Patent Publication Number: US-2022225983-A1

Title: Suture needle adaptors for delivering suture needles through cannulas while simultaneously visualizing the delivery of the suture needles through the cannulas

Description:
BACKGROUND OF THE INVENTION 
     Field of the Invention 
     The present patent application is generally related to surgical instruments, and is more specifically related to surgical instruments used for delivering suture needles through cannulas for use at surgical sites. 
     Description of the Related Art 
     Sutures are used to approximate tissue that has been separated during a surgical procedure or due to an accident or trauma. Instruments used for suturing tissue typically include a suture needle and a trailing length of suture thread that is attached to an end of the suture needle. 
     In order to minimize patient trauma during minimally invasive surgical (MIS) procedures, many efforts have been directed to reducing the size (e.g., the diameter) of the trocars and cannulas (hereinafter commonly referred to as cannulas) that are inserted into patients. When a surgical procedure requires suturing tissue, a problem arises in the types of needle and suture assemblies that can be delivered through the cannula to the surgical site. Many surgeons prefer to use curved needles, which are typically in the range of ¼ to ⅝ of a circle (i.e., an arc whose interior angle is in the range of about 90 degrees-225 degrees). Curved needles having these dimensions require the cannula to be large enough to accommodate the needle, as well as the instrument(s) necessary to deliver the needle within the surgical space, to ensure a safe and controlled delivery of the sharp needle within the endoscopic space. In many instances, the combined size of the curved surgical needle and the delivery instrument is too large so that the curved surgical needle and the delivery instrument cannot be passed through the narrower cannula to reach the surgical site. 
     Constraints on the size of the cannula or trocar create challenges when selecting instruments and devices that are used for accessing invasive surgical spaces. When introducing a curved suture needle, in a controlled fashion, the delivery instrument and the largest size needle is limited to what will fit within a cannula typically having an interior diameter in a range from 5 mm to 15 mm. 
     Methods of passing suture needles into peritoneal spaces without the using cannulas have been disclosed. For example, Dr. H. Reich disclosed a method for introducing any size curved needle into the peritoneal cavity through a 5 mm lower quadrant incision in an article entitled, “All You Need to Know About Laparoscopic Suturing,” in the book  A Practical Manual of Laparoscopy and Minimally Invasive Gynecology—A Clinical Cookbook,  second edition, 2007, by Resad Pasic, M.D., Ph.D. As disclosed by Dr. H. Reich, a 5 mm trocar is withdrawn from the abdomen of a patient. A grasper is passed through the withdrawn 5 mm trocar cannula and the suture is grasped slightly away from the needle base. The grasper is then forced into the unoccupied trocar cannula incision with the needle trailing alongside the grasper. The trocar cannula is also passed back through the incision along with the grasper. The disadvantage of this method is that insertion of the needle into the abdominal wall, after the removal of the trocar sleeve, makes it difficult for the surgeon to find the original incision resulting in additional damage as he or she attempts to follow the original path. Also, the unprotected needle point may damage the soft tissue, vessels, and nerves as the needle travels through the soft tissue. 
     Another method for introducing a large curved needle through a small cannula involves forcibly bending the needle at a distinct location to flatten the arc of the needle. The semi-flattened needle is then passed through the cannula and is subsequently manually bent back into the larger arced configuration prior to use within the endoscopic space. This manipulation of the surgical needle results in malformed arced geometries that are more difficult to guide, damaged needle points, and an increased likelihood that the bent needle will break because the curved needles are not designed to be altered (e.g., bent). 
     U.S. Pat. No. 6,527,793 to Valtchev discloses a device for introducing and removing a laparoscopic needle through an incision in a wall of a body cavity. The device includes a rod unit with an elongated rod member having proximal and distal end segments that are disposed on opposite ends of an interior chamber. The interior chamber has an elongated slot that is dimensioned to receive a curved laparoscopic needle and a handle member for manipulating the position of the laparoscopic needle within the body cavity. The device provides a mechanism for placing the needle within the cavity directly through the incision, similar to that as disclosed by Dr. H. Reich, however, it protects the ends of the needle from contacting the tissue during passage through the incision. Like the Reich method, the device requires the removal of the cannula, however, due to the presence of the rod geometry, the back span of the needle must dilate the tissue incision to compensate for the shortening of the incision length due to the accommodation of the rod volume. 
     U.S. Pat. No. 5,219,358 to Bendel et. al. discloses a surgical needle made of a shape memory alloy, which has a first, low temperature state and a second, high temperature state, and methods for using the surgical needle. The shape memory alloy has a low temperature state, in which the needle is formable into an elongated shape to pass through an elongated tube, and a high temperature state, in which the needle forms an arc. The needle is particularly adapted for use in endoscopic surgery. A needle that has a curved shape is straightened and passed to a surgical site through a cannula. It is then returned to its curved shape by heating it at the surgical site. After use, the needle is withdrawn through the cannula. While the shape memory alloy needle provides a methodology for passing surgical needles with large geometries through smaller diameter cannulas, the methods of manufacture require revised tooling as well as increased manufacturing costs. 
