devices and methods for minimally invasive suturing are disclosed. One suturing device for minimally invasive suturing includes a proximal section a distal end, and an intermediate region therebetween. The device includes a suture head assembly having a suturing needle with a pointed end and a second end. The suturing needle is capable of rotating about an axis approximately perpendicular to a longitudinal axis of the device, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to deployment of guides that are adapted and configured to guide the needle around a circular path when advanced by a drive mechanism having a needle driver for engaging and rotating the suturing needle.
1. A method of performing a suturing operation, comprising:
providing a suturing device including:
an arced needle having a leading end, a trailing end, a length of suture, the arced needle having at least one drive surface formed into its surface, the arced needle being disposed within a suturing head located at a distal end of the suturing device;
an arced needle track defined in the suturing head for receiving the arced needle, the arced needle track defining a circular path;
a needle driver configured to drive the arced needle along the circular path in a first rotational direction, the needle driver including a drive pawl that is configured to engage the drive surface formed into the arced needle and advance the arced needle along the needle track in the first rotational direction during a drive stroke from a starting position to a driven position, wherein the needle driver drives the arced needle about 180 degrees along the needle track during the drive stroke; and
performing a drive stroke by actuating the needle driver to drive the arced needle along the needle track and through at least one tissue segment;
performing a return stroke to permit the needle driver to return from the driven position to the starting position, wherein the needle driver moves backward with respect to the arced needle along a second rotational direction opposite to the first rotational direction during the return stroke; and
resisting backward movement of the arced needle along the second rotational direction during the return stroke by engaging the arced needle in at least two discrete physical locations that are spaced apart from one another along the circular path defined by the needle track by interfering with the needle's movement at both of said at least two discrete physical locations.
2. The method of claim 1 , wherein the two discrete physical locations are spaced apart a multiple of about 90 degrees from one another along the circular path defined by the needle track.
3. The method of claim 1 , further comprising pulling the length of suture through said at least one tissue segment.
4. The method of claim 3 , further comprising using a forceps or grasping instrument to tighten a knot in said suture.
5. The method of claim 3 , further comprising tightening a plurality of stitches by exerting a pull on the length of suture so that the length of suture is tensioned uniformly along a length of said at least one tissue segment.
6. The method of claim 1 , wherein the arced needle follows a circular path that lays in a plane that is generally parallel to a longitudinal axis of the suturing device.
7. The method of claim 1 , wherein said at least one tissue segment includes a plurality of tissue segments that are to be joined by suturing.
8. The method of claim 1 , further comprising introducing the suturing device through a cannula into an internal body portion of a patient.
9. The method of claim 8 , wherein the cannula has an internal diameter of about 5 mm.
10. The method of claim 1 , further comprising articulating a portion of the suturing device about an articulation joint near a distal end of the suturing device to adjust the relative position of the needle track with respect to said at least one tissue segment.
11. The method of claim 10 , wherein said articulation joint permits articulation about an axis of articulation that is perpendicular to a longitudinal axis of the suturing device.
12. The method of claim 10 , further comprising rotating the suturing device about a longitudinal axis defined by the suturing device to adjust the relative position of the needle track with respect to said at least one tissue segment.
13. The method of claim 12 , wherein rotating the suturing device about the longitudinal axis defined by the suturing device to adjust the relative position of the needle track with respect to said at least one tissue segment includes rotating a distal portion of said suturing device with respect to a proximal portion of said suturing device.
14. The method of claim 1 , further comprising rotating the suturing device about a longitudinal axis defined by the suturing device to adjust the relative position of the needle track with respect to said at least one tissue segment.
15. The method of claim 14 , wherein rotating the suturing device about the longitudinal axis defined by the suturing device to adjust the relative position of the needle track with respect to said at least one tissue segment includes rotating a distal portion of said suturing device with respect to a proximal portion of said suturing device.