Flexible suturing instrument

Abstract

A suturing instrument includes a handle, an elongate shaft, and a suturing head. One or more pull wires extend from the handle into the elongate shaft for controllably deflecting a deflectable portion of the elongate shaft in one or more directions and/or planes for improved maneuverability within the body of a patient during an endoscopic or laparoscopic surgical procedure and for changing the positioning of the suturing head.

1 . A suturing instrument, comprising
 a handle;   an elongate shaft extending from the handle, at least a portion of the elongate shaft being flexible;   one or more pull wires extending from the handle into the flexible portion of the elongate shaft for deflecting the flexible portion of elongate shaft; and   a suturing head extending from a distal end of the elongate shaft, the suturing head comprising a needle carrier channel, a needle carrier configured to releasably hold a needle, and a needle catch, the needle carrier being movably disposed within the needle carrier channel.   
     
     
         2 . The suturing instrument of  claim 1  wherein the needle carrier moves along the needle carrier channel out of the suturing head into an extended position, and back into the suturing head into a retracted position. 
     
     
         3 . The suturing instrument of  claim 2  further comprising a needle deployment system at least partially disposed within the elongate shaft and coupled to needle carrier for moving the needle carrier between the extended position and the retracted position. 
     
     
         4 . The suturing instrument of  claim 3  wherein the needle deployment system moves the needle carrier out of the suturing head in a semi-circular path towards the needle catch such that the needle held by the needle carrier is released from the needle carrier and retained in the needle catch. 
     
     
         5 . The suturing instrument of  claim 3  wherein the handle includes an actuating mechanism coupled to the needle deployment system for actuating the needle deployment system. 
     
     
         6 . The suturing instrument of  claim 1  wherein the handle includes a control system coupled to the one or more pull wires for controlling deflection of the flexible portion of the elongate shaft. 
     
     
         7 . The suturing instrument of  claim 6  wherein the control system includes a rotatable cam coupled to the one or more pull wires. 
     
     
         8 . The suturing instrument of  claim 6  wherein the control system includes one or more knobs, hubs or levers attached to the one or more pull wires. 
     
     
         9 . The suturing instrument of  claim 1  wherein the elongate shaft is capable of being deflected into multiple different planes relative to a longitudinal axis of the elongate shaft. 
     
     
         10 . The suturing instrument of  claim 1  wherein the elongate shaft comprises a flexible coil. 
     
     
         11 . The suturing instrument of  claim 10  wherein the flexible coil comprises a Bowden coil. 
     
     
         12 . The suturing instrument of  claim 10  wherein the elongate shaft further includes an outer sleeve disposed on the outside of the flexible coil to provide a smooth exterior surface. 
     
     
         13 . The suturing instrument of  claim 1  wherein at least a portion of the elongate shaft includes an articulation structure. 
     
     
         14 . The suturing instrument of  claim 13  wherein the flexible portion of the elongate shaft includes an articulation structure. 
     
     
         15 . The suturing instrument of  claim 13  wherein the articulation structure comprises a series of stacked links disposed adjacent to one another and movable with respect to each other, each link including a front face tapered to a pair of pivot points and a rear face defining a wedge shaped recess for receiving the pivot points of the adjacent link, and wherein said one or more pull-wires are configured for providing tension to the articulation structure and holding the adjacent links together. 
     
     
         16 . The suturing instrument of  claim 13  wherein the articulation structure comprises:
 a first articulation section, the first articulation section includes a first series of stacked links disposed adjacent to one another and movable with respect to each other, each link including a front face tapered to a pair of pivot points and a rear face defining a wedge shaped recess for receiving the pivot points of the adjacent link; 
 a second articulation section, the second articulation section includes a second series of stacked links disposed adjacent to one another and movable with respect to each other, each link including a front face tapered to a pair of pivot points and a rear face defining a wedge shaped recess for receiving the pivot points of the adjacent link, the wedge shaped recesses of the first articulation section radially offset from the wedge shaped recesses of the second articulation section; 
 wherein said one or more pull wires are configured for providing tension to the articulation structure and holding the adjacent links together. 
 
     
     
         17 . The suturing instrument of  claim 13  wherein said articulation structure comprises:
 a number of ring links, each having an inner circumference and an outer circumference, each ring link including: 
 two concave recesses with openings that face radially outward from the outer circumference of the ring link that are positioned on opposite sides of the outer circumference of the ring link; and 
 two concave recesses with openings that face radially inward from the inner circumference of the ring link that are positioned on opposite sides of the inner circumference of the ring link and are oriented at 90 degrees to the two concave recesses positioned on opposite sides of the outer circumference of the ring link; and 
 a plurality of spring segments that are secured within the concave recesses on the outer circumferences and inner circumferences of the ring links to join adjacent ring links together and that are bendable in the articulating joint; 
 wherein the concave recesses on the outer circumference of a given ring link are aligned with the concave recesses on the inner circumference of an adjacent ring link in the articulating joint. 
 
     
     
         18 . The suturing instrument of  claim 17  wherein the spring segments define apertures adapted to receive the one or more pull wires therethrough. 
     
     
         19 . A suturing instrument, comprising
 a handle including a control system;   an elongate shaft extending from the handle, the elongate shaft including a distal portion, at least a portion of the elongate shaft being flexible;   one or more pull wires extending from the handle into the distal portion of the elongate shaft, the one or more pull wires coupled to the control system to allow active control of the flexible portion of the elongate shaft; and   a suturing head extending from a distal end of the distal portion of the elongate shaft, the suturing head comprising a needle carrier channel, a needle carrier configured to releasably hold a needle, and a needle catch, the needle carrier being movably disposed within the needle carrier channel.   
     
     
         20 . A suturing instrument, comprising
 a handle;   an elongate shaft extending from the handle, the elongate shaft including a distal portion, at least a portion of the shaft being flexible and including an articulation structure;   one or more pull wires extending from the handle into the distal portion of the elongate shaft for deflecting the articulated portion of elongate shaft; and   a suturing head extending from a distal end of the distal portion of the elongate shaft, the suturing head comprising a needle carrier channel, a needle carrier configured to releasably hold a needle, and a needle catch, the needle carrier being movably disposed within the needle carrier channel.