US3638654A - Suturing instrument - Google Patents

Abstract

A surgical suturing instrument for applying sutures to a wound or the like comprising a first handle movably mounting a second handle which is operable to rotate a shaft when moved from a first position to a second position. Needle means including a needle is affixed to the shaft so that movement of the second handle affects rotation of the needle. Provided in the needle is a suture-retaining slot which carries a suture so that as said needle is rotated through tissue it automatically threads the sutures.

Description

United States Patent Akuba [54] SUTURING INSTRUMENT [72] Inventor: Uche Akuba, 30 Park Ave., Suite 19F, New York,N.Y. 10016 [22] Filed: July 11, 1969 211 Appl. No.: 841,051

521' vs. C1 ..l28/340, 112/80 [51] Int. Cl. ..A6lb 17/04, DOSb 91/00, D05c 15/00 [58] Field of Search ..1 12/80, 169; 128/339, 340; 223/104 [56] References Cited UNITED STATES PATENTS 194,759 9/1877 Atwood ..1 12/169 UX 1,055,058 3/1913 Leighton...

2,737,954 3/1956 Knapp ..128/340 [451 Feb. 1,1972

3,038,475 6/1962 Orcutt ..128/339 3,090,386 5/1963 Curtis .128/340 X 3,168,097 2/ l 965 Dormia ..128/340 Primary Examiner-Channing L. Pace ArtorneyPaul Fields [57] ABSTRACT A surgical suturing instrument for applying sutures to a wound or the like comprising a first handle movably mounting a second handle which is operable to rotate a shaft when moved from a first position to a second position. Needle means including a needle is affixed to the shaft so that movement of the second handle affects rotation of the needle. Provided in the needle is a suture-retaining slot which carries a suture so that as said needle is rotated through tissue it automatically threads the sutures.

10 Claims, 10 Drawing Figures PATENIEBEB mzz -3.638,654

INVENTOR. Uche Akuba ATTORNEY SUTURING INSTRUMENT This invention relates generally to a surgical suturing instrument and, more particularly, pertains to a device for quickly and easily applying sutures to a wound or the like.

Presently used techniques for suturing opentissuedue to a woundoran operation or .the like have a number of drawbacks. To be more specific, an example of a suturing method includes the. use .ofa curvedneedle and a plurality of forceps. The suture is threaded through the needle eye. One. lip of the open tissue is grasped with one set of forceps and the needle is manipulated with a second set of forceps to pierce the tissue at a point adjacent to the opening. The needle is then .released and is grasped on the other side of the tissue with the forceps and is pulled through. the tissue thereby carrying the suture throughthe tissue orskin. This procedure is continued for the' opposite lip of the opening and is repeated until the opening or wound has been completely closed. In view of the difficulties involved in placing and manipulating the needle, the use of thismethod is usually time consuming; Additionally, it is to be noted that the needle is supportedonly by the tissue during the time that the needle is released and is again grasped. on theexit side of the tissue. As a result it has been found that the needle maymove in the tissue duringthe interval .it is unsupported thereby risking damage to the tissue, as well as loss of the needle-itself.

A further disadvantage resides in the fact that the needle must pass completely through the tissue. since the suture is connected to the rear of the needle. This introduces a further risk of damaging the tissue since the complete passageof the needle tends to widen the punctiform passage formed thereby. Moreover, this drawback is compounded further by the fact thatmany'suturing procedures must be carried out at some distance from the operator in conditions of poor visibility, such as at the'bottom of a bladder,.so-that the accurate placement and withdrawal of the needle becomes difficult.

One furtherdisadvantage of the above-described method is that the needle must be grasped tightly by the forceps which, in many cases, results in fracture and breakage of the needle. On the other hand, if the needle is loosely retained by the'forceps it rocks back and forth and gets out of position thereby delaying the. closing-of the wound and/or damaging the tissue.

Accordingly, an object of the invention is to provide an improved suturingdevice.

A more specificobject of the invention is to provide a suturing .device. or instrument which may be quickly and easily operated to pierce tissue.

A further object of the invention resides in the novel details of construction which provide a suturing instrument of the type described in which the needle is always'under the control of the operator.

Another object of the invention residesin the provision of a suturing instrumentor device whichincludes a needle portion which may be accurately positioned to eliminate anyunnecessary damage to the. tissue due to inaccurately positioned needles.

