Suture passing surgical instrument

Abstract

A surgical instrument includes first and second members configured to receive tissue therebetween. The first member is adapted to receive suture, the second member is coupled to the first member, and a grasper coupled to the second member engages the suture received by the first member. A method of passing suture includes loading suture into a first member of a suture passing surgical instrument, stabilizing tissue between the first member and a second member of the surgical instrument, passing suture through tissue via the first member of the surgical instrument, holding the passed suture via a suture grasper of the surgical instrument, and removing the first member from the tissue.

1 - 37 . (canceled)  
   
   
       38 . Suturing instrumentation adapted for use with a needle having a sharpened distal tip and attachable to a length of suture material, the instrumentation comprising: 
 an elongated member having a distal end terminating in a nonlinear portion; and a trocar configured for introduction into the elongated member, and    the member having a linear slot to receive a linear needle, the trocar including a distal end operative to push the needle through the nonlinear portion, such that when the distal end of the member is positioned proximate to a tissue to be sutured and the needle is pushed by the distal end of the trocar through the nonlinear portion, the needle is deformed, causing the needle and suture material to enter into the tissue such that at least a portion of a distal tip of the needle protrudes from the tissue.    
   
   
       39 . The suturing instrumentation as set forth in  claim 38 , wherein: the elongated member defines a primary axis; and the nonlinear portion is off-axis.  
   
   
       40 . The suturing instrumentation as set forth in  claim 38 , wherein: the slot enabling the suture material to extend therefrom as the needle is pushed through the nonlinear portion.  
   
   
       41 . The suturing instrumentation as set forth in  claim 38 , wherein the needle comprises a malleable needle.  
   
   
       42 . The suturing instrumentation as set forth in  claim 38 , wherein the needle comprises a deflectable needle.  
   
   
       43 . Suturing instrumentation adapted for use with a needle having a sharpened distal tip and attachable to a length of suture material, the instrumentation comprising: 
 an elongated member having a distal end terminating in a nonlinear portion;    a trocar configured for introduction into the elongated member,    the member having a linear slot to receive a linear needle, the trocar including a distal end operative to push the needle through the nonlinear portion,    such that when the distal end of the member is positioned proximate to a tissue to be sutured and the needle is pushed by the distal end of the trocar through the nonlinear portion, the needle is deformed, causing the needle and suture material to enter into the tissue such that a least a portion of a distal tip of the needle protrudes from the tissue; and    a jaw coupled to the distal end of the member for holding tissue as the needle enters into the tissue and for retaining the needle upon exiting the tissue.    
   
   
       44 . The suturing instrumentation as set forth in  claim 43 , wherein the jaw includes an aperture, slot, or cavity to receive and retain the deformed needle upon exiting the tissue.  
   
   
       45 . The suturing instrumentation as set forth in  claim 43 , wherein: the elongated member defines a primary axis; and the nonlinear portion is off-axis.  
   
   
       46 . The suturing instrumentation as set forth in  claim 43 , wherein: the slot-enabling the suture material to extend therefrom as the needle is pushed through the nonlinear portion by the trocar.  
   
   
       47 . The suturing instrumentation as set forth in  claim 43 , further including a manually operated control enabling a user to open and close the jaw.  
   
   
       48 . The suturing instrumentation as set forth in  claim 43 , wherein the needle comprises a malleable needle.  
   
   
       49 . The suturing instrumentation as set forth in  claim 43 , wherein the needle comprises a deflectable needle.  
   
   
       50 . Suturing instrumentation adapted for use with a needle having a sharpened distal tip and attachable to a length of suture material, the instrumentation comprising: 
 a hand-held tool having proximal and distal ends;    an elongated member extending the length of the tool and terminating distally in a nonlinear portion;    the member having a linear slot to receive a linear needle,    a trocar having a distal end disposed within the elongated member and an exposed proximal end,    such that when the distal end of the member is positioned proximate to a tissue to be sutured and the exposed proximal end of the trocar is pushed, the needle inelastically deforms as it passes through the nonlinear portion, causing the needle and suture material to enter into the tissue such that at least a portion of a distal tip of the needle protrudes from the tissue;    a pivoting jaw at the distal end of the member for holding tissue as the needle enters into the tissue and for retaining the needle upon exiting the tissue; and    a manually operated control at the proximal end of the hand-held tool enabling a user to open and close the jaw.    
   
   
       51 . The suturing instrumentation as set forth in  claim 50 , wherein: the slot-enabling the suture material to extend therefrom as the needle is pushed through the nonlinear portion.  
   
