Suturing devices and methods for suturing an anatomic structure

Abstract

Suturing devices and systems used to apply sutures and/or to close openings at, within, or into a biological structure. The suturing device can comprise an elongate member having a proximal end, a distal end, one or more distal arms, one or more proximal extensions, and one or more needles. A sheath may be used with the device to maintain or substantially maintain haemostasis while the device is used and while a procedure is performed in the biological structure.

1 . A suturing system, comprising:
 a suturing device comprising an elongate body having a proximal end and a distal end;   a plurality of arms near the distal end, wherein each arm is configured to move between a first position wherein the arm is retracted within the elongate body, and a second position wherein the arm has a free end extending away from the elongate body, each arm comprising at least one suture mount at the free end;   a sheath adapted to surround at least a portion of the elongate body;   a needle carriage comprising a plurality of outer lumens and a central lumen adapted to surround at least a portion of the sheath;   a plurality of needles, each needle configured to move between a retracted position in which the needle is within a corresponding outer lumen to a deployed position in which a distal point of the needle extends out of the corresponding outer lumen and into a corresponding suture mount; and   a plurality of suture portions, wherein each suture portion has a suture end releasably retained within a suture mount of a corresponding arm of the plurality of arms.   
     
     
         2 . The suturing system of  claim 1 , further comprising at least one alignment extension positioned proximal to the plurality of arms, wherein each alignment extension is configured to move between a first position wherein the alignment extension is retracted within the elongate body, and a second position wherein the alignment extension has a free end extending away from the elongate body. 
     
     
         3 . The suturing system of  claim 2 , wherein each of the at least one alignment extensions comprises at least one detent configured to engage the needle carriage. 
     
     
         4 . The suturing system of  claim 2 , wherein each of the at least one alignment extensions comprises an angled surface configured to deflect a needle moving from the retracted to the deployed position. 
     
     
         5 . The suturing system of  claim 2 , wherein when each of the at least one alignment extensions is in the second position, the free end of the alignment extension is closer to the elongate body than are the free ends of the plurality of arms when the plurality of arms are in the second position. 
     
     
         6 . The suturing system of  claim 2 , wherein the free end of each of the at least one alignment extensions moves proximally when the alignment extension moves from the first position to the second position. 
     
     
         7 . The suturing system of  claim 2 , wherein the at least one alignment extension is a plurality of arms. 
     
     
         8 . The suturing system of  claim 2 , wherein each needle in the deployed position passes through one of the at least one alignment extensions. 
     
     
         9 . The suturing system of  claim 2 , wherein each of the at least one alignment extensions has one needle guiding section. 
     
     
         10 . The suturing system of  claim 1 , wherein the suturing device comprises at least one alignment detent near the distal end, and the needle carriage comprises at least one carriage detent configured to engage a corresponding alignment detent. 
     
     
         11 . The suturing system of  claim 10 , wherein the at least one alignment detent is a recess and the at least one carriage detent is a projection. 
     
     
         12 . The suturing system of  claim 10 , wherein the at least one carriage detent is a projection extending into the central lumen. 
     
     
         13 . The suturing system of  claim 10 , wherein each outer lumen is longitudinally aligned with a corresponding suture mount when each of the at least one carriage detents is engaged with a corresponding one of the at least one alignment detents. 
     
     
         14 . The suturing system of  claim 1 , wherein the free ends of each of the plurality of arms move proximally when the arms move from the first position to the second position. 
     
     
         15 . The suturing system of  claim 1 , further comprising a needle deflector at a distal end of the needle carriage. 
     
     
         16 . The suturing system of  claim 15 , wherein the needle deflector is integrally formed with the needle carriage. 
     
     
         17 .- 29 . (canceled) 
     
     
         30 . A method of delivering suture portions to an opening in a biological structure of a patient, said method comprising:
 delivering a suturing system through an opening in a biological structure, wherein the suturing system comprises:
 an elongate body having a proximal end and a distal end; 
 a plurality of arms near the distal end; and 
 a sheath at least partially surrounding the elongate body; 
   extending the plurality of arms from the elongate body, each of the arms carrying a suture portion having a suture end releasably retained in a respective arm;   positioning the plurality of arms against or near an interior surface of the biological structure;   advancing a plurality of needles from a position outside of the biological structure and outside of the sheath through tissue of the biological structure to engage the suture ends releasably retained in the respective arms;   retracting the plurality of needles through the tissue of the biological structure to draw the respective suture ends through the tissue of the biological structure;   advancing the sheath at least partially through the opening in the biological structure; and   with the plurality of arms retracted into the elongate body, withdrawing the elongate body from the biological structure while leaving the sheath at least partially within the opening of the biological structure.   
     
     
         31 .- 37 . (canceled) 
     
     
         38 . A method of delivering suture portions to an opening in the vasculature of a patient, said method comprising:
 delivering a suturing system through an opening in the wall of a blood vessel and into the blood vessel, wherein the suturing system comprises:
 an elongate body having a proximal end and a distal end; 
 a plurality of arms near the distal end; 
 a sheath at least partially surrounding the elongate body; and 
 a plurality of needles positioned at least partially within a needle carriage that surrounds at least a portion of the elongate body, the needle carriage further configured to surround at least a portion of the sheath; 
   extending the plurality of arms from the elongate body, each of the arms carrying a suture portion having a suture end releasably retained in a respective arm;   positioning the plurality of arms against an inside surface of the wall of the blood vessel;   advancing the needle carriage into a position aligned with the plurality of arms;   advancing the plurality of needles from the needle carriage through the wall of the blood vessel, each needle aligned with a respective suture mount located in a respective arm and engaging a respective suture portion positioned in the respective suture mount;   retracting the plurality of needles through the wall of the blood vessel to draw the respective suture ends through the wall of the blood vessel;   retracting the needle carriage to withdraw the suture ends engaged by the needles to a location outside of the patient;   advancing the sheath at least partially through the wall of the blood vessel;   retracting the plurality of arms into the elongate body of the suturing device; and   withdrawing the elongate body from the blood vessel while leaving the sheath at least partially within the wall of the blood vessel.   
     
     
         39 .- 48 . (canceled)