A further object of the invention is the provision ofa sutur. ing instrument of the type describecllwhich eliminates-the need for the completerpassage. of the needlethrough the'tissue. thereby eliminating unnecessary widening of the needle.

passage.

Accordingly, a surgical suturing instrument constructed according to the present inventionincludes a first handle which movably mounts a second handlesA rotatable shaft is pro-- vided and motion-transmittingmeans interconnects the shaft and the second handle whereby movement of the second ban-- the second handle effects'rotationof. the needle. The needle includes suture-retaining means for receiving a'suture'therein so that.as..=.the'needle pierces.;tissue.:thewsuture is carried therewith and is automatically. threaded through the tissue.

A feature of the present invention is to provide a suturing instrumentfor easily applying sutures to a wound or the like whichincludes an operating member which mounts a needle thereby eliminating the need for an external forceps to hold the needle during the tissue-piercing operation.

Other features and advantages of the present invention will become more apparent from a consideration of the following detailed'description when taken in conjunction with the accompanying drawing, in which:

FIG. 1 is a perspective view of a surgical suturing instrument constructed in accordance with the present invention, with a portion broken away in the interests of clarity;

FIG. 2 is a sectional view thereof taken along theline 22 of FIG. 1;

FIG. 3 is a sectional detail view illustrating one form of the connection between the handle and the rotatable needle support;

FIG. 4 is a sectional view taken along the line 4-4 of FIG.

FIG. 5 is a front elevational view of a needle constructed according to the present invention;

FIG. 6 is a sectional view thereof taken along the line 6-6 of FIG..5;

F IG. 7 is a front elevational view of a modified embodiment of the needle forming a part of the suturing instrument of the present invention;

FIG. 8 is a sectional view thereof taken along the line 8-8 of FIG. 7;

FIG. 9 is a detail view, to an enlarged scale, of an arrangement for fastening a needle to the needle mount; and

FIG. 10 is an enlarged detail view of the end portion of a needle which is received in the needle mount.

Accordingly, the surgical suturing instrument or device constructed according to the present invention is designated generally by thereference numeral 10 in the figures and includes a first ormain handle 12. More specifically, thehandle 12 is hollow and includes a thumb-receivingportion 14, an enlargedintermediate portion 16 and ashaft support portion 18 whichextends outwardly from theintermediate portion 16. Rotatably supported in 'acentral bore 20 in theshaft support portion 18, by appropriate ball bearings or the like (not shown), is ashaft 22. Fixedly received in theshaft 22, adjacent to the forward end thereof is a radially extendingcross member 24. Fixedly received on the other end of theshaft 22 is a pinion gear 26. The pinion 26 is in meshing engagement with an arcuate orsegmental gear 28 which, in turn, is rotatably mounted within the enlarged intermediateportion 16ofthe handle 12.

More particularly, thegear 28 is supported betweenradial arms 30 which are connected to a hub 32. Apivot pin 34 extends through the center of the hub 32 and is connected to opposite sides of thehandle 12 thereby to pivotally mount the gear 28within theportion 16. Also connected to the hub 32 is an operating orsecond handle 36. As shown in FIG. 2, thehandle 36 includesa-bent section 38 which extends outwardly and downwardly from the hub 32 through aslot 40 in the bottom of thehandle l2 and arearwardly extending section 42. The handle 36'is slightly concave downwardly to follow the natural curvature of the fingers when the instrument is in use to facilitate theoperation thereof. Additionally, thehandle 36 is provided with a depending hookedfinger rest 44.

The thumb-receivingportion 14 of thehandle 12 is provided with a substantiallyelliptical aperture 46 on the far surface of the handle which includes a rearcurved portion 48 havinga relatively large radius of curvature and an upper forward curvedportion 50 having a small radius of curvature. The near surface of thehandle 12 is provided with a substantiallyelliptical aperture 52 similar to theaperture 46. However, theforwardcurved surface 54 of theaperture 52 extends beyondthe forwardcurved surface 50 of theaperture 46 and is connected thereto by a sloping orinclined wall 56. Ac-

h cordingly, theapertures 46 and 52 and the connecting wall form athumb'hole 58.