   
       52 . The suturing instrumentation as set forth in  claim 50 , wherein the jaw includes an aperture, slot, or cavity to receive and retain the deformed needle upon exiting the tissue.  
   
   
       53 . The suturing instrumentation as set forth in  claim 50 , wherein: the elongated member defines a primary axis; and the nonlinear portion is off-axis.  
   
   
       54 . The suturing instrumentation as set forth in  claim 50 , wherein the needle comprises a malleable needle.  
   
   
       55 . The suturing instrumentation as set forth in  claim 50 , wherein the needle comprises a deflectable needle.  
   
   
       56 . Suturing instrumentation, comprising: 
 a linear needle having a sharpened distal tip and attachable to a length of suture material;    an elongated member having a distal end terminating in a nonlinear portion; and    a trocar configured for introduction into the elongated member, the trocar including a distal end operative to push the needle through the nonlinear portion,    such that when the distal end of the member is positioned proximate to a tissue to be sutured and the needle is pushed by the distal end of the trocar through the nonlinear portion, the needle is deformed by the nonlinear portion, causing the needle and suture material to enter into the tissue such that at least a portion of a distal tip of the needle protrudes from the tissue.    
   
   
       57 . The suturing instrumentation as set forth in  claim 56 , wherein: the elongated member defines a primary axis; and the nonlinear portion is off-axis.  
   
   
       58 . The suturing instrumentation as set forth in  claim 56 , wherein: the distal end of the member includes an elongated slot to receive the needle enabling the suture material to extend therefrom as the needle is pushed through the nonlinear portion.  
   
   
       59 . The suturing instrumentation as set forth in  claim 56 , further including a pivoting jaw at the distal end of the member for holding tissue as the needle enters into the tissue and for retaining the needle upon exiting the tissue.  
   
   
       60 . The suturing instrumentation as set forth in  claim 59 , wherein the jaw includes an aperture, slot, or cavity to receive and retain the deformed needle.  
   
   
       61 . The suturing instrumentation as set forth in  claim 59 , further including a manually operated control enabling a user to open and close the jaw.  
   
   
       62 . The suturing instrumentation as set forth in  claim 56 , wherein the needle and elongated member have at least one flat side to resist rotation of the needle as it passes through the non-linear portion.  
   
   
       63 . The suturing instrumentation as set forth in  claim 56 , wherein the needle and elongated member have opposing flat sides to resist rotation of the needle as it passes through the non-linear portion.  
   
   
       64 . The suturing instrumentation as set forth in  claim 56 , further comprising a jaw at the distal end of the member, the jaw including an aperture, slot, or cavity to receive and retain the needle.  
   
   
       65 . The suturing instrumentation as set forth in  claim 56 , wherein the needle comprises a malleable needle.  
   
   
       66 . The suturing instrumentation as set forth in  claim 56 , wherein the needle comprises a deflectable needle.  
   
   
       67 . A suture needle adapted for use with a substantially rigid cannula defining an axis and having an off-axis distal end, the needle comprising: 
 a length of material attachable to a suture on a lateral surface of the needle at a distance from a proximal end of the needle and a sharpened distal tip; and    the needle being formed such that when the needle is pushed through the cannula, it inelastically deforms in accordance with the off-axis distal end.    
   
   
       68 . The suture needle as set forth in  claim 67 , wherein the length of material includes one or more flat sides to resist rotation particularly as the needle passes through the off-axis portion of the cannula.  
   
   
       69 . The suture needle as set forth in  claim 68 , wherein the length of material includes opposing flat sides.  
   
   
       70 . The suture needle as set forth in  claim 67 , wherein the needle comprises a malleable needle.  
   
   
       71 . The suture needle as set forth in  claim 67 , wherein the needle comprises a deflectable needle.  
   
   
       72 . Suturing instrumentation for suturing tissue comprising: a needle portion having a sharpened distal tip and constructed and arranged to deliver a length of suture material to the tissue; 
 a handheld instrument having a passageway and having a distal end terminating in a nonlinear portion; and    a force-supplying structure configured for applying a force to the needle portion,    wherein the force-supplying structure includes a distal end capable of pushing the needle portion through the nonlinear portion, such that when the distal end of the handheld instrument is positioned proximate to the tissue to be sutured and the needle portion is pushed by the distal end of the force-supplying structure through the nonlinear portion, the needle portion is deformed, thereby causing the needle portion to deliver the suture material to the tissue.    
   
   
       73 . The suturing instrumentation of  claim 72 , wherein the handheld instrument includes a proximal insertion opening to receive the distal end of the force-supplying structure.  
   
