Suture driver

The suture driver includes an outer elongated member tube having a hollow passage extending longitudinally therein. The outer member tube has a recessed channel that is positioned proximal the closed distal end of the passage and communicates exterior to the outer member tube and with the hollow passage. The driver also includes an inner, elongated member rod that passes through the recessed channel and reinforces the distal end of outer member tube during percutaneous introduction into a patient.

The inner member rod also advantageously has a position for securely clamping the suture in the hollow passage and the recessed channel when the inner member rod is positioned adjacent the closed distal end of the outer member tube and through the recessed channel. Advantageously, the suture is not only clamped between the clamping surfaces of the inner member rod and closed distal end of the outer member tube, but is also captured between the surface of the inner member rod and the inner surface of the outer member tube.

Furthermore, the suture also engages the edges of the distal portion of the recessed channel, thus advantageously establishing additional engagement points to securely position the suture in the driver when manipulating the suture to and from the surgical site. The suture driver also comprises a handle that is attached to the proximal end of the outer member tube and has a chamber therein communicating with the hollow passage of the outer member tube.

The handle further includes a piston that is movably positioned in the chamber and removably attached to the inner member rod. The handle also has a slot extending longitudinally therealong through which a thumb screw laterally extends from the piston and through the slot for movement of the inner member rod to the clamping position.

The piston of the handle includes a passage for receiving the proximal end of the inner member rod. The thumb screw threadably and selectively engages the proximal end of the inner member rod when the rod is positioned in the passage of the piston. To facilitate capture of the suture, the recessed channel includes an undercut distal portion and a beveled proximal portion for positioning the suture distally in the channel.

The closed distal end of the passage includes a pointed distal end for penetrating tissue. The closed distal end also has a clamping surface facing the hollow passage of the outer member tube. The inner member rod includes a second clamping surface facing the clamping surface of the closed distal end when positioned in the hollow passage of the outer member tube. The suture is advantageously clamped between these two surfaces when the clamping surface of the inner member rod is positioned adjacent the clamping surface of the closed distal end when the inner rod is also positioned through the recessed channel.

The suture driver includes an outer, elongated member tube 11 with inner elongated member rod 15 slidably positioned in hollow passage 13 of the outer tube. For example, after percutaneous introduction into a patient, the suture driver is used to clamp and pull a suture internally from the body of a patient in such procedures as a periurethral suspension. When advancing or introducing the suture driver into tissue, the rigid, inner member rod is advanced to the distal end of the suture driver for supporting and reinforcing the outer member tube.

Positioned proximal the closed distal end of hollow passage 13, recessed channel 14 is transversely positioned through the outer member tube to communicate exterior to the outer member tube and with the hollow passage.

Suture driver 10 also includes handle 18 that is attached to proximal end 17 of the outer member tube for manual manipulation of the suture driver by the attending physician. The handle includes chamber 19 extending longitudinally therein and communicating with hollow passage 13 of the outer member tube. The handle also includes piston 20 that is removably attached to the proximal end of the inner member rod with thumb screw Thumb screw 21 laterally extends from piston 20 through slot 22 that extends longitudinally along the handle.

The longitudinal slot permits communication with the chamber and the exterior of the handle. The piston also is slidably positioned in the chamber with the thumb screw for movement of the inner member rod to a position for clamping the suture between the clamping surfaces of the closed distal end and the inner member rod. Handle 18 comprises an aluminum tube 40 approximately 4.

Longitudinal slot 22 is approximately 2" long and approximately 0. The proximal end of the handle includes a proximal end cap 23 glued in passage 19 of the handle tube. The proximal end cap also includes passage 28 to facilitate cleaning and sterilization of the reusable handle. Externally threaded distal through cap 24 is glued into the distal end of the handle tube.

Through cap 24 includes passage 29 for passing inner member rod 15 therethrough. Outer tube 11 includes internally threaded hub 25 attached to the proximal end thereof with, for example, silver solder, for threadably attaching the proximal end of outer tube 11 to through cap 24 and the distal end of the handle. Hub 25 is approximately 0. Adjacent the plurality of threads, an inside diameter of 0.

As a result, chamber 19 communicates with hollow passage 13 of the outer member tube via cap passage Chrome-plated brass piston 20, with passage 27 extending longitudinally therethrough, is slidably positioned in handle chamber A reduced diameter extension rod 26 is attached to the proximal end of inner member rod 15 using, again, for example, silver solder.

