The present disclosure relates generally to a surgical instrument for applying a suture to body tissue. More particularly, the present disclosure relates to a surgical instrument suitable for laparoscopically applying a purse-string style suture around hollow tissue organs.
Anastomosis is the surgical joining of separate hollow organ sections. Typically, an anastomosis procedure follows surgery in which a diseased or defective section of hollow tissue is removed, and the end sections are stapled via a linear surgical stapler. Depending on the desired anastomosis procedure, the end sections may be joined by either circular, end-to-end, or side-to-side organ reconstruction methods.
In a circular anastomosis procedure, the two ends of the organ sections are joined by means of a stapling instrument which is inserted through a first opening in a patient. The stapling instrument drives a circular array of staples through the end section of each organ section and simultaneously cores any tissue interior of the driven circular array of staples to free the tubular passage. Typically, these instruments include an elongated shaft having a handle portion at a proximal end to actuate the instrument and a staple holding component disposed at a distal end. An anvil assembly including an anvil rod with attached anvil head is mounted to the distal end of the instrument adjacent the staple holding component. The anvil assembly is then positioned within a distal portion of the hollow organ, for instance. Next, the tissue of the tubular vessel is tied or purse stringed with a suture about a portion of the anvil assembly. Then, opposed end portions of tissue of the hollow organ(s) clamped between the anvil head and the staple holding component, the clamped tissue is stapled, and finally the annular knife is advanced to core the tissue within the hollow organ.
During such surgical procedures, it is often challenging to apply the suture to the tissue about a portion of the anvil assembly laparoscopically. Accordingly, it may be helpful to provide a surgical instrument to facilitate the laparoscopic application of a purse string suture to an anvil assembly.
The present disclosure relates to a surgical instrument including a handle assembly, an elongated portion extending distally from the handle assembly and defining a longitudinal axis, an end effector, and a needle assembly. The end effector is disposed adjacent a distal end of the elongated portion and includes a first jaw member and a second jaw member. The first jaw member is movable relative to the second jaw member between a first position where the jaw members are in an open position and a second position where the jaw members are in an approximated position. The first jaw member includes a plurality of undulations and a needle channel. Each undulation of the plurality of undulations of the first jaw member includes a peak, a valley, and a connecting portion which interconnects one peak with one valley. The needle channel of the first jaw member extends through each undulation of the plurality of undulations of the first jaw member and is parallel to the longitudinal axis. The second jaw member includes a plurality of undulations and a needle channel. Each undulation of the plurality of undulations of the second jaw member includes a peak, a valley, and a connecting portion which interconnects one peak with one valley. The needle channel of the second jaw member extends through each undulation of the plurality of undulations of the second jaw member and is parallel to the longitudinal axis. The needle assembly includes a first needle and a second needle. Each of the first needle and the second needle includes a suture catch configured to releasably engage a portion of a suture. The first needle is movable from a first position where a distal end of the first needle is positioned proximally of the first jaw member to a second position where the distal end of the first needle is positioned distally of the first jaw member. The second needle is movable from a first position where a distal end of the second needle is positioned proximally of the second jaw member to a second position where the distal end of the second needle is positioned distally of the second jaw member.
In aspects, the peaks of at least a majority of undulations of the plurality of undulations of the first jaw member and the second jaw member may be flat along a majority of their lengths in a direction that is parallel to the longitudinal axis. The peaks of at least a majority of undulations of the plurality of undulations of the second jaw member may be flat along a majority of their lengths in a direction that is parallel to the longitudinal axis. In aspects, the valleys of at least a majority of undulations of the plurality of undulations of the first jaw member and the second jaw member may be flat along a majority of their lengths in a direction that is parallel to the longitudinal axis.
In additional aspects, a cumulative length of the flat portions of the peaks of the plurality of undulations of the first jaw member and the second jaw member may be between about 40% and about 60% of a total length of the respective jaw member.
In aspects, the connecting portions of at least a majority the plurality of undulations of the first jaw member may be perpendicular to the longitudinal axis.
In additional aspects, the needle channel of the first jaw member may extend through the connecting portion of each undulation of the plurality of undulations of the first jaw member, and the needle channel of the second jaw member may extend through the connecting portion of each undulation of the plurality of undulations of the second jaw member.
In aspects, each undulation of the plurality of undulations of the first jaw member may be longitudinally aligned with one undulation of the plurality of undulations of the second jaw member.
In further aspects, the needle channel of the first jaw member may define a cross-sectional shape having a first portion and a second portion. The first portion of the cross-sectional shape may be circular, and the second portion of the cross-sectional shape may be rectangular. The first portion of the cross-sectional shape of the needle channel of the first jaw member may extend through the connecting portion of each undulation of the plurality of undulations of the first jaw member. The second portion of the cross-sectional shape of the needle channel of the first jaw member may extend through the peak of each undulation of the plurality of undulations of the first jaw member.