   
       74 . The suturing instrumentation of  claim 72 , wherein the distal end of the handheld instrument includes an elongated slot to receive the needle portion enabling the suture material to extend therefrom as the needle portion is pushed through the nonlinear portion.  
   
   
       75 . The suturing instrumentation of  claim 72 , wherein the needle portion has a degree of spring back of from 0 to about 100 percent.  
   
   
       76 . The suturing instrumentation of  claim 72 , wherein the needle portion comprises a Nitinol needle.  
   
   
       77 . The suturing instrumentation of  claim 76 , wherein the Nitinol needle is substantially linear in shape, further wherein the Nitinol needle is forcibly deformed through the nonlinear portion of the handheld instrument.  
   
   
       78 . The suturing instrumentation of  claim 72 , wherein the needle comprises a malleable needle.  
   
   
       79 . The suturing instrumentation of  claim 72 , wherein the needle comprises a deflectable needle.  
   
   
       80 . Suturing instrumentation for suturing tissue comprising: a needle portion having a sharpened distal tip and constructed and arranged to deliver a length of suture material to the tissue; 
 a handheld instrument having a passageway and having a distal end terminating in a nonlinear portion; and    a force supplying structure configured for applying a force to the needle portion,    wherein the force supplying structure includes a distal end capable of pushing the needle portion through the nonlinear portion, such that when the distal end of the handheld instrument is positioned proximate to the tissue to be sutured and the needle portion is pushed by the distal end of the force supplying structure through the nonlinear portion, the needle portion is deformed, thereby causing the needle portion to deliver the suture material to the tissue; and    a jaw at the distal end of the handheld instrument for holding tissue as the needle portion and suture material enters into the tissue.    
   
   
       81 . The suturing instrumentation of  claim 80 , wherein the jaw includes an aperture, slot, or cavity to receive the deformed needle portion.  
   
   
       82 . The suturing instrumentation of  claim 80 , wherein the handheld instrument includes a proximal insertion opening to receive the distal end of the force-supplying structure.  
   
   
       83 . The suturing instrumentation of  claim 80 , wherein the distal end of the handheld instrument includes an elongated slot to receive the needle portion enabling the suture material to extend therefrom as the needle portion is pushed through the nonlinear portion.  
   
   
       84 . The suturing instrumentation of  claim 80 , wherein the needle portion comprises a Nitinol needle.  
   
   
       85 . The suturing instrumentation of  claim 80 , further including a manually operated control enabling a user to open and close the jaw.  
   
   
       86 . The suturing instrumentation of  claim 80 , wherein the jaw pivots.  
   
   
       87 . The suturing instrumentation of  claim 80 , wherein the needle comprises a malleable needle.  
   
   
       88 . The suturing instrumentation of  claim 80 , wherein the needle comprises a deflectable needle.  
   
   
       89 . A suture needle adapted for use with a handheld instrument defining an axis and having an off-axis distal end, the needle comprising: 
 a length of material having a sharpened distal tip and constructed and arranged to deliver a length of suture material; and    the needle being formed such that when the needle is pushed through the handheld instrument, it deforms in accordance with the off-axis distal end.    
   
   
       90 . The suture needle of  claim 89 , wherein the length of material includes one or more flat sides to resist rotation as the needle passes through the off-axis portion of the handheld instrument.  
   
   
       91 . The suture needle of  claim 90 , wherein the length of material includes opposing flat sides.  
   
   
       92 . The suture needle of  claim 89 , wherein the needle comprises a malleable needle.  
   
   
       93 . The suture needle of  claim 89 , wherein the needle comprises a deflectable needle.  
   
   
       94 . A suturing system comprising: 
 a needle portion having a sharpened distal tip and constructed and arranged to deliver a length of suture material;    a handheld instrument having a passageway and having a distal end terminating in a nonlinear portion; and    a push member configured for movement in the passageway of the handheld instrument, the push member being operative to push the needle portion through the nonlinear portion, such that when the distal end of the handheld instrument is positioned proximate to a tissue to be sutured and the needle portion is pushed by the push member through the nonlinear portion, the needle portion is deformed and enters into the tissue and delivers the suture material to the tissue being sutured.    
   
   
       95 . The suturing system of  claim 94 , wherein the needle portion is substantially straight when in at least a portion of the passageway, curved when in the distal end, and curved upon exiting the distal end of the handheld instrument.  
   
   
       96 . The suturing system of  claim 94 , wherein the needle portion is substantially straight when in at least a portion of the passageway, deformed when in the distal end, and substantially straight upon exiting the distal end of the handheld instrument.  
   