It is to be noted that the instrument shown in FIGS. 1 and 2 is a so-called left-hand suturing instrument which is to be utilized by left-handed surgeons. Accordingly, when an operator desires to use the instrument he inserts his thumb through thethumb hole 58. The slopingwall 56 abuts the meaty or fleshy base portion of the thumb while the fingers curl around thehandle 36 and the index finger abuts the hookedfinger rest 44. Hence, since thewall 56 abuts the fleshy part of the thumb the operator of the instrument can maintain a great deal of control over the instrument and hold the same relatively steady while it is in use. It will be obvious, however, that for right-handed operators, the slopingwall 56 will be reversed so that it is inclined forwardly from the near surface of thehandle 12 to the far surface of thehandle 12, as taken in FIG. 2.

When the operator closes his fingers to move thehandle 36 toward thehandle 12, thegear 28 will move in the direction indicated by thearrowhead 60. Hence, theshaft 22 will rotate in the direction indicated by the arrowhead 62. Additionally, acoil spring 64 is provided which encircles the hub 32 and is connected to theupper arm 30 at one end and abuts the lower wall of thehandle 12 at the other end to normally bias thegear 28 to the position shown in FIG. 2. Movement of thegear 28 to this position is limited by the engagement of thebent portion 38 of thehandle 36 with the end of theslot 40. Further, asetscrew 66 is provided which is threadedly received in the upper and lower walls of thehandle 12 and extends through the lower wall thereof into the path of movement of thehandle 36. Thesetscrew 66 may be rotated to move the same axially, wither upwardly or downwardly, as indicated by thedoubleheaded arrowhead 68 to limit the upward movement of thehandle 36 and, consequently, to limit the angle of rotation of theshaft 22 for the reasons noted below.

Rotatably mounted on theshaft support portion 18 is a needle mount designated generally by thereference numeral 70. To be more specific, the needle mount includes a rearcylindrical portion 72 and a forward truncatedconical portion 74. The rear end of theportion 72 is provided with arecess 76, as shown in FIG. 3, which receives a reduceddiameter end portion 78 of theshaft support portion 18 of thehandle 12. As shown in FIG. 4, theportion 18 is provided with radially extendingbores 80 which receiveballs 82 which, in turn, are biased outwardly by biasingsprings 84. Therecess 76 is provided with anannular groove 86, as shown in FIG. 3, which receive theballs 82 to retain theneedle mount 70 on theshaft support portion 18 of thehandle 12. In other words, theneedle mount 70 is connected to theshaft support portion 18 by pressing the needle mount rearwardly on the reduceddiameter portion 78. This action depresses theballs 82 against thespring 80. However, when theneedle mount 70 is firmly seated on the reduceddiameter portion 78, thesprings 84 again bias the balls outwardly and into theannular groove 86 to prevent separation of theneedle mount 70 and theshaft support portion 18. The opening of thebores 80 is made slightly smaller than the diameter of theballs 82 so that theballs 82 are retained in thebores 80 to prevent their loss when theneedle mount 70 is removed.

Theneedle mount 70 is provided withopposed grooves 88 which extend forwardly from the rear edge thereof. Thegrooves 88 receive thecross member 24 therein so that rotation of theshaft 22 effects rotation of theneedle mount 70.

Theneedle mount 70 is provided with a substantially rectangular transverse throughopening 90 adjacent the end thereof. Theopening 90 is adapted to receive the complementary formedend 92 of a needle 94 (FIG. therein. In other words, theend 92 of theneedle 94 is inserted into theopening 90 in theneedle mount 70 when the needle is connected to the needle mount. The needle is affixed in place by asetscrew 96 which is threaded into the truncated end of theconical portion 74 of theneedle mount 70. That is, when theneedle 94 is inserted into theopening 90, theset screw 96 is tightened so that it abuts theend 92 of the needle to retain the same in place. When it is desired to remove the needle, theset screw 96 is loosened so that the needle easily may be removed.

