Apparatus and method for minimally invasive suturing

Abstract

An apparatus and method for minimally invasive suturing is disclosed. A suturing device for minimally invasive suturing includes an elongated barrel having a proximal end, a distal end, and a longitudinal axis therebetween; a suture head assembly extending from the distal end of the elongated barrel; a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the elongated barrel, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle; and an actuator extending from the proximal end of the elongated barrel to actuate a drive mechanism having a needle driver for engaging and rotating the suturing needle.

1 . A surgical suturing apparatus, comprising:
 a) a suture housing;   b) a needle mounted within the suture housing for movement about an arcuate path;   c) a drive assembly operably associated with the needle for controlling movement of the needle with a suture secured thereto about the arcuate path in a manner facilitating application of the suture to tissue; and   d) wherein the suture housing has an open position and a closed position, and the needle can be removed from the suture housing when in the open position.   
     
     
         2 . The suturing apparatus according to  claim 1 , wherein the drive assembly moves the needle about a continuous circular path. 
     
     
         3 . The suturing apparatus according to  claim 1 , wherein the suture housing is shaped and dimensioned for insertion through a natural orifice of a patient. 
     
     
         4 . The suturing apparatus according to  claim 1 , wherein the suture housing is shaped and dimensioned for laparoscopic insertion through a trocar. 
     
     
         5 . The suturing apparatus according to  claim 1 , wherein the suture housing includes a first housing member and a second housing member, and a hinge connects the first housing member and the second housing member. 
     
     
         6 . The suturing apparatus according to  claim 1 , wherein a needle may be reloaded within the suture housing when in its open position. 
     
     
         7 . A surgical suturing apparatus shaped and dimensioned for insertion through a natural orifice of a patient, comprising:
 a) a suture housing;   b) a needle mounted within the suture housing for movement about an arcuate path;   c) a drive assembly operably associated with the needle for controlling movement of the needle with a suture secured thereto about the arcuate path in a manner facilitating application of the suture to tissue; and   d) wherein the suture housing has an open position and a closed position, wherein the needle can be removed from the suture housing when in the open position.   
     
     
         8 . A surgical suturing apparatus shaped and dimensioned for laparoscopic insertion through a trocar, comprising:
 a) a suture housing;   b) a needle mounted within the suture housing for movement about an arcuate path;   c) a drive assembly operably associated with the needle for controlling movement of the needle with a suture secured thereto about the arcuate path in a manner facilitating application of the suture to tissue; and   d) wherein the suture housing has an open position and a closed position, wherein the needle can be removed from the suture housing when in the open position.   
     
     
         9 . A surgical suturing apparatus, comprising:
 a) a suture housing;   b) a needle having a proximal end and a distal end, the needle being mounted within the suture housing for movement about an arcuate path;   c) a drive assembly operably associated with the needle for controlling movement of the needle with a suture secured thereto about the arcuate path in a manner facilitating application of the suture to tissue; and   d) means for determining the position of a predetermined point on the needle relative to the needle's path of travel when the predetermined point not visually detectable.   
     
     
         10 . A surgical suturing apparatus, comprising:
 a) a suture housing;   b) a needle mounted within the suture housing for movement about an arcuate path;   c) a drive assembly operably associated with the needle for controlling movement of the needle with a suture secured thereto about an arcuate path in a first direction in a manner facilitating application of the suture to tissue; and   d) an anti-backup mechanism associated with the needle for preventing movement of the needle in a second direction opposite to the first direction.   
     
     
         11 . The suturing apparatus according to  claim 10 , wherein the drive assembly moves the needle about a continuous circular path. 
     
     
         12 . The suturing apparatus according to  claim 10 , wherein the suture housing is shaped and dimensioned for insertion through a natural orifice of a patient. 
     
     
         13 . The suturing apparatus according to  claim 10 , wherein the suture housing is shaped and dimensioned for laparoscopic insertion through a trocar. 
     
     
         14 . The suturing apparatus according to  claim 10 , wherein the anti-backup mechanism includes a lever arm secured to the suture housing for selectively engaging the needle. 
     
     
         15 . The suturing apparatus according to  claim 14 , wherein the lever arm is pivotally secured to the suture housing. 
     
     
         16 . The suturing apparatus according to  claim 10 , wherein the anti-backup mechanism includes a biased latch mounted within the suture housing for selectively engaging the needle. 
     
     
         17 . The suturing apparatus according to  claim 10 , wherein the anti-backup mechanism further prevents the needle from moving between actuations of the drive assembly. 
     
     
         18 . A surgical suturing apparatus shaped and dimensioned for insertion through a natural orifice of a patient, comprising:
 a) a suture housing;   b) a needle mounted within the suture housing for movement about an arcuate path;   c) a drive assembly operably associated with the needle for controlling movement of the needle with a suture secured thereto about an arcuate path in a first direction in a manner facilitating application of the suture to tissue; and   d) an anti-backup mechanism associated with the needle for preventing movement of the needle in a second direction opposite to the first direction.   
     
     
         19 . The suturing apparatus according to  claim 18 , wherein the drive assembly moves the needle about a continuous circular path. 
     
     
         20 . The suturing apparatus according to  claim 18 , wherein the anti-backup mechanism includes a lever arm secured to the suture housing for selectively engaging the needle. 
     