The present disclosure also relates to a surgical instrument including a handle assembly, an elongated portion extending distally from the handle assembly and a defining a longitudinal axis, a first jaw member, and a needle channel. The first jaw member is disposed adjacent a distal end of the elongated portion and includes a plurality of undulations. Each undulation includes a peak, a valley, and a connecting portion which interconnects one peak with one valley. The needle channel extends through each undulation of the plurality of undulations and is parallel to the longitudinal axis. The needle channel defines a cross-section having a first portion and a second portion. The first portion extends through the connecting portion of each undulation of the plurality of undulations and the second portion extends through the peak of each undulation of the plurality of undulations.
In aspects, the first portion of the cross-section of the needle channel may be circular and the second portion of the cross-section of the needle channel may be rectangular.
In additional aspects, the peaks of at least a majority of undulations of the plurality of undulations of the first jaw member may be flat along a majority of their lengths in a direction that is parallel to the longitudinal axis, the valleys of at least a majority of undulations of the plurality of undulations of the first jaw member may be flat along a majority of their lengths in a direction that is parallel to the longitudinal axis, and the connecting portions of at least a majority of the plurality of undulations of the first jaw member may be perpendicular to the longitudinal axis.
In aspects, a cumulative length of the flat portions of the peaks of the plurality of undulations of the first jaw member may be between about 40% and about 60% of a total length of the first jaw member.
The present disclosure also relates to a method of performing a purse string closure, including positioning an end effector of a laparoscopic surgical instrument adjacent a surgical site, moving a first jaw member of the end effector toward a second jaw member of the end effector to clamp tissue therebetween, advancing a first needle and a suture through a plurality of undulations of the first jaw member such that the first needle punctures tissue disposed between adjacent undulations of the first jaw member, and advancing a second needle and the suture through a plurality of undulation of the second jaw member such that the second needle punctures tissue disposed between adjacent undulations of the second jaw member.
In aspects, advancing the first needle may include moving the first needle from a first position where a distal tip of the first needle is disposed proximally of the first jaw member to a second position where the distal tip of the first needle is disposed distally of the first jaw member.
In additional aspects, advancing the first needle and advancing the second needle may occur simultaneously.
Various aspects of the present disclosure are illustrated herein with reference to the accompanying drawings, wherein:
Aspects of the presently disclosed surgical instrument will now be described in detail with reference to the drawings wherein like numerals designate identical or corresponding elements in each of the several views. As is common in the art, the term “proximal” refers to that part or component closer to the user or operator, i.e. surgeon or physician, while the term “distal” refers to that part or component farther away from the user.
The handle assembly 200 includes a first actuator or trigger 210 and a second actuator or slider 220. Actuation of the trigger 210 is configured to translate a drive member longitudinally, which results in at least one jaw member (e.g., the first jaw member 410) to move with respect to the other jaw member (e.g., the second jaw member 420). That is, actuation of the trigger 210 causes the jaw members 410, 420 to move between an open position (e.g.,
Details of the first jaw member 410 and the second jaw member 420 are shown in
More particularly, each peak 413, 423 is flat or generally flat along a majority or an entirety of its length and is parallel to the longitudinal axis “A-A” (when the jaw members are in the approximated position). Further, cumulatively, the length of the flat portions of each of the peaks 413, 423 is in the range of about 40% to about 60% (e.g., about 50%) of the total length of the respective jaw member 410, 420. Additionally, each valley 414, 424 is flat or generally flat along a majority or an entirety of its length and is parallel to the longitudinal axis “A-A” (when the jaw members are in the approximated position). Further, cumulatively, the length of the flat portions of each of the valleys 414, 424 is in the range of about 40% to about 60% (e.g., about 50%) of the total length of the respective jaw member 410, 420.
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After the tissue “T” has been clamped, the needle assembly 500 is advanced distally, in the general direction of arrow “B” in
Additionally, since the suture 600 is engaged with the first needle 510 and the second needle 520, the distal advancement of the first needle 510 and the second needle 520 causes the suture 600 to follow the same or similar path of the first needle 510 and the second needle 520 through the channels 416, 426 and tissue “T” within the spaces 417, 427 between adjacent undulations 412, 422 of the first jaw member 410 and the second jaw member 420, respectively. The suture 600 is released (e.g., in response to proximal movement of the needles 510, 520) through the second portions 416b, 426b of the respective needle channels 416, 426 (
As a result of the distal translation of the first needle 510, the second needle 520, and the suture 600 through the tissue “T,” a purse string is formed around and through the tissue “T”, as schematically shown in
While the above description contains many specifics, these specifics should not be construed as limitations on the scope of the present disclosure, but merely as illustrations of various aspects thereof. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various aspects. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.