     Accordingly, there remains a need for improved systems, devices and methods for passing curved suture needles through smaller diameter cannulas in a controlled and safe manner. 
     SUMMARY OF THE INVENTION 
     In one embodiment, a needle camera adaptor is designed for delivering a suture needle through a cannula while simultaneously visualizing the suture needle during passage through the cannula and subsequent placement within a surgical site. In one embodiment, the suture needle may be a curved suture needle and may have a suture thread secured to an end thereof. In one embodiment, the needle camera adaptor is configured for removing a curved suture needle (and the attached suture) through a cannula while simultaneously visualizing the suture needle and the suture. 
     In the prior art, before a suture needle may be passed through a cannula for being placed at a surgical site, the camera must first be removed from the cannula. As a result, the suture needle is passed through the cannula without visibility, and the camera may only be re-introduced into the cannula after the suture needle has been positioned at the surgical site. In contrast, in one embodiment of the present patent application, the needle camera adaptor preferably enables a suture needle to be passed through a cannula for placement at a surgical site, while maintaining continuous visualization of the suture needle at all times. In addition, the needle camera adaptor may be used for removing the suture needle from the surgical site while maintaining continuous visualization of the suture needle as it is removed through the cannula. 
     In one embodiment, a needle camera adaptor preferably includes an elongated body having a proximal end, a distal end, and a longitudinal axis that extends from the proximal end to the distal end thereof. The terms proximal and distal are defined as relative to the location of the instrument user, wherein proximal refers to structure that is closer to the user and distal refers to structure that is further away from the user and/or closer to the working end of the instrument. In one embodiment, the elongated body includes a tube-shaped outer wall that extends from the proximal end to the distal end of the elongated body, and a lumen that extends along the longitudinal axis of the elongated body from the proximal end to the distal end thereof. 
     In one embodiment, the needle camera adaptor desirably includes a lateral access opening formed in the tube-shaped outer wall that provides lateral access to the lumen. In one embodiment, the lateral access opening is located in a central region of the elongated body, which is preferably between the proximal and distal ends of the elongated body. 
     In one embodiment, a needle securing channel is preferably formed in the tube-shaped outer wall of the elongated body. In one embodiment, the needle securing channel extends between the lateral access opening and the distal end of the elongated body. In one embodiment, the needle securing channel extends along an axis that defines an oblique angle with the longitudinal axis of the elongated body. 
     In one embodiment, the needle camera adaptor desirably includes a visualization device that is positioned within the lumen of the elongated body, at the proximal end of the elongated body. In one embodiment, the lateral access opening and the needle securing channel are located within a field of view of the visualization device. 
     In one embodiment, the visualization device preferably includes an endoscope, which may be flexible or rigid, and which may be made of metal or polymer materials. 
     In one embodiment, the visualization device may include a camera for capturing images, and one or more lighting elements (e.g., fiber optic lights; LEDs) for illuminating the field of view of the visualization device. 
     In one embodiment, the needle camera adaptor preferably includes a proximal needle securing recess formed in an inner surface of the tube-shaped outer wall that is located within the central region of the elongated body, and a distal needle securing recess formed in the inner surface of the tube-shaped outer wall that is located adjacent the distal end of the elongated body. In one embodiment, the axis of the needle securing channel desirably extends between and is aligned with the proximal and distal needle securing recesses. 
     In one embodiment, the proximal needle securing recess is off-set from the longitudinal axis of the elongated body, and the distal needle securing recess is in alignment with the longitudinal axis of the elongated body. 
     In one embodiment, the needle camera adaptor may include a curved suture needle having a proximal end with a suture attachment barrel, a distal end with a sharpened tip, and a curved elongated body extending from the proximal end to the distal end of the curved suture needle. 
     In one embodiment, the proximal end of the curved suture needle may be disposed within the proximal needle securing recess, the distal end of the curved suture needle may be disposed within the distal needle securing recess, and the curved elongated body may be disposed within the needle securing channel for releasably securing the curved suture needle to the needle camera adaptor. 
     The distal needle securing recess preferably seats the sharpened tip of a curved suture needle and prevents accidental needle sticks from puncturing tissues, such as bowel, upon insertion into the surgical site. The distal needle securing recess also preferably provides protection for the needle tip from damage due to drag in the cannula and protects the trocar or cannula seal from damage due to needle punctures/rips. 
     In one embodiment, the needle securing channel preferably includes an elongated gap formed in the tube-shaped outer wall of the elongated body that extends from an outer surface to the inner surface of the tube-shaped outer wall. The needle securing channel desirably includes one or more resilient elements (e.g., scalloped features) that project into the gap that are adapted to provide a compressive force on lateral sides of the curved elongated body of the curved suture needle when the curved suture needle is disposed within the needle securing channel for releasably securing the curved suture needle within the needle securing channel. 
