Abstract:
A surgical apparatus for use in endoscopic and/or laparoscopic procedures is provided. The surgical apparatus has an elongated body portion, a first jaw member extending from the body portion, and a second jaw member extending from the body portion and opposing the first jaw member. The second jaw member has a split nest slide coupled thereto that is configured to position a surgical incision member in a folded or unfolded position.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims the benefit of, and priority to, U.S. Provisional Patent Application Ser. No. 61/421,699 filed on Dec. 10, 2010, the disclosure of which is hereby incorporated by reference in its entirety. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    The device relates generally to surgical instrumentation and, more particularly, to a suturing apparatus adapted for use in endoscopic or laparoscopic surgical procedures. 
         [0004]    2. Description of Related Art 
         [0005]    Endoscopic or laparoscopic procedures are characterized by the use of an elongated cannula structure having a relatively small diameter with a proximal and distal end. The distal end of the cannula is passed through the surrounding tissue into the body cavity wherein the surgical procedure or examination is to be effected, thus providing a conduit for the insertion of surgical instrumentation. A plurality of cannula structures may be used to allow operation of a variety of instruments simultaneously during a given procedure. For example, one cannula may provide a conduit for an endoscope for vision and illumination within the operative cavity while the other cannulas may provide conduits for control of specialized surgical instruments designed for performing specific procedural functions. 
         [0006]    Many surgical procedures call for placing stitches through tissue, a procedure traditionally accomplished by hand. Laparoscopic suturing presents a particularly challenging task, because it must be accomplished using remote instrumentation through a port that typically averages between five and ten millimeters. One instrument for facilitating laparoscopic suturing is discussed in commonly owned U.S. Pat. No. 5,591,181, the contents of which are herein incorporated by reference. 
         [0007]    Although the suturing device described in U.S. Pat. No. 5,591,181 can be used to place laparoscopic sutures, the suturing device may require the use of a larger cannula to allow a needle to be passed through in order to place stitches through tissue. As it is generally considered desirable to reduce the size of a cannula used during a laparoscopic procedure to limit the amount of trauma to a patient as well as reduce the time it takes to heal, it would be advantageous to provide a laparoscopic suturing instrument that can pass through a smaller cannula. 
       SUMMARY 
       [0008]    In an embodiment of the present disclosure, a surgical apparatus for use in endoscopic and/or laparoscopic procedures is provided. The surgical apparatus has an elongated body portion, a first jaw member extending from the body portion, and a second jaw member extending from the body portion and opposing the first jaw member. The second jaw member has a split nest slide coupled thereto that is configured to position a surgical incision member in a folded or unfolded position. The second jaw member may include a needle blade configured to secure the surgical incision member in the second jaw member and a flexible link coupled to the split nest slide. The flexible link may be configured to control the movement of the split nest slide to position the surgical incision member in a folded or unfolded position. Additionally, the first jaw member and second jaw member are rotatably connected to the body portion. The flexible link may include an elastic blade and a holding pin. 
         [0009]    In another embodiment of the present disclosure, a method of assembling a surgical apparatus having an elongated body portion, and an end effector having a first jaw member and a second jaw member opposing the first jaw member is provided. The method includes placing the end effector assembly in an open state, attaching a split nest slide to the second jaw member and coupling the slit nest slide to a flexible link in the second jaw member using a pin. A needle blade in the second jaw member is moved in a distal direction such that an aperture in the needle blade corresponds to an aperture in the split nest slide and an aperture in the second jaw member. Then a surgical incision member is placed through the aperture of the split nest slide, the aperture of the second jaw member and the aperture of the needle blade. The needle blade is then moved in a proximal direction to secure the surgical incision member in the second jaw member. 
