Systems and methods for suturing tissue

Abstract

A device for suturing tissue includes a handle including a housing and a suturing needle for advancing a suture through the tissue. The device also includes a first needle gripper that is configured to both grasp and release the suturing needle. A second needle gripper is also configured to both grasp and release the suturing needle. An actuator is coupled to the housing and is operatively coupled to: (a) a first linkage that pivots the second gripping gripper between a fully extended position and a retracted position relative to the housing; and (b) a second linkage that is operatively coupled to the first and second needle grippers and configured to alter a state of each of the first and second needle grippers. The second linkage can include a one-way clutch.

1 . A device for suturing tissue comprising:
 a handle including a housing having a distal end and an opposite proximal end;   a suturing needle for advancing a suture through the tissue, the suturing needle having a first pointed end and an opposite second end;   a first needle gripper coupled to the housing, the first needle gripper being configured to both grasp and release the suturing needle;   a second needle gripper coupled to the housing, the second needle gripper being configured to both grasp and release the suturing needle; and   an actuator that is coupled to the housing, the actuator being operatively coupled to: (a) a first linkage that pivots the second gripping gripper between a fully extended position and a retracted position relative to the housing; and (b) a second linkage that is operatively coupled to the first and second needle grippers and configured to alter a state of each of the first and second needle grippers to permit each respective needle gripper to either: (a) receive and grasp the suturing needle or (b) release the suturing needle;   wherein the second linkage includes a one-way clutch that is operatively coupled to the actuator and is configured to synchronously alter the states of the first and second needle grippers to permit each respective needle gripper to either: (a) receive and grasp the suturing needle or (b) release the suturing needle.   
     
     
         2 . The device of  claim 1 , wherein the actuator moves in a sweeping, non-linear motion relative to the housing 
     
     
         3 . The device of  claim 1 , wherein the first linkage comprises a plurality of gears that operatively couple the actuator to the second needle gripper such that motion of the actuator is translated into the second needle gripper rotating about a first pivot point between the fully extended position and a retracted positions. 
     
     
         4 . The device of  claim 3 , wherein the first linkage includes a first gear that is associated with the actuator; a second gear that meshes with the first gear; and a third gear that is fixedly coupled to the second needle gripper such that a pivoting movement of the actuator causes the first, second and third gears to rotate resulting in rotation of the second needle gripper. 
     
     
         5 . The device of  claim 4 , wherein the first gear is a fan gear and the second gear is a reducer gear that is configured such that the second needle gripper rotates a greater number of degrees than the actuator. 
     
     
         6 . The device of  claim 1 , wherein the second linkage comprises an energy storage mechanism that is configured to store energy during an inward stroke of the actuator and release the stored energy during one stage of an outstroke of the actuator, whereby the release of the stored energy causes the states of the first and second needle grippers to be altered. 
     
     
         7 . The device of  claim 6 , wherein the one stage of the outstroke comprises a final stage of the outstroke. 
     
     
         8 . The device of  claim 6 , wherein the energy storage mechanism includes a windup mechanism and a crankshaft assembly whose operation alters the states of the first and second needle grippers, the windup mechanism includes a first spring that stores energy during the inward stroke of the actuator as a result of a coupling between the actuator and the windup mechanism and release the stored energy during the one stage of the outstroke of the actuator, the windup mechanism being configured to selectively engage and interlock with the crankshaft assembly, the crankshaft assembly being maintained in a held position until the one stage of the outstroke at which time the crankshaft assembly is released from the held position and the windup mechanism releases its stored energy resulting in the crankshaft assembly rotating a predetermined number of degrees. 
     
     
         9 . The device of  claim 8 , wherein the windup mechanism rotates 180 degrees in a first direction during the inward stroke of the actuator and during the one stage of the outstroke, the windup mechanism and the crankshaft assembly rotate 180 degrees in an opposite second direction. 
     
     
         10 . The device of  claim 8 , wherein the one-way clutching comprises a portion of the windup mechanism, a portion of the crankshaft assembly and a pawl that selectively engages the crankshaft assembly to restrict movement of the windup mechanism and the crankshaft assembly until the one stage of the outstroke. 
     
     
         11 . The device of  claim 8 , wherein the windup mechanism includes a torsion spring that is fixed to the housing at a first end and has a second end that is fixed to a pinion gear that is coupled to the actuator by a rack that moves when the actuator moves relative to the housing such that movement of the actuator is translated into rotation of the pinion gear and rotation of the windup mechanism, the windup mechanism further including a windup ratchet that is fixedly attached to the pinion gear and rotates therewith. 
     
     
         12 . The device of  claim 11 , wherein the windup ratchet has a pair of windows formed therein that selectively receive a pair of first flexible tabs that are part of a crankshaft ratchet that is part of the crankshaft assembly to releasably interlock the windup ratchet to the crankshaft ratchet, the pair of windows being formed 180 degrees apart from one another and the pair of first flexible tabs being formed 180 degrees apart from one another, the crankshaft ratchet being fixedly connected to a crankshaft that drives the movements of the first and second needle grippers. 
     
     
         13 . The device of  claim 12 , wherein the crankshaft ratchet includes an anti-reverse feature to prevent rotation of the crankshaft during the inward stroke of the actuator. 
     
     
         14 . The device of  claim 13 , wherein the anti-reverse feature comprises a pair of second flexible tabs formed as part of the crankshaft ratchet, wherein the second flexible tabs contact a portion of the housing to prevent rotation of the crankshaft ratchet in one direction when the windup mechanism is being wound during the inward stroke. 
     
     
         15 . The device of  claim 12 , wherein the crankshaft assembly includes a stop mechanism to restrict rotation of the crankshaft to a predetermined number of degrees when the windup mechanism releases its stored energy. 
     
     
         16 . The device of  claim 15 , wherein the stop mechanism comprises a body attached to the crankshaft and at least one biased pin slidably disposed within an opening formed in the body such that rotation of the body during the release of energy by the windup mechanism causes the pin to protrude beyond a peripheral edge of the body due to centrifugal force exacted onto the pin and make contact with a fixed stop that is part of the housing resulting in the crankshaft only traveling the predetermined number of degrees when the windup mechanism releases its stored energy. 
     
     
         17 . The device of  claim 8 , wherein the crankshaft includes an eccentrically mounted bearing that is rotated and applies an alternating force to the first and second needle grippers to change the states of first and second needle grippers in a reciprocal manner. 
     
     
         18 . The device of  claim 1 , wherein each of the first and second needle grippers comprises a first static clamp and a second movable clamp that is pivotally attached to the first static clamp at a pivot to permit the second movable clamp to pivot between open and closed positions, each of the first static clamp and the second movable clamp defining a needle receiving groove in which the suturing needle is captured. 
     
     
         19 . The device of  claim 1 , wherein the second movable clamp is biased to the open position. 
     
     
         20 . The device of  claim 18 , wherein the second linkage includes a part that applies a force to the second movable clamps of the first and second needle grippers in an alternating manner to cause the reciprocal opening and closing of the first and second needle grippers. 
     
     
         21 - 23 . (canceled)