   
       97 . The suturing system of  claim 94 , wherein the needle portion comprises a Nitinol needle.  
   
   
       98 . The suturing system of  claim 94 , wherein the needle comprises a malleable needle.  
   
   
       99 . The suturing system of  claim 94 , wherein the needle comprises a deflectable needle.  
   
   
       100 . A method for suturing, comprising the steps of: 
 providing a needle portion having a sharpened distal tip;    positioning the needle portion in a passageway of a handheld instrument;    providing a suture material to be delivered by the needle portion; and    using a push member to push the needle portion in the handheld instrument, the needle portion upon exiting the handheld instrument penetrating the tissue being sutured and delivering the suture material to the tissue being sutured.    
   
   
       101 . The method of  claim 100 , wherein the handheld instrument has a distal end terminating in a nonlinear portion, and the needle portion is deformed as it traverses the nonlinear portion.  
   
   
       102 . The method of  claim 100 , wherein the needle portion comprises a Nitinol needle.  
   
   
       103 . The method of  claim 100 , wherein the needle portion comprises a malleable needle.  
   
   
       104 . The method of  claim 100 , wherein the needle portion comprises a deflectable needle.  
   
   
       105 . A suture passing instrument, comprising: 
 an elongated member having a proximal end and a distal end, the member comprising at least one axial throughbore for receiving a tissue penetrating element therein;    a tip and a jaw provided at the distal end of the member, a first of the tip and jaw being integral with the member and the second of the tip and jaw being pivotable with respect to the first of the tip and the jaw, one of the tip and jaw including at least one axial bore in communication with the axial throughbore of the tubular member for receiving the tissue penetrating element, and the other of the tip and jaw comprising a distal transverse opening aligned with the axial bore of the one of the tip and jaw for receiving the tissue penetrating element therein.    
   
   
       106 . The suture passing instrument of  claim 105 , wherein the tip further comprises a slot for receiving suture.  
   
   
       107 . The suture passing instrument of  claim 106 , wherein the slot is orthogonal to the at least one axial bore.  
   
   
       108 . The suture passing instrument of  claim 105 , wherein the member comprises another axial throughbore for receiving an actuator.  
   
   
       109 . The suture passing instrument of  claim 105 , wherein the distal transverse opening is an open slot.  
   
   
       110 . The suture passing instrument of  claim 105 , further comprising a pusher provided at the proximal end of the member and comprising a pusher axial bore in communication with both the axial throughbore of the member and the axial bore.  
   
   
       111 . The suture passing instrument of  claim 105 , wherein the jaw further comprises a plurality of teeth for gripping tissue.  
   
   
       112 . The suture passing instrument of  claim 105 , wherein the tissue penetrating element is superelastic.  
   
   
       113 . The suture passing instrument of  claim 112 , wherein the tissue penetrating element comprises nitinol.  
   
   
       114 . A method of suturing tissue, comprising the steps of: 
 positioning a suture passing instrument in the proximity of a tissue to be sutured, the suture passing instrument being formed of an elongated member having a proximal end and a distal end, the member comprising at least one axial throughbore for receiving a shape-memory tissue penetrating element therein; a tip and a jaw provided at the distal end of the member, a first of the tip and jaw being integral with the member and a second of the tip and jaw being pivotable with respect to the first of the tip and jaw, one of the tip and jaw including at least one axial bore in communication with the axial throughbore of the member; and the other of the tip and jaw being provided with a distal transverse opening aligned with the axial bore of the one of the tip and jaw for receiving the tissue penetrating element therein;    placing a strand of suture within a slot of the one of the tip and jaw, the slot being substantially orthogonal to and intersecting the axial bore of the one of the tip and jaw;    moving the tissue penetrating element through the axial throughbore of the one of the tip and jaw to engage the strand of suture and penetrate the tissue to be sutured with the tissue penetrating element and the suture.    
   
   
       115 . The method of  claim 114 , further comprising the step of retrieving the tissue penetrating element from at least one of the tip and jaw subsequent to the step of penetrating the tissue to be sutured.  
   
   
       116 . The method of  claim 115 , further comprising the steps of forming a suture loop in the tissue to be sutured and pulling the suture through the tissue to be sutured.  
   
   
       117 . The method of  claim 114 , wherein the step of advancing the tissue penetrating element through the axial throughbore of the member and the one of the tip and jaw further comprises actuating a pusher provided at the proximal end of the member.  
   
   
       118 . The method of  claim 114 , wherein the tissue penetrating element comprises nitinol.  
   
   
       119 . The method of  claim 114 , wherein the distal transverse opening has an open slot configuration.