Surgical suturing instrument and method of use

Abstract

A device is disclosed for joining a first layer of material to a second layer of material, the device comprising a handle, a first jaw and a second jaw mounted on the handle, at least one of the first jaw and the second jaw being moveable relative to the other; the first jaw defining therein: a first channel for retaining a wire guide; a second channel extending from the first channel for supporting a suture wire extending from the wire guide; and a passageway for retaining a cutting bar; the second channel being curved to impart a looping configuration to portions of the suture wire passed therethrough; a wire advancing actuator mounted on the handle for moving the suture wire through the second channel and through the first and second layers of material in the looping configuration; and a wire cutting actuator mounted on the handle for moving the cutting bar into cutting engagement with the suture wire, wherein the suture wire in the looping configuration joins the first layer of material to the second layer of material.

1 . A tool for joining a first layer of material to a second layer of material, said tool comprising: 
 a handle;    a first jaw and a second jaw mounted on said handle, at least one of said first jaw and said second jaw being moveable relative to the other;    said first jaw defining therein: 
 a first channel for retaining a wire guide;  
 a second channel extending from the first channel for supporting a suture wire extending from the wire guide; and  
 a passageway for retaining a cutting bar;  
 said second channel being curved to impart a looping configuration to portions of the suture wire passed therethrough;  
   a wire advancing actuator mounted on said handle for moving the suture wire through said second channel and through the first and second layers of material in said looping configuration; and    a wire cutting actuator mounted on said handle for moving the cutting bar into cutting engagement with the suture wire, wherein the suture wire in said looping configuration joins the first layer of material to the second layer of material.    
     
     
         2 . A tool in accordance with  claim 1  wherein said first jaw is moveable relative to said handle.  
     
     
         3 . A tool in accordance with  claim 1  wherein said second jaw is moveable relative to said handle.  
     
     
         4 . A tool in accordance with  claim 1  wherein both of said first jaw and said second jaw are moveable relative to said handle.  
     
     
         5 . A tool in accordance with  claim 1  wherein said first jaw and said second jaw are rotatable about a longitudinal axis of said tool.  
     
     
         6 . A tool in accordance with  claim 1  wherein said first jaw and said second jaw define a first surface and a second surface in opposition to one another, respectively, and further wherein said first surface and said second surface are positionable to provide sufficient clearance for formation of said looping configuration therebetween whereby the geometry of said second channel solely imparts the curvature of said looping configuration.  
     
     
         7 . A tool in accordance with  claim 1  wherein said first jaw and said second jaw define a first surface and a second surface opposed to one another, respectively, and further wherein said second surface contains a recess therein corresponding to said looping configuration of the suture wire received from said first jaw.  
     
     
         8 . A tool in accordance with  claim 7  wherein said recess of said second surface is positionable to act as a deflecting anvil on the suture wire received from said first jaw.  
     
     
         9 . A tool in accordance with  claim 1  wherein said second jaw is bifurcated into a first arm and a second arm whereby said looping configuration of the suture wire is formable between said first arm and said second arm.  
     
     
         10 . A tool in accordance with  claim 1  wherein said first jaw and said second jaw define a first surface and a second surface opposed to one another, respectively, and further wherein said first surface contains a recess therein corresponding to a returning portion of said looping configuration of the suture wire.  
     
     
         11 . A tool in accordance with  claim 10  wherein said recess of said first surface is positionable to act as a deflecting anvil on said returning portion of said looping configuration of the suture wire.  
     
     
         12 . A tool in accordance with  claim 1  wherein said first jaw and said second jaw define a first surface and a second surface opposed to one another, respectively, and said first surface and said second surface each contain serrations corresponding to one another.  
     
     
         13 . A tool according to  claim 1  wherein the first layer of material and the second layer of material are tissue.  
     
     
         14 . A tool according to  claim 1  wherein the first layer of material comprises an implantable device.  
     
     
         15 . A tool according to  claim 14  wherein said implantable device comprises one of a group consisting of a piece of hernia mesh and a prosthetic valve.  
     
     
         16 . A method for joining a first layer of material and a second layer of material, said method comprising: 
 providing a tool for joining a first layer of material to a second layer of material, said tool comprising: 
 a handle;  
 a first jaw and a second jaw mounted on said handle, at least one of said first jaw and said second jaw being moveable relative to the other;  
 said first jaw defining therein: 
 a first channel for retaining a wire guide;  
 a second channel extending from the first channel for supporting a suture wire extending from the wire guide; and  
 a passageway for retaining a cutting bar;  
 said second channel being curved to impart a looping configuration to portions of the suture wire passed therethrough;  
 
 a wire advancing actuator mounted on said handle for moving the suture wire through said second channel and through the first and second layers of material in said looping configuration; and  
 a wire cutting actuator mounted on said handle for moving the cutting bar into cutting engagement with the suture wire, wherein the suture wire in said looping configuration joins the first layer of material to the second layer of material;  
   placing the first layer of material and the second layer of material between said first jaw and said second jaw;    advancing the suture wire out of said first jaw to form said looping configuration of the suture wire through the first layer of material and the second layer of material between said first jaw and said second jaw so as to join the first layer and the second layer to one another;    advancing said cutting bar through the suture wire so as to sever said looping configuration of the suture wire and a remaining portion of the suture wire in said second channel from one another.    
     
     
         17 . A method according to  claim 16  further comprising the step of closing said first jaw and said second jaw toward one another so as to grip the first layer of material and the second layer of material prior to the step of advancing the suture wire therethrough.  
     
     
         18 . A method according to  claim 16  further comprising the step of opening said first jaw and said second jaw away from one another so as to release the first layer and second layer joined to one another after the step of advancing said cutting bar through the suture wire.  
     
     
         19 . A method according to  claim 16  further comprising, after severing said looping configuration, the step of compressing said looping configuration so as to reduce the height thereof and tighten fixation of said first and second layers.  
     
     
         20 . A method according to  claim 19  wherein compressing of said looping configuration is accomplished using said first and second jaws.  
     
     
         21 . A method according to  claim 19  wherein compressing of said looping configuration is accomplished using a separate forceps-type tool.