Devices and methods for surgical suturing

Abstract

An apparatus and a method for surgical suturing with thread management. An apparatus for tissue suturing comprising a cartridge having a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis; a pusher assembly comprising a cartridge holder having a needle rotation drive capable of releasably engaging the cartridge and rotating the suturing needle about the axis; and an actuator capable of releasably engaging the needle rotation drive to rotate the needle rotation drive. A method for suturing tissue comprising placing a suturing device having a cartridge containing a suturing needle to span separated tissue segments; activating an actuator to cause rotational movement of the suturing needle through the separated tissue segments; and deactivating the actuator to stop an advancing movement of the suturing needle to cause a suturing material to be pulled through the separated tissue segments forming a stitch.

1 . A surgical suturing device, comprising:
 a needle defined at least in part by a leading end, a trailing end, an arced body between the leading and trailing ends, and at least one engagement surface formed into the needle;   a length of suturing material connected to the needle;   a needle rotation drive including a needle driver that reciprocates at least 180 degrees between a driven position and a returned position, the needle driver adapted to engage the engagement surfaces of the needle to rotate the needle in a circular path in first rotational direction along a circular needle track defined by a portion of the suturing device; and   an anti-rotate pawl that remains stationary with respect to the needle along the needle track as the needle is advanced in the first rotational direction by the needle driver, the anti-rotate pawl being configured to engage the at least one engagement surface of the needle to prevent the needle from rotating in a second rotational direction opposite to the first rotational direction to facilitate advancement of the needle along the needle track along the first direction in a plurality of drive strokes of the needle driver.   
     
     
         2 . The surgical suturing device of  claim 1 , wherein the anti-rotate pawl is positioned adjacent the driven position of the needle driver. 
     
     
         3 . The surgical suturing device of  claim 1 , wherein the anti-rotate pawl extends into the needle's path of travel along the needle track. 
     
     
         4 . The surgical suturing device of  claim 3 , wherein the anti-rotate pawl deflects at least partially in a plane that is defined by the circular needle path. 
     
     
         5 . The surgical suturing device of  claim 1 , wherein the anti-rotate pawl includes a body configured to pivot about a pin and an edge that is configured to move about the pivot between a first radially inward position where the edge engages the at least one engagement surface of the needle, to a second, radially outward position. 
     
     
         6 . The surgical suturing device of  claim 1 , wherein the needle is disposed in a removable cartridge that is removably attached to a cartridge holder assembly of the surgical suturing device. 
     
     
         7 . The surgical suturing device of  claim 6 , wherein the cartridge holder assembly is configured to releasably engage the cartridge and to bring the needle rotation drive into operational contact with the suturing needle. 
     
     
         8 . The surgical suturing device of  claim 1 , further comprising an actuator configured to engage the needle rotation drive to drive the suturing needle along the needle track. 
     
     
         9 . The surgical suturing device of  claim 6 , wherein the suturing material is also disposed within the cartridge. 
     
     
         10 . The surgical suturing device of  claim 9 , wherein the cartridge further includes a suturing material dispenser containing the suturing material. 
     
     
         11 . The suturing device of  claim 10  wherein the cartridge further includes a thread management system for managing the dispensation of suturing material. 
     
     
         12 . The surgical suturing device of  claim 6 , wherein the cartridge further includes at least one mounting clip wherein the cartridge is releasably engaged with the cartridge holder assembly having the needle rotation drive. 
     
     
         13 . The suturing device of  claim 1  wherein the needle covers an arc greater than about 180° and less than about 330°, and further wherein the needle further defines an aperture adjacent to a blunt end of the needle for engaging the suturing material. 
     
     
         14 . The suturing device of  claim 1 , wherein the needle is disposed within a disposable portion of the suturing device. 
     
     
         15 . The suturing device of  claim 14 , wherein the disposable portion of the suturing device includes a removable cartridge. 
     
