Devices, systems, and methods for wound closure
A system includes a wound closure device having a shaft, proximal and distal arms coupled to the shaft, and one or more linkages coupling the proximal and distal arms. The arms are pivotable relative to the shaft between a linear position, wherein the arms and shaft are linearly aligned, a first pivoted position, wherein the proximal arm is pivoted in a first direction to pivot the distal arm in a second, opposite direction, and a second pivoted position, wherein the proximal arm is pivoted in the second direction to pivot the distal arm in the first direction. A suture including a first portion disposed about a first surface of the distal arm and a second portion disposed about a second surface of the distal aim is also provided.
1. A wound closure system, comprising:
a wound closure device, including:
an elongated shaft defining a proximal region and a distal region, the distal region of the shaft configured for insertion into an opening in tissue;
a proximal arm pivotably coupled to the shaft in the proximal region of the shaft;
a distal arm pivotably coupled to the shaft in the distal region of the shaft and defining a first surface and a second, opposite surface;
at least one linkage extending through the shaft and coupling the proximal and distal arms to one another such that the proximal and distal arms are pivotable relative to the shaft between a linear position, wherein the proximal and distal arms and the shaft are linearly aligned with one another, a first pivoted position, wherein the proximal arm is pivoted in a first direction relative to the shaft to pivot the distal arm in a second, opposite direction relative to the shaft such that the first surface is positioned adjacent an internal surface of tissue, and a second pivoted position, wherein the proximal arm is pivoted in the second direction relative to the shaft to pivot the distal arm in the first direction relative to the shaft such that the second surface is positioned adjacent an internal surface of tissue;
a sleeve including a proximal end, a distal end having a bifurcated portion, first and second needle lumens, and a central passage extending longitudinally therethrough, the central passage configured to receive the wound closure device, the first and second needle lumens extending longitudinally through the sleeve and the bifurcated portion at the distal end thereof on either side of the central passage; and
a suture including a first portion disposed about the first surface of the distal arm and a second portion disposed about the second surface of the distal arm.
2. The wound closure system according to claim 1 , wherein the central passage configured to receive the wound closure device for removably positioning the sleeve about the wound closure device when the wound closure device is disposed in the linear position, the sleeve being distally slidable about the shaft to retain tissue between the distal end of the sleeve and one of the first surface or the second surface of the distal arm positioned adjacent an internal surface of tissue.
3. The wound closure system according to claim 2 , further including a needle insertable through one of the first and second needle lumens, the needle defining a distal portion configured to retrieve at least one of the first portion or the second portion of suture disposed about the first surface and the second surface, respectively, of the distal arm positioned adjacent an internal surface of tissue.
4. The wound closure system according to claim 3 , wherein the first and second needle lumens define curved configurations.
5. The wound closure system according to claim 4 , wherein the needle defines a curved configuration.
6. The wound closure system according to claim 4 , wherein the needle defines a flexible configuration.
7. The wound closure system according to claim 4 , wherein the needle defines a hooked distal end.
8. The wound closure system according to claim 1 , wherein the at least one linkage includes at least one cable coupling the proximal and distal arms to one another.