     
         21 . The suturing apparatus according to  claim 18 , wherein the anti-backup mechanism includes a biased latch mounted within the suture housing for selectively engaging the needle. 
     
     
         22 . A surgical suturing apparatus shaped and dimensioned for laparoscopic insertion through a trocar, comprising:
 a) a suture housing;   b) a needle mounted within the suture housing for movement about an arcuate path;   c) a drive assembly operably associated with the needle for controlling movement of the needle with a suture secured thereto about an arcuate path in a first direction in a manner facilitating application of the suture to tissue; and   d) an anti-backup mechanism associated with the needle for preventing movement of the needle in a second direction opposite to the first direction.   
     
     
         23 . The suturing apparatus according to  claim 22 , wherein the drive assembly moves the needle about a continuous circular path. 
     
     
         24 . The suturing apparatus according to  claim 22 , wherein the anti-backup mechanism includes a lever arm secured to the suture housing for selectively engaging the needle. 
     
     
         25 . The suturing apparatus according to  claim 22 , wherein the anti-backup mechanism includes a biased latch mounted within the suture housing for selectively engaging the needle. 
     
     
         26 . A surgical suturing apparatus, comprising:
 a) a flexible member having a proximal end and a distal end, the proximal end having a handle attached thereto, the distal end having a suturing body attached thereto, wherein the handle is operatively connected to the suturing body;   b) the suturing body comprising a suture housing in which a needle and drive assembly are housed for movement of the needle with a suture secured thereto about an arcuate path facilitating application of a suture to tissue; and   c) means for accommodating and operating different sized needles and different sized sutures while maintaining the operative connection between the handle and the suturing body.   
     
     
         27 . The suturing apparatus according to  claim 26 , wherein the means for accommodating includes a cartridge housing the needle. 
     
     
         28 . The suturing apparatus according to  claim 26 , wherein the drive assembly moves the needle about a continuous circular path. 
     
     
         29 . The suturing apparatus according to  claim 26 , wherein the suture housing is shaped and dimensioned for insertion through a natural orifice of a patient. 
     
     
         30 . The suturing apparatus according to  claim 26 , wherein the suture housing is shaped and dimensioned for laparoscopic insertion through a trocar. 
     
     
         31 . A surgical suturing apparatus shaped and dimensioned for insertion through a natural orifice of a patient, comprising:
 a) a flexible member having a proximal end and a distal end, the proximal end having a handle attached thereto, the distal end having a suturing body attached thereto, wherein the handle is operatively connected to the suturing body;   b) the suturing body comprising a suture housing in which a needle and drive assembly are housed for movement of the needle with a suture secured thereto about an arcuate path facilitating application of a suture to tissue; and   c) means for accommodating and operating different sized needles and different sized sutures while maintaining the operative connection between the handle and the suturing body.   
     
     
         32 . The suturing apparatus according to  claim 31 , wherein the means for accommodating includes a cartridge housing the needle. 
     
     
         33 . A surgical suturing apparatus shaped and dimensioned for laparoscopic insertion through a trocar, comprising:
 a) a flexible member having a proximal end and a distal end, the proximal end having a handle attached thereto, the distal end having a suturing body attached thereto, wherein the handle is operatively connected to the suturing body;   b) the suturing body comprising a suture housing in which a needle and drive assembly are housed for movement of the needle with a suture secured thereto about an arcuate path facilitating application of a suture to tissue; and   c) means for accommodating and operating different sized needles and different sized sutures while maintaining the operative connection between the handle and the suturing body.   
     
     
         34 . The suturing apparatus according to  claim 33 , wherein the means for accommodating includes a cartridge housing the needle. 
     
     
         35 . A method for suture lacing, comprising:
 a) providing a suture with a needle attached thereto;   b) inserting the needle and suture into an organ through a passageway;   c) throwing a single stitch through a first tissue member, throwing a single stitch through an opposed and spaced apart second tissue member;   d) repeating step (c) at least once;   e) bringing the first and second tissue members in contact by tensioning the suture, whereby suture drag is minimized during the tensioning and even tissue compression substantially achieved; and   f) securing the suture.   
     
     
         36 . The method according to  claim 35 , wherein the suture includes first and second leads, and the step of securing includes knotting the first and second leads of the suture. 
     
     
         37 . The method according to  claim 35 , wherein the suture includes first and second leads and the step of securing includes anchoring at least one of the first and second leads of the suture to tissue. 
     
     
         38 . The method according to  claim 37 , wherein the step of securing includes anchoring both the first and second leads of the suture to tissue. 
     
     
         39 . The method according to  claim 35 , wherein the step of inserting includes insertion through a natural orifice of a patient. 
     
     
         40 . The method according to  claim 35 , wherein the step of inserting includes insertion through a trocar. 
     
     
         41 . A method for suture lacing, comprising:
 a) inserting a needle with a suture secured thereto through a passageway, wherein the suture includes a first lead and a second lead;   b) anchoring the first lead of the suture to a first tissue member;   c) alternately throwing the suture through a first tissue member and an opposed second tissue member; and   d) securing the suture.   
     
     
         42 . The method according to  claim 41 , further including the step of anchoring the second lead to either the first tissue member or the second tissue member. 
     
     
         43 . The method according to  claim 41 , wherein the step of inserting includes insertion through a natural orifice of a patient. 
     
     
         44 . The method according to  claim 41 , wherein the step of inserting includes insertion through a trocar.