FIGS. 5 and 6 illustrate anatraumatic needle 98 which forms a part of the present invention. Theneedle 98 is provided with anend 100 which is similar in construction to theend 92 of theneedle 94 illustrated in FIG. 10 so that theneedle 98 may be connected with theneedle mount 70. Theneedle 98 extends through an arc of approximately 270 and includes a conventionalrounded body portion 102 which tapers to apointed end 104. An open-endedslot 106 is provided in theneedle 98 which extends to the inner wall of the needle. Theslot 106 is positioned to the rear of thepointed end 104 and, in practice, is positioned approximately 3540 behind theend 104. The interior portion of theslot 106 is enlarged to receive asuture 108. The opening of theslot 106 is constricted and the bottom wall is closed to prevent accidental removal of thesuture 108.

In practice, theneedle end 100 is inserted into theopening 90 in theneedle mount 70 and theset screw 96 is tightened to affix the needle in place. Thereafter, thecross member 24 is inserted into thegrooves 88 in theneedle mount 70 and the needle mount is mounted on the reduceddiameter portion 76 of theshaft support portion 18 of thehandle 12. It is to be noted that theneedle 98 curves downwardly toward the right, as taken in FIG. 1. Thesuture 108 is then inserted into theslot 106 in theneedle 98 and is positioned in the enlarged portion of the slot.

Thehandle 12 is grasped by the left hand, as noted above, with the thumb projecting through thethumb hole 58 and thewall 56 engaging the meaty or fleshy part of the thumb base. Thesetscrew 66 may be adjusted to limit the movement of thehandle 36 and, accordingly, the degree of rotation of theneedle 98 so that the needle rotates through a desired arc.

The two lips forming the opening in the tissue are compressed together and lifted slightly by an appropriate forceps. Theinstrument 10 is then positioned so that theend 104 of theneedle 98 is adjacent the beginning of the wound or the opening. The operator then squeezes thehandle 36 to rotate theshaft 22 in the direction indicated by the arrowhead 62, in the manner noted above. Since theshaft 22 is connected to theneedle mount 70 via thecross member 24 and thegrooves 88, theneedle mount 70 and, consequently, theneedle 98 will move in the direction indicated by thearrowhead 110 in FIG. 1. Hence, theneedle 98 will pierce the tissue adjacent each side of the opening or wound thereby carrying thesuture 108 through the tissue. Thesuture 108 is then removed through the constricted opening of theslot 106 and thehandle 36 is released. When the pressure on thehandle 36 is released thespring 64 biases thesegmental gear 28 back to the normal position illustrated in FIG. 2. Thus, theshaft 22 and, therefore, theneedle 98 will rotate in a direction opposite to the direction indicated by thearrowheads 62 and 110 whereby theneedle 98 is removed from the tissue. In other words, the rotation of theneedle 98 is reversed so that the needle is removed from the tissue while thesuture 108 remains in place. This procedure is again repeated until the wound or opening has been sutured.

In practice, the elements comprising thesuturing instrument 10 of the present invention may be fabricated from stainless steel or the like so that the entire instrument may be sterilized. However, in view of the fact that only the needle contacts the tissue of a patient, only the needle is required to be sterilized. Additionally, depending upon the size of the wound, the toughness of the tissue and the like, differently sized needles or different types of needles may be substituted for the needle illustrated in FIGS. 5 and 6.

For example, FIGS. 7 and 8 illustrate a modified embodiment of aneedle 112 which is referred to as a cutting edge needle. As is conventional in cutting edge needles, the cross section of the needle is triangular in shape, as shown in FIG. 8. Additionally, the needle is provided with a substantiallyrectangular end 114, which is similar to theend 92 of theneedle 94, which is adapted to be received in theopening 90 in theneedle mount 70. Theneedle 112 subtends an arc of approximately 270 and is provided with a pointed piercingend 116. Approximately 30-45 behind the piercingend 116 is a suture-receivingslot 118 which receives thesuture 108. Similarly to theslot 106, theslot 118 is provided with aconstricted opening 120 through which thesuture 108 passes and an enlarged interior bottom portion having a closed wall 122 in which the suture is retained during the piercing operation. It is to be noted that the section of theneedle 112 containing theslot 118 is rounded at 124 to facilitate passage of the needle outwardly of the tissues after the suture has been located in place.

