Patent Application
20210259680
The present application relates generally to surgical devices for suturing body tissue and, more particularly, to devices for handling suture material during the suturing process.
Suturing is used to close the edges of a wound or incision and to repair damaged tissue during surgery. Sutures can be applied using a suturing device having a needle, which can be manipulated to draw a suture through the tissue at the edges of the incision. The suture can be tightened to draw the edges of the tissue together, and then knotted and the suture tail trimmed.
When suturing, particularly in a minimally invasive surgery (MIS), there is a need to control the suture material so that it stays out of the way of the suture path and also so that the entire length of the suture can be used. This would avoid the need to pass suture/needles in and out when there is extensive knot tying in a procedure. In current MIS procedures, the surgeon typically clears the area prior to tying a knot with one of their available hand tools or grasps the suture and pulls it out of the way. However, when grasping the suture, if it is too close to the exit point of the tissue, forces can be exerted on the tissue that can result in poor patient outcomes (tissue trauma, poor anastomosis results, etc.) or inefficient use of time in the operating room (suture breakage, etc.).
In accordance with one or more embodiments, a surgical grasper with an integrated suture pulley for engaging a suture during a suturing process is disclosed. The grasper includes a jaw member pivotally connected to another jaw member, each having a suture engagement surface facing the suture engagement surface of the other. One of the jaw members includes a suture pivot post extending from its suture engagement surface, and the other jaw member has an opening in its suture engagement surface sized and arranged to receive the suture pivot post. The grasper can be operated to position the jaw members relative to each other in a suture grasping mode, in which the suture pivot post is received in the opening and the suture engagement surfaces securely engage the suture to inhibit movement of the suture relative to the grasper. The jaw members can also be positioned relative to each other in a pulley mode, in which the grasper slidably supports the suture and the suture pivot post acts as a pivot point and bearing surface for the suture.
In accordance with one or more further embodiments, a method is disclosed for handling a suture using surgical grasper having opposing jaws during a suturing process. The method includes (a) positioning the jaws of the surgical grasper on opposite sides of the suture; (b) moving the jaws relative to each other to a grasping mode in which the grasper fixedly holds a portion of the suture and inhibits movement of the suture relative to the grasper for one part of the suturing process; and (c) moving the jaws relative to each other to a pulley mode in which the grasper slidably supports the suture at a pivot point and permits the suture to slide relative to the grasper for another part of the suturing process.
In accordance with one or more further embodiments, a surgical grasper for engaging a suture in multiple modes of operation is disclosed. The grasper includes a first jaw member having a suture engagement surface and a suture pivot post extending from the suture engagement surface at a distal end of the first jaw member. The grasper also includes a second jaw member opposing the first jaw member. The second jaw member has a suture engagement surface facing the suture engagement surface of the first jaw member. The second jaw member also has an opening in the suture engagement surface at a distal end of the second jaw member configured to receive the suture pivot post. The first jaw member and said second jaw member are pivotally connected at a proximal end of each jaw member. One or both of the first jaw member and the second jaw member can be actuated to move relative to the other among at least a first grasper position, a second grasper position, and a third grasper position. In the first grasper position, the distal ends of the first jaw member and the second jaw member are separated such that a gap is present between the suture pivot post in the first jaw member and the opening in the second jaw member such that the suture can be inserted in the grasper. In the second position, the distal ends of the first and second jaw members are moved closer together than in the first position and the post engages the opening but the suture engagement surfaces are sufficiently separated to enable the suture to slidably move using the post as a pivot point and bearing surface. In the third position, the distal ends of the first and second jaw members are moved closer together than in the second position and the suture engagement surfaces engage the suture to inhibit movement of the suture relative to the grasper.
