Laparoscopic port site closure tool
A device is provided to assist in closing an incision through body tissue that comprises a tubular body sized for introduction through the incision and carrying a plurality of stabilizer elements at the distal end thereof. The stabilizer elements are configured to be deployed within the body cavity to engage the lowermost tissue layer. In one method, the device is pulled with the stabilizer elements deployed to retract the body tissue away from adjacent body structure. In another method, a plurality of needle tips carrying sutures are guided through the body tissue to a retention device at the ends of the stabilizer elements. With the needle tips captured in the retention devices, the device is withdrawn from the incision so that the sutures form ligatures that can be tied off to close the incision.
1. A device for assisting in closure of an incision, the device comprising:
a tubular body for introduction through the incision, the tubular body having a distal portion, a proximal portion, and a length between the distal portion and the proximal portion; and
at least one wing element movably supported at the distal portion of the tubular body, the at least one wing element being selectively movable between a retracted position to permit insertion of the tubular body through the incision, and a deployed position where the at least one wing element extends laterally away from the tubular body,
wherein the tubular body defines a first guide channel extending, obliquely relative to a longitudinal axis of the tubular body, from a first proximal opening on a first side of the tubular body to a first distal opening on the first side, and a second guide channel extending, obliquely relative to the longitudinal axis, from a second proximal opening on a second side of the tubular body to a second distal opening on the second side, and each of the first and second guide channels is configured to direct a needle toward one or more openings defined by the at least one wing element.
2. The device of claim 1 , wherein the at least one wing element is pivotably mounted to the tubular body.
3. The device of claim 1 , further comprising an actuator, the actuator being coupled to the at least one wing element to selectively actuate the at least one wing element between at least the retracted position and the deployed position.
4. The device of claim 3 , wherein the actuator is connected to the at least one wing element via at least one actuator wire.
5. The device of claim 1 , wherein the at least one wing element includes a first wing and a second wing, each being pivotably mounted to the tubular body, and the first guide channel is configured to direct the needle to a first opening defined by the first wing, and the second guide channel is configured to direct the needle to a second opening defined by the second wing.
6. The device of claim 5 , wherein the first and second wings are substantially aligned with the tubular body in the retracted position and extend transversely outward from the tubular body in the deployed position.
7. The device of claim 5 , further comprising a first needle configured to be advanced through the first guide channel to a first opening defined by the at least one wing element, and a second needle configured to be advanced through the second guide channel to a second opening defined by the at least one wing element.
8. The device of claim 1 , wherein the at least one wing element is supported at the distal portion of the tubular body to be selectively movable to a removal position where the at least one wing element is substantially in alignment with the tubular body for removal of the tubular body through the incision.
9. The device of claim 1 , wherein the proximal portion includes a conical opening to facilitate introduction of the needle into the first and second guide channels.
10. The device of claim 1 , wherein the at least one wing element includes a rigid wing element configured to bear against tissue from within an insufflated surgical site to provide pressure to compress the tissue during insertion of a suture.
11. The device of claim 1 , wherein at least one of the one or more openings defined by the at least one wing element is aligned with one of the first and second guide channels when the at least one wing element is in the deployed position.
12. A method comprising:
introducing a tubular body through an incision in a body tissue;
deploying at least one wing element between the body tissue and a body structure adjacent the incision by actuating the at least one wing element to a deployed position; and
advancing a needle through each of a first guide channel and a second guide channel, the first guide channel extending, obliquely relative to a longitudinal axis of the tubular body, from a first proximal opening on a first side of the tubular body to a first distal opening on the first side, the second guide channel extending, obliquely relative to the longitudinal axis, from a second proximal opening on a second side of the tubular body to a second distal opening on the second side, each of the first and second guide channels directing the needle toward one or more openings of the at least one wing element.
13. The method of claim 12 , wherein deploying the at least one wing element includes deploying a first wing element and a second wing element, and the first guide channel is for directing the needle through a first opening of the first wing element, and the second guide channel is for directing the needle through a second opening of the second wing element.
14. The method of claim 12 , wherein deploying the at least one wing element includes aligning at least one of the one or more openings defined by the at least one wing element with one of the first and second guide channels.
15. The method of claim 12 , wherein advancing a needle through each of a first guide channel and a second guide channel includes advancing a first needle through the first guide channel to a first opening defined by the at least one wing element and advancing a second needle through the second guide channel to a second opening defined by the at least one wing element.
16. A device for assisting in closure of an incision, the device comprising:
a tubular body for introduction through the incision, the tubular body having a distal portion, a proximal portion, and a length between the distal portion and the proximal portion; and
at least one capture element movably supported at the distal portion of the tubular body, the at least one capture element being selectively movable between a retracted position to permit insertion of the tubular body through the incision, and a deployed position where the at least one capture element extends laterally away from the tubular body,
wherein the tubular body defines a first guide channel extending, obliquely relative to a longitudinal axis of the tubular body, from a first proximal opening on a first side of the tubular body to a first distal opening on the first side, and a second guide channel extending, obliquely relative to the longitudinal axis, from a second proximal opening on a second side of the tubular body to a second distal opening on the second side, and each of the first and second guide channels is configured to direct a needle toward one or more openings defined by the at least one capture element.
17. The device of claim 16 , wherein the at least capture element includes a first capture element and a second capture element, each being pivotably mounted at the distal portion of the tubular body, the first guide channel is configured to direct the needle to a first opening defined by the first capture element, and the second guide channel is configured to direct the needle to a second opening defined by the second capture element.
18. The device of claim 16 , wherein at least one of the one or more openings defined by the at least one capture element is aligned with one of the first and second guide channels when the at least one capture element is in the deployed position.