     
         16 . A suturing device comprising:
 a cartridge having a protective housing and a suturing needle having a pointed end and a second end, the suturing needle being configured to rotate about an axis, wherein the pointed end of the suturing needle is positioned within the protective housing after a complete rotation of the suturing needle about the axis; and   an actuator including a cartridge holder configured to releasably attach the cartridge, the actuator including at least a portion of a needle rotation drive for driving the needle about the axis, wherein engagement of the cartridge with the cartridge holder operably couples the needle rotation drive of the actuator to the suturing needle.   
     
     
         17 . The suturing device of  claim 16 , wherein the actuator is reusable and the cartridge is disposable. 
     
     
         18 . The suturing device of  claim 17 , wherein the suturing needle defines an opening in the second end thereof in the form of a cylindrical bore aligned axially with respect to the needle. 
     
     
         19 . The suturing device of  claim 18 , wherein a leading end of a suturing material is inserted into the bore and restrained by mechanically crimping material of the needle onto the suturing material. 
     
     
         20 . The suturing device of  claim 19 , wherein the needle is configured to be advanced along a circular needle track defined by the cartridge, across a gap in the needle track, and back into the needle track. 
     
     
         21 . The suturing device of  claim 20 , wherein a center of rotation of the needle track that passes through the axis is unobstructed by the needle rotation drive. 
     
     
         22 . The suturing device of  claim 21 , wherein the needle path defines a circular plane, and wherein a majority of the circular plane is unobstructed by the needle rotation drive. 
     
     
         23 . The suturing device of  claim 22 , wherein the device is configured to push suture away from the circular needle track so the suture does not get pinched by the needle as the needle re-enters the circular needle track after passing across the gap. 
     
     
         24 . The suturing device of  claim 16 , further comprising a deflectable anti-rotate lever that is configured to engage a surface of the needle to prevent the needle from backing up in the needle track. 
     
     
         25 . The suturing device of  claim 24 , wherein the anti-rotate lever is configured to be engaged by the needle while the needle drive reciprocates from a driven position to a home position. 
     
     
         26 . The suturing device of  claim 16 , wherein the device defines a window near a distal end of the device that facilitates viewing of the suturing needle as it is advanced along the needle track. 
     
     
         27 . The suturing device of  claim 16 , wherein the actuator is electrically automated. 
     
     
         28 . The suturing device of  claim 16 , wherein the actuator includes an electric motor. 
     
     
         29 . The suturing device of  claim 16 , wherein the actuator includes an electromagnetic motor. 
     
     
         30 . The suturing device of  claim 16 , wherein the needle drive includes a drive shaft. 
     
     
         31 . The suturing device of  claim 30 , wherein the needle drive further includes a flexible joint coupled to the drive shaft configured to transmit torque. 
     
     
         32 . The suturing device of  claim 16 , further comprising a drive shaft configured to transmit torque through a flexible joint. 
     
     
         33 . A suturing device comprising a needle rotation drive configured to drive an arcuate suturing needle having a first pointed end and a second end in a forward direction led by the first pointed end about a circular orbit, the needle rotation drive being configured to prevent the needle from moving in a backward direction opposite to the forward direction to maintain positional registration of the needle with respect to the needle rotation drive while the needle rotation drive is operating. 
     
     
         34 . The suturing device of  claim 33 , wherein the circular orbit lays in a plane that is generally perpendicular to a longitudinal axis of the suturing device 
     
     
         35 . The suturing device of  claim 33 , further comprising an actuatable control assembly disposed within a housing of the suturing device, the actuatable control assembly including an actuatable rack configured to linearly actuate along a linear path. 
     
     
         36 . The suturing device of  claim 35 , wherein the actuatable rack includes at least one rack gear fixed to the actuatable rack, wherein the control assembly is operable to control the needle rotation drive in response to actuation of the control assembly. 
     
     
         37 . The suturing device of  claim 36 , wherein the actuable control assembly is coupled to a motor, wherein the motor is operable to actuate the rack.