In accordance with one or more further embodiments, a robotic suturing system is disclosed. The system includes a first robotic arm, a second robotic arm, a suturing device operatively coupled to the first robotic arm, a suture handling device operatively coupled to the second robotic arm, and a control system. The control system is operatively coupled to the first robotic arm, the second robotic arm, the suturing device, and the suture handling device to control operation thereof to cooperatively perform a suturing procedure on a patient. The suture handling device includes a surgical grasper for engaging a suture. The grasper includes a first jaw member having a suture engagement surface and a suture pivot post extending from the suture engagement surface at a distal end of the first jaw member. The grasper also includes a second jaw member opposing the first jaw member. The second jaw member has a suture engagement surface facing the suture engagement surface of the first jaw member. The second jaw member also has an opening in the suture engagement surface at a distal end of the second jaw member configured to receive the suture pivot post. The first jaw member and said second jaw member are pivotally connected at a proximal end of each jaw member. One or both of the first jaw member and the second jaw member can be actuated to move relative to the other among at least a first grasper position, a second grasper position, and a third grasper position. In the first grasper position, the distal ends of the first jaw member and the second jaw member are separated such that a gap is present between the suture pivot post in the first jaw member and the opening in the opening in the second jaw member such that the suture can be inserted in the grasper. In the second position, the distal ends of the first and second jaw members are moved closer together than in the first position and the post engages the opening but the suture engagement surfaces are sufficiently separated to enable the suture to slidably move using the post as a pivot point and bearing surface. In the third position, the distal ends of the first and second jaw members are moved closer together than in the second position and the suture engagement surfaces engage the suture to inhibit movement of the suture relative to the grasper.
The system includes a first robotic arm 102 operatively coupled to a suturing device 106. The system also includes a second robotic arm 104 operatively coupled to a suture handling device 108. Each robot arm is connected to a computer control system 110, which controls movement of the robot arms and operation of the suturing device 106 and the suture handling device 108.
Examples of robotic arms that can be configured for use in the suturing system include those available from KUKA Robotics, Medineering Surgical Robotics, and ABB Robotics, among others.
The suture handling device 108 includes an elongated tubular housing 130 having a proximal end (not shown) connected to the second robotic arm 104 and an opposite distal end having first and second suture grasping end effectors 132, 133 and a laparoscope 134.
The elongated tubular housing 130 includes three internal working channels extending longitudinally along the length of the tubular housing 130. The first and second channels house the first and second suture grasping instruments 132, 133, respectively. The third channel houses the laparoscope 134.
The first and second suture grasping end effectors 132, 133 each include a surgical grasper 150 shown in
By way of non-limiting example, the jaw assembly can be a 2-3.5 mm surgical grasper.
The first jaw member 152 has a suture engagement surface 156 and a suture pivot post 158 extending from the suture engagement surface 156 at a distal end of the first jaw member 152.
The second jaw member 154 opposes the first jaw member 152. The second jaw member 154 has a suture engagement surface 160 facing the suture engagement surface 156 of the first jaw member 152. The second jaw member 154 also has an opening 162 in its suture engagement surface at a distal end of the second jaw member 154 sized and arranged to receive the suture pivot post 158.
In accordance with one or more embodiments, the suture engagement surfaces 156, 160 of the first and second jaw members 152, 154 have complementary serrations (e.g., V or U-shaped teeth) to more securely grip the suture.
The first and second jaw members 152, 154 are pivotally connected at a proximal end of each jaw member. One or both of the first and second jaw members 152, 154 can be actuated to move relative to the other among at least a first open position, a second suture pulley mode position, and a third suture grasping mode position as illustrated in
In the first open position (
In the second suture pulley mode position (
In the third suture grasping mode position (
The suturing system including the grasper with integrated suture pulley can be utilized in a variety of robotic surgical equipment, including autonomous robotic surgical systems as well as surgeon-controlled robotic equipment.
The descriptions of the various embodiments of the present disclosure have been presented for purposes of illustration, but are not intended to be exhaustive or limited to the embodiments disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the described embodiments. The terminology used herein was chosen to best explain the principles of the embodiments, the practical application or technical improvement over technologies found in the marketplace, or to enable others of ordinary skill in the art to understand the embodiments disclosed herein.
This application is a continuation application of International Application No. PCT/US2019/050308, filed on Sep. 10, 2019, which application claims priority from U.S. Provisional Patent Application No. 62/729,069, filed on Sep. 10, 2018, which applications are incorporated herein by reference in their entirety for all purposes.
| Number | Date | Country | |
|---|---|---|---|
| 62729069 | Sep 2018 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/US2019/050308 | Sep 2019 | US |
| Child | 17191200 | US |