         [0010]    In yet another embodiment of the present disclosure a method of using a surgical apparatus including an elongated body portion, and an end effector having a first jaw member and a second jaw member opposing the first jaw member, a split nest slide coupled to the second jaw member, a flexible link coupled to the slit nest slide and a needle blade is provided. The end effector assembly is placed in an open state to secure a surgical incision member in the second jaw member using the needle blade. The flexible link is moved in a proximal direction to place the surgical incision member in a folded position and the end effector assembly is placed in a closed state. The end effector assembly is passed through a surgical port and placed in an open state before moving the flexible link in a distal direction to place the surgical incision member in an unfolded position. When the end effector assembly needs to be removed, the flexible link is moved in a proximal direction to place the surgical incision member in a folded position. The end effector assembly is then placed in a closed state and removed through the surgical port. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0011]    The above and other aspects, features, and advantages of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which: 
           [0012]      FIG. 1  is a perspective view of an end effector assembly of a surgical suturing apparatus in a closed position according to an embodiment of the present disclosure; 
           [0013]      FIG. 2  is a perspective view of a surgical suturing device according to an embodiment of the present disclosure; 
           [0014]      FIG. 3  is an exploded view of a jaw member of the end effector assembly depicted in  FIG. 1 ; 
           [0015]      FIG. 4  is a detailed view of the area outlined in  FIG. 3 ; 
           [0016]      FIG. 5  is a perspective view of the end effector assembly of  FIG. 1  in an open position; 
           [0017]      FIG. 6  is a plan view of the end effector assembly shown in  FIG. 6 ; 
           [0018]      FIG. 7  is a detailed view of the area outlined in  FIG. 6 ; 
           [0019]      FIG. 8  is a perspective view of a jaw member of the end effector assembly of  FIG. 1  with some of the parts removed; 
           [0020]      FIG. 9  is a perspective view of a needle and cam when the end effector assembly is in an open position; 
           [0021]      FIG. 10  is a plan view of the needle and cam in an open position taken along the line  10 - 10  of  FIG. 9 ; 
           [0022]      FIG. 11  is a side view of the end effector assembly of  FIG. 1 ; 
           [0023]      FIG. 12  is a plan view of the end effector assembly of  FIG. 11 ; 
           [0024]      FIG. 13  a detailed view of the area outlined in  FIG. 12 ; 
           [0025]      FIG. 14  is a perspective view illustrating operation of the split news needle folding mechanism; 
           [0026]      FIG. 15  is a perspective view of a needle and cam when the end effector assembly is in a closed position; and 
           [0027]      FIG. 16  is a plan view of the needle and cam in a closed position taken along the line  16 - 16  of  FIG. 15 . 
       
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
       [0028]    Particular embodiments of the present disclosure are described hereinbelow with reference to the accompanying drawings; however, it is to be understood that the disclosed embodiments are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure. 
         [0029]    Like reference numerals may refer to similar or identical elements throughout the description of the figures. As shown in the drawings and described throughout the following description, as is traditional when referring to relative positioning on a surgical instrument, the term “proximal” refers to the end of the apparatus which is closer to the clinician and the term “distal” refers to the end of the apparatus which is further away from the clinician. The term “clinician” refers to any medical professional (i.e., doctor, surgeon, nurse, or the like) performing a medical procedure involving the use of embodiments described herein. 
         [0030]    Referring now to the drawings and in particular to  FIGS. 1 and 2 , there is shown an end effector for a surgical suturing apparatus generally designated by reference numeral  100 . An example of surgical suturing apparatus capable of employing end effector  100  is described in U.S. Pat. No. 5,591,181. 
         [0031]    End effector  100  is disposed at the distal end of a shaft  20  that is coupled to a handle (not shown) of a surgical suturing apparatus and includes a pair of opposing jaw members  110  and  120 . The handle is used to control the opening and closing of jaws  110  and  120  and may be designed to move in the same plane as jaws  110  and  120  to provide an ergonomic advantage. The handle may also be rotatably connected to shaft  20  to provide further ergonomic advantage. Jaw members  110  and  120  are pivotally connected to each other by pin  104  extending through aperture or hole  102 . During a laparoscopic procedure, shaft  20  may be inserted through a cannula or surgical port  200   
         [0032]    Each jaw member  110 ,  120  is adapted to receive a needle  400  ( FIG. 3 ) in recesses  112 ,  122  respectively ( FIG. 12 ). Needle  400  is depicted throughout the figures as a surgical incision member (as defined above), however, the use of other varieties of surgical needles is also contemplated. When jaws  110  and  120  are closed as shown in  FIG. 1 , the needle  400  sits in a cavity  106  formed between jaws  110  and  120 . When the jaws are opened, the needle  400  is retained in recesses  112  or  122 . 