Theneedle 112 is utilized in the same manner as theneedle 98. That is, theneedle 112 is connected to theneedle mount 70 via theopening 90 and thesetscrew 96. Thesuture 108 is inserted into the bottom portion 122 of theslot 118 and the instrument is operated so that theneedle 112 pierces the tissue adjacent the opening of the wound or the cut thereby carrying thesuture 108 with it. Thesuture 108 is then removed through theconstricted opening 120 of theslot 118 and handle 36 is released to allow theneedle 112 to rotate in the opposite direction and pass out of the tissue. As noted above, theportion 124 of theneedle 112 is rounded to facilitate reverse travel of the needle without tearing any tissue.

Accordingly, a suturing instrument has been described which is extremely simple to operate and which permits control of the needle at all times during the suturing operation.

While preferred embodiments of the invention have been shown and described herein it will become obvious that numerous omissions, changes and additions may be made in such embodiments without departing from the spirit and the scope of the present invention.

What is claimed is:

l. A surgical suturing instrument comprising a first handle, a second handle movably mounted on said first handle, a rotatable shaft, motion-transmitting means interconnecting said shaft and said second handle whereby movement of said second handle from a first to a second position causes rotation of said shaft, and needle means including a needle and a needle mount affixed to said shaft and rotatable therewith whereby movement of said second handle affects rotation of said needle, said needle mount further including means for releasably and rigidly retaining said needle therein in tight frictional engagement therewith, said needle including suture retaining means for receiving a suture therein, said first handle being hollow and forming an enclosed housing, said motiontransmitting means being encased within said hollow handle housing and including a first gear connected to said second handle and being movable in response to movement of said second handle from said first to said second position, and a second gear connected to said shaft and in meshing engagement with said first gear to transmit motion of said first gear to said shaft.

2. A surgical suturing instrument as in claim 1, in which said first handle is provided with a thumb-receiving portion, said thumb-receiving portion including an inclined wall which slopes outwardly and forwardly from one surface of said first handle to the opposite surface of said handle and which is adapted to abut the fleshy base of the thumb when the suturing instrument is held in the hand of an operator.

3. A surgical suturing instrument comprising a first handle, a second handle movably mounted on said first handle, a rotatable shaft, motion transmitting means interconnecting said shaft and said second handle whereby movement of said second handle from a first to a second position causes rotation of said shaft, needle means including a needle affixed to said shaft and rotatable therewith whereby movement of said second handle affects rotation of said needle, said needle including suture retaining means for receiving a suture therein, said needle means further including a needle mount for releasably connecting said needle with said shaft, mounting means for mounting said needle mount on said first handle, and connecting means for connecting said needle mount with said shaft whereby said needle mount is rotatable with said shaft.

4. A surgical suturing instrument as in claim 3, in which said mounting means includes a reduced diameter portion extending outwardly from said first handle, a recess in said needle mount sized and positioned to receive said reduced diameter portion ofsaid first handle, and retaining means on said needle mount and said reduced diameter portion for retaining said needle mount on said reduced diameter portion.

5. A surgical suturing instrument as in claim 3, in which said connecting means includes a radially extending cross member connected to said shaft, and at least one slot in said needle mount adapted to receive said cross member therein.

6. A surgical suturing instrument as in claim 3, in which said needle mount includes an opening having a predetermined geometric shape adjacent the end thereof, said needle having an end formed complementary to said needle mount opening and being adapted to fit therein, and means for releasably retaining said needle end in said needle mount opening.

7. A surgical suturing instrument comprising a first handle, a second handle movably mounted on said first handle, a rotatable shaft, motion-transmitting means interconnecting said shaft and said second handle whereby movement of said second handle from a first to a second position causes rotation of said shaft, and needle means including a needle and a needle mount affixed to said shaft and rotatable therewith whereby movement of said second handle affects rotation of said needle, said needle mount further including means for releasably and rigidly retaining said needle therein in tight frictional engagement therewith, said needle including suture retaining means for retaining a suture therein, said needle being arcuate in shape and including a pointed end, said suture-retaining means comprising a slot adjacent said pointed end, said slot having a restricted entrance thereto through the inner wall of said arcuate needle, and being closed by the outer wall of said arcuate needle, and an enlarged interior portion to prevent accidental removal of the suture retained in said slot.

8. A curved needle having an inner and and outer circumferential wall and having a first end adapted to be attached to a surgical suturing instrument, a second pointed end adapted to pierce tissue, and a single slot in said needle near said second end adapted to retain a suture therein, said slot being accessible through a restricted opening in the said inner wall and closed by said outer wall, and an enlarged interior portion to prevent accidental removal of the suture.

