Needle and guide apparatus for passing suture
A trocar wound closure system includes a suture passing needle and a guide for directing the needle through the wound site. A distal portion of the needle includes a capture rod with a slot. An obturator tube with a cutout section can be axially actuated to align the cutout section with the slot, and then moved out of alignment so as to capture the suture. The guide includes at least two tracks for directing the needle through the tissue track. A suture catcher is located adjacent to the exit of each track, and configured to be actuated from a radially extended configuration to a retracted configuration so as to capture the suture section inserted through each loop. Radially expandable arms at distal section are movable between an expanded configuration and a slender configuration.
1. A method for retrieving suture, comprising:
inserting a guide in a slender configuration into a body cavity;
positioning the guide in the body cavity by: deploying within the body cavity a first self-supporting suture catcher extending from a distal portion of the guide and an opposing second self-supporting suture catcher extending from the distal portion of the guide;
directing a first section of suture configured to be attached to a distal end of a suture engaging device into the body cavity subcutaneously with a first channel in the guide;
releasing the first section of suture, independent of the first self-supporting suture catcher, to be loosely disposed within the first self-supporting suture catcher;
directing a second section of suture configured to be attached to a distal end of a suture engaging device into the body cavity subcutaneously with a second channel in the guide;
releasing the second section of suture, independent of the second self-supporting suture catcher, to be loosely disposed within the second self-supporting suture catcher;
actuating the first self-supporting suture catcher to capture the first section of suture; and
actuating the second self-supporting suture catcher to capture the second section of suture.
2. The method of claim 1 , further comprising:
retracting the guide with the first self-supporting suture catcher and the second self-supporting suture catcher each in an expanded configuration.
3. The method of claim 2 , wherein retracting the guide comprises:
abutting a peritoneal wall of the body cavity with the first self-supporting suture catcher and the second self-supporting suture catcher each in an expanded configuration.
4. The method of claim 1 , further comprising:
positioning a first exit of the first channel and a second exit of the second channel beneath an outer skin surface surrounding the body cavity.
5. The method of claim 4 , wherein positioning the first exit of the first channel and the second exit of the second channel beneath the outer skin surface comprises:
retracting the guide from the body cavity only so far as a mark on a barrel of the guide is beneath the outer skin surface or is not visible above the outer skin surface.
6. The method of claim 1 , wherein:
the first self-supporting suture catcher comprises a first self-supporting snare loop;
the second self-supporting suture catcher comprises a second self-supporting snare loop; and
the deploying step comprises actuating a monolithic snare.
7. The method of claim 1 , further comprising:
retracting the guide with the captured first and second sections of suture.
8. The method of claim 7 , further comprising:
releasing the first section of suture from the first self-supporting suture catcher; and
releasing the second section of suture from the second self-supporting suture catcher.
9. The method of claim 7 , wherein retracting the guide comprises:
translating the guide in a proximal direction away from the body cavity.
10. A method for retrieving suture, comprising:
inserting a guide in a slender configuration into a body cavity;
positioning the guide in the body cavity by:
deploying within the body cavity a first self-supporting suture catcher extending from a distal portion of the guide and an opposing second self-supporting suture catcher extending from the distal portion of the guide, and
positioning a first exit of a first channel in the guide and a second exit of a second channel in the guide beneath an outer skin surface surrounding the body cavity;
directing a first section of suture configured to be attached to a distal end of a suture engaging device into the body cavity subcutaneously with the first channel in the guide;
releasing the first section of suture loosely disposed within the first self-supporting suture catcher;
directing a second section of suture configured to be attached to a distal end of a suture engaging device into the body cavity subcutaneously with the second channel in the guide;
releasing the second section of suture loosely disposed within the second self-supporting suture catcher;
actuating the first self-supporting suture catcher to capture the first section of suture against a first side portion of the guide; and
actuating the second self-supporting suture catcher to capture the second section of suture against a second side portion of the guide.
11. The method of claim 10 , further comprising:
retracting the guide with the first self-supporting suture catcher and the second self-supporting suture catcher each in an expanded configuration.
12. The method of claim 11 , wherein retracting the guide comprises:
abutting a peritoneal wall of the body cavity with the first self-supporting suture catcher and the second self-supporting suture catcher each in an expanded configuration.
13. The method of claim 11 , wherein retracting the guide comprises:
translating the guide from the body cavity only so far as an indicator on a barrel of the guide is beneath the outer skin surface or is not visible above the outer skin surface.
14. The method of claim 10 , further comprising:
retracting the guide with the captured first and second sections of suture.
15. The method of claim 10 , wherein:
the first self-supporting suture catcher comprises a first snare loop; and
the second self-supporting suture catcher comprises a second snare loop.
16. The method of claim 15 , wherein the deploying step comprises actuating a monolithic snare.
17. A method for retrieving suture, comprising:
inserting a guide in a slender configuration into a body cavity;
positioning the guide in the body cavity by:
deploying within the body cavity a first self-supporting suture catcher extending from a distal portion of the guide and an opposing second self-supporting suture catcher extending from the distal portion of the guide,
positioning a first exit of a first channel in the guide and a second exit of a second channel in the guide beneath an outer skin surface surrounding the body cavity, and
abutting a peritoneal wall of the body cavity with the first self-supporting suture catcher and the second self-supporting suture catcher each in an expanded configuration;
directing a first section of suture configured to be attached to a distal end of a suture engaging device into the body cavity subcutaneously with the first channel in the guide;
releasing the first section of suture loosely disposed within the first self-supporting suture catcher;
directing a second section of suture configured to be attached to a distal end of a suture engaging device into the body cavity subcutaneously with the second channel in the guide;
releasing the second section of suture loosely disposed within the second self-supporting suture catcher;
actuating the first self-supporting suture catcher to capture the first section of suture;
actuating the second self-supporting suture catcher to capture the second section of suture; and
retracting the guide with the captured first and second sections of suture.
18. The method of claim 17 , further comprising:
retracting the guide with the first self-supporting suture catcher and the second self-supporting suture catcher each in an expanded configuration.
19. The method of claim 18 , wherein retracting the guide comprises:
translating the guide from the body cavity only so far as an indicator on a barrel of the guide is beneath the outer skin surface.
20. The method of claim 17 , wherein:
the first self-supporting suture catcher comprises a first self-supporting snare loop; and
the second self-supporting suture catcher comprises a second self-supporting snare loop.
21. The method of claim 20 , wherein the deploying step comprises actuating a monolithic snare.