         [0033]    Referring to  FIGS. 3-16 , the suturing apparatus having end effector  100  will be described hereinbelow. Distal end  410  of needle  400  is placed through aperture  312  of the split nest slide  310 , aperture  122  of jaw member  120  and aperture  332  of needle blade  322 . Needle  400  is locked in place by a flexible needle blade  322  on the split nest side  412  of needle  400 . More specifically, and as shown in  FIGS. 4 ,  9  and  10 , split nest side  412  includes a protrusion  420  having a channel  428  and  430  and edges  424  and  426 . Before placing needle  400  in jaw member  120 , needle blade  322  is pushed distally until aperture  332  of needle blade  322  is in line with aperture  312  of split nest slide  310  and aperture  122  of jaw member  120 . After needle  400  is placed in an unfolded position in jaw member  120 , needle blade  322  is pulled proximally so that channel  428  of needle  400  slides between fingers  334  of needle blade  322  while channel  430  slides between opposing edges of aperture  312  of split nest slide  310 . Edges  424  and  426  abut one of fingers  334  thereby locking needle  400  in jaw member  120 . Flexible needle blade  322  may be composed from a 17-4 PH SST which is a precipitation hardening martensitic stainless steel having a Rockwell hardness scale C number between 41-47. Alternatively, 301 hardened stainless steel may be used. Flexible needle blade  322  should have leaf spring properties and a good hardness to be able to hold needle  400 . 
         [0034]    Split nest slide  310  is driven by a flexible link  324 . Flexible link  324  may be composed from a 17-4 PH SST which is a precipitation hardening martensitic stainless steel having a Rockwell hardness scale C number between 41-47. Flexible link  324  may also be composed of two portions: an elastic blade; and a hard head holding pin  320 . As shown in  FIGS. 3 ,  7  and  8 , split nest slide  310  has a notch  314  that corresponds to an aperture  326  in flexible link  324 . A pin  320  is placed through channel  124   a  on one side of jaw member  120 , through aperture  326  and out the other side of jaw member  120  through a corresponding channel  124   b  ( FIG. 1 ). Notch  314  of split nest slide  310  rests on pin  320 . As such, when flexible link  324  is moved distally or proximally, split nest slide  310  also moves distally or proximally. 
         [0035]      FIGS. 5 and 6  depict end effector assembly in an open state with needle  400  in an unfolded position. As shown in  FIGS. 5 and 6 , when flexible link  324  is pushed distally, split nest slide  310  is positioned on the distal end of jaw member  120  thereby positioning needle  400  in an unfolded position. 
         [0036]      FIGS. 11 through 16  depict end effector assembly  100  in a closed state with needle  400  in a folded position. As shown in  FIGS. 11 and 12 , when flexible link  324  is pulled proximally, split nest slide  310  is positioned near the proximal end of jaw member  120  thereby positioning needle  400  in a folded position. The folding of needle  400  is more clearly shown in  FIGS. 13-16 , which show flexible link  324  moving in a proximal direction. As flexible link  324  is pulled proximally, split nest slide  310  moves proximally because split nest slide  310  is coupled to flexible line  324  via pin  320 . Movement of the split nest slide  310  in the proximal direction causes proximal end  414  of needle  400  to move in an arcuate direction toward jaw member  120  until edge  422  of split nest side  412  rests on one of fingers  334  of needle blade  322  ( FIG. 15 ). Further, when split nest slide  310  is moved in the proximal direction, edge  432  engages the edges of aperture  312 . 
         [0037]    The split nest needle folding mechanism described above in accordance with an embodiment of the present disclosure permits the use of a larger needle  400  with a surgical suturing apparatus suitable for use with a smaller port or cannula thereby allowing needle  400  to be used with, e.g., a 5 mm port opening. During a surgical procedure, needle  400  is loaded into jaw member  120  as described above and folded inwards using flexible link  324  and split nest slide  310 . End effector assembly  100  is placed in a closed state that secures the folded needle and is passed through port  200  ( FIG. 2 ). After passing through port  200 , end effector assembly  100  is placed in an open state and link  324  is pushed distally causing split nest slide  310  to move distally thereby placing needle  400  in an unfolded position. After completing a stitching procedure, the needle is folded inward by pulling flexible link  324  proximally and end effector  100  is placed in a closed state in order to pull end effector  100  out of port  200 . 
         [0038]    It should be understood that the foregoing description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variances. The embodiments described with reference to the attached drawing figs. are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.