9. A needle as inclaim 8, in which said needle is arcuate in shape and said slot opens radially inwardly of said needle.

10. A needle as in claim 9, in which said needle subtends an arc of substantially 270 and said slot is positioned substantially 3045 behind said second end.

Claims (10)

1. A surgical suturing instrument comprising a first handle, a second handle movably mounted on said first handle, a rotatable shaft, motion-transmitting means interconnecting said shaft and said second handle whereby movement of said second handle from a first to a second position causes rotatioN of said shaft, and needle means including a needle and a needle mount affixed to said shaft and rotatable therewith whereby movement of said second handle affects rotation of said needle, said needle mount further including means for releasably and rigidly retaining said needle therein in tight frictional engagement therewith, said needle including suture retaining means for receiving a suture therein, said first handle being hollow and forming an enclosed housing, said motion-transmitting means being encased within said hollow handle housing and including a first gear connected to said second handle and being movable in response to movement of said second handle from said first to said second position, and a second gear connected to said shaft and in meshing engagement with said first gear to transmit motion of said first gear to said shaft.

2. A surgical suturing instrument as in claim 1, in which said first handle is provided with a thumb-receiving portion, said thumb-receiving portion including an inclined wall which slopes outwardly and forwardly from one surface of said first handle to the opposite surface of said handle and which is adapted to abut the fleshy base of the thumb when the suturing instrument is held in the hand of an operator.

3. A surgical suturing instrument comprising a first handle, a second handle movably mounted on said first handle, a rotatable shaft, motion transmitting means interconnecting said shaft and said second handle whereby movement of said second handle from a first to a second position causes rotation of said shaft, needle means including a needle affixed to said shaft and rotatable therewith whereby movement of said second handle affects rotation of said needle, said needle including suture retaining means for receiving a suture therein, said needle means further including a needle mount for releasably connecting said needle with said shaft, mounting means for mounting said needle mount on said first handle, and connecting means for connecting said needle mount with said shaft whereby said needle mount is rotatable with said shaft.

4. A surgical suturing instrument as in claim 3, in which said mounting means includes a reduced diameter portion extending outwardly from said first handle, a recess in said needle mount sized and positioned to receive said reduced diameter portion of said first handle, and retaining means on said needle mount and said reduced diameter portion for retaining said needle mount on said reduced diameter portion.

5. A surgical suturing instrument as in claim 3, in which said connecting means includes a radially extending cross member connected to said shaft, and at least one slot in said needle mount adapted to receive said cross member therein.

6. A surgical suturing instrument as in claim 3, in which said needle mount includes an opening having a predetermined geometric shape adjacent the end thereof, said needle having an end formed complementary to said needle mount opening and being adapted to fit therein, and means for releasably retaining said needle end in said needle mount opening.

7. A surgical suturing instrument comprising a first handle, a second handle movably mounted on said first handle, a rotatable shaft, motion-transmitting means interconnecting said shaft and said second handle whereby movement of said second handle from a first to a second position causes rotation of said shaft, and needle means including a needle and a needle mount affixed to said shaft and rotatable therewith whereby movement of said second handle affects rotation of said needle, said needle mount further including means for releasably and rigidly retaining said needle therein in tight frictional engagement therewith, said needle including suture retaining means for retaining a suture therein, said needle being arcuate in shape and including a pointed end, said suture-retaining means comprising a slot adjacent said pointed end, said slot having a restricted entrance thereto through the inner wall of said arcuaTe needle, and being closed by the outer wall of said arcuate needle, and an enlarged interior portion to prevent accidental removal of the suture retained in said slot.

8. A curved needle having an inner and and outer circumferential wall and having a first end adapted to be attached to a surgical suturing instrument, a second pointed end adapted to pierce tissue, and a single slot in said needle near said second end adapted to retain a suture therein, said slot being accessible through a restricted opening in the said inner wall and closed by said outer wall, and an enlarged interior portion to prevent accidental removal of the suture.

9. A needle as in claim 8, in which said needle is arcuate in shape and said slot opens radially inwardly of said needle.

10. A needle as in claim 9, in which said needle subtends an arc of substantially 270* and said slot is positioned substantially 30*-45* behind said second end.

Images