The inner member rod extension is inserted into piston passage 27 and selectively engaged with thumb screw 21 threadably inserted into the piston passage. The diameter of the proximal portion of piston passage 27 is enlarged to lighten the weight of the piston and to facilitate cleaning of the handle components.

Piston 20 is approximately 1. Piston passage 27 has a diameter of approximately 0. Closed and pointed distal end 12 is positioned in hollow passage 13 at the distal end of outer member tube 11 with clamping surface 32 at the proximal end of pointed end plug 12 facing proximally into hollow passage Inner member rod 15 with clamping surface 33 thereof facing clamping surface 32 is positioned in hollow passage 13 proximal to recessed channel With the inner member rod slidably removed from recessed channel 14, suture 16 is positioned into undercut distal portion 30 of the channel.

Recessed channel 14 also includes beveled proximal portion 31 for guiding the suture distally downward and into undercut distal portion Distal end plug 12 includes cylindrically convex clamping surface 38, and inner member rod 15 includes oppositely facing cylindrically concave clamping surface Clamping surfaces 38 and 39 are alternative embodiments of blunt clamping surfaces 32 and 33, respectively.

Clamping surface 39 of inner member rod 15 engages and centers suture 16 against oppositely facing clamping surface 38 of closed distal end plug Undercut distal portion 30, as well as cylindrically concave clamping surface 39 and cylindrically convex clamping surface 38, also facilitates the central positioning of suture 16 in hollow passage Suture 16 is engaged by clamping surface 33 of the inner member rod and oppositely facing clamping surface 32 of the closed distal end plug.

Distal to recessed channel 14, suture 16 is further maintained in hollow passage 13 by engagement longitudinally between the outer longitudinal surface inner member rod 15 and the inner surface of outer member tube The free ends of suture 16 extend transversely from recessed channel 14 at undercut distal portion 30 thereof. As a result, the suture makes three or more bends with the driver in the clamped position to further secure the suture in the driver.

As depicted in the preferred embodiment of suture driver 10, outer member tube 11 comprises, for example, a 7. Recessed channel 14 is approximately 0. Beveled proximal portion 31 extends along the axis of the tube for a length of 0. Undercut distal portion 30 extends along the axis of the tube for a length of 0. Recessed channel 14 extends intermediately between portions 31 and 32 for a length of 0. Undercut distal portion 30 of the recessed channel is formed 0.

Pointed and closed distal end plug 12 comprises, for example, a 0. The conically shaped distal point extends 0. The plug includes a minimum outside diameter of 0. The edges adjacent clamping surface 33 are smoothed. Inner member rod 15 is a 8. Inner rod extension 26 is a 1. Trocar-shaped distal end 34 cuts a cylindrical hole in tissue during use. In contrast, conically shaped, closed distal end 12 of FIG.

On the opposite side of closed distal end 35, secondary bevel 37 extends longitudinally therealong at an approximately 27 degree angle. The secondary bevel provides increased sharpness to closed distal end Beveled, closed distal end 35 cuts a slit-like opening in tissue during use.

It is to be understood that the above-described suture driver is merely an illustrative embodiment of the principles of this invention and that other suture drivers may be devised by those skilled in the art without departing from the spirit and scope of this invention.

In particular, a hole extending transversely through the outer member tube can be substituted for the recessed channel. The suture driver can also be made with other materials such as plastics or other metals depending on whether the instrument will be reused or used only one time.

The outer member tube and inner rod can be made for onetime use in conjunction with a reusable handle. All rights reserved. Login Sign up. Search Expert Search Quick Search. Suture driver. United States Patent A suture driver for clamping a suture in the hollow passage and a recessed channel thereof and manipulating the suture to and from a surgical site. This can be time-consuming and difficult to achieve especially following long trying surgical procedures.

The aim was to develop and evaluate a new mechanical suture device for standardized wound closure. Methods: A mechanical suture device Suture-tool was developed in collaboration between a medical technology engineer team with the aim to achieve a standardized suture line of high quality that could be performed speedy and safe.

Ten surgeons closed an incision in an animal tissue model after a standardized introduction of the instrument comparing the device to conventional needle driver suturing NDS using the technique. Results: In total, 80 suture lines were evaluated.