Apparatus and method for suturing
The invention generally relates to devices and methods for suturing tissue. The invention provides methods and devices for suturing by pushing two ends of a suture through tissue from a proximal side of the tissue and fastening the two ends together on a distal side of the tissue through one operation of a trigger.
1. A device for delivering a plurality of sutures, one at a time, into tissue of a patient, the device comprising:
a handle including a trigger;
a shaft extending from the handle along a longitudinal axis;
an applicator section configured to be movable off of the longitudinal axis, the plurality of sutures disposed within the applicator section, each of the plurality of sutures formed as a single piece with a first terminating end and a second terminating end, one of the first and second terminating ends of each of the sutures including a hook and the other one of the first and second terminating ends of each of the sutures including a loop;
a first push rod disposed at least partially within the applicator section, the first push rod comprising a first member at a distal end of the first push rod and engagable with the first terminating end of a first one of the sutures; and
a second push rod disposed at least partially within the applicator section, the second push rod comprising a second member comprising a flexible, pre-shaped portion, the second member at a distal end of the second push rod and engagable with the second terminating end of the first one of the sutures wherein the sutures further comprise a first needle interface hook on the first terminating end to interface with the first member, and a second needle interface hook on the second terminating end to interface with the second member,
operation of the trigger causing
the first member, carrying the first terminating end of the first one of the sutures, to extend out of the applicator section and penetrate the patient's tissue along a straight path,
the second member, carrying the second terminating end of the first one of the sutures, to extend straight out of the applicator section and parallel to the first member for a certain distance and then curve to approach the first member to bring the first and second terminating ends together and fasten the first one of the sutures within the patient's tissue, and
the first and second members to retract back into the applicator section and engage the first and second terminating ends of a next one of the sutures.
2. The device of claim 1 , wherein the first and second members are configured to penetrate a prosthetic mesh and the patient's tissue.
3. The device of claim 2 , wherein the first and second push rods are operable to pull the first and second members together during delivery, thereby approximating wound edges before fastening the suture.
4. The device of claim 3 , wherein the device further comprises an articulation joint disposed between the shaft and the applicator section, the articulation joint allowing movement of the applicator section off of the longitudinal axis.
5. The device of claim 4 , wherein the articulation joint comprises at least one living hinge to limit a radius of curvature of the joint.
6. The device of claim 5 , wherein the applicator section is configured to receive a cartridge loaded with the plurality of sutures.
7. The device of claim 6 , wherein the cartridge is from a set of cartridges, at least two of the cartridges in the set carrying sutures of a different size.
8. The device of claim 7 , wherein the device is configured to deliver sutures of different sizes to different penetration depths within the patient's tissue.
9. The device of claim 1 , wherein each of the hooks is tapered.
10. The device of claim 9 , wherein each of the loops comprises an aperture comprising a wide section and a narrow section, the narrow section being distal to the wide section and having a width such that the narrow section retains the terminating end comprising the hook of that suture.
11. The device of claim 9 , wherein each of the sutures is at least partially composed of a biodegradable material.
12. The device of claim 1 , wherein the single piece is of a material selected from the list consisting of a metal, a monofilament, a multifilament, a biodegradable material, a polymer, nylon, PDS, PGLA, PLA, a non-degradable material, polypropylene, polyethylene, and a nickel-titanium alloy.