     In one embodiment, the curved elongated body of the curved suture needle that is disposed within the needle securing channel extends along the axis that defines the oblique angle with the longitudinal axis of the elongated body. As a result, the visualization device is able to obtain images of the side of the curved suture needle as it is passed through a cannula to a surgical site. This side image adds depth perception, which allows the needle to be easily grasped by the needle driver. 
     In one embodiment, the needle camera adaptor may have a distal stop located between the distal needle securing recess and the distal end of the elongated body for preventing the sharpened tip of the curved suture needle from moving distal to the distal end of the elongated body. 
     In one embodiment, a first end of a suture may be secured to the suture attachment barrel of the curved suture needle. In one embodiment, when the curved suture needle has been secured within the needle securing channel, and the suture attachment barrel is disposed within the proximal needle securing recess, the suture may extend out of the proximal needle securing recess, through the lateral access opening, and toward the proximal end of the elongated body of the needle camera adaptor. 
     In one embodiment, the needle camera adaptor may include at least one suture retrieval slot formed in the tube-shaped outer wall of the elongated body. In one embodiment, the at least one suture retrieval slot has an open end that is in communication with the lateral access opening, which faces toward the visualization device, and a closed end that is distal to the open end. In one embodiment, the at least one suture retrieval slot narrows between the open end and the closed end thereof. 
     In one embodiment, the at least one suture retrieval slot and the suture captured within the at least one suture retrieval slot are desirably disposed within a field of view of the visualization device. 
     In one embodiment, the needle camera adaptor may include one or more suture retrieval slots (e.g., two suture retrieval slots). In one embodiment, a first suture retrieval slot may be formed in the tube-shaped outer wall on a first lateral side of the elongated body, and a second suture retrieval slot may be formed in the tube-shaped outer wall on a second lateral side of the elongated body. 
     In one embodiment, the one or more suture retrieval slots are preferably located adjacent an upper end and/or top side of the tube-shaped outer wall of the elongated body of the needle camera adaptor, as opposed to a mid-section of the tube-shaped outer wall. If the one or more suture retrieval slots were positioned in the mid-section of the tube-shaped outer wall, during removal of a suture needle from a cannula, the suture strand material would be much more likely to catch on the overlapping seal flaps inside the head of the cannula. Thus, placing the suture retrieval slots at the upper end and/or top side of the tube-shaped outer wall, as well as proper shaping of the suture retrieval slots, desirably prevents the suture strand material from snagging and/or getting hung up on the seal flaps during removal of the suture needle from the cannula. 
     In one embodiment, the needle camera adaptor preferably includes a sloping distal end face that extends between the distal end of the elongated body and a distal end of the needle securing channel. 
     In one embodiment, a needle camera adaptor preferably includes a tube-shaped body having a proximal end, a distal end, a longitudinal axis that extends from the proximal end to the distal end, and a lumen that extends along the longitudinal axis of the tube-shaped body from the proximal end to the distal end thereof. 
     In one embodiment, the needle camera adaptor preferably has a lateral access opening formed in an outer wall of the tube-shaped body that provides lateral access to the lumen. The lateral access opening is desirably located in a central region of the tube-shaped body, which is preferably between the proximal and distal ends of the tube-shaped body. 
     In one embodiment, the needle camera adaptor preferably includes a needle securing channel formed in the outer wall of the tube-shaped body that extends between the lateral access opening and the distal end of the tube-shaped body. In one embodiment, the needle securing channel extends along an axis that is not parallel to the longitudinal axis. In one embodiment, the needle securing channel extends along an axis that defines an oblique angle with the longitudinal axis of the tube-shaped body. 
     In one embodiment, a curved suture needle is preferably disposed within the needle securing channel and may be accessible via the lateral access opening. 
     In one embodiment, the needle securing channel and the curved suture needle preferably extend along an axis that defines an oblique angle with the longitudinal axis of the tube-shaped body. 
     In one embodiment, the needle camera adaptor preferably includes a visualization device positioned within the lumen at the proximal end of the tube-shaped body and facing toward the distal end of the tube-shaped body. In one embodiment, the lateral access opening, the needle securing channel, and the curved suture needle secured within the needle securing channel are desirably located within a field of view of the visualization device. 
     In one embodiment, the visualization device preferably includes an endoscope having a distal end that is assembled with the proximal end of the tube-shaped body, a camera, and one or more lighting elements (e.g., an optical fiber; an LED) for illuminating the field of view of the visualization device. 
     In one embodiment, a needle camera adaptor may include a proximal needle recess formed in an inner surface of the tube-shaped body that is located within the central region of the tube-shaped body and that is adapted to seat a proximal end of the curved suture needle. 
     In one embodiment, a needle camera adaptor may include a distal needle recess formed in the inner surface of the tube-shaped body that is located adjacent the distal end of the tube-shaped body and that is adapted to seat a distal end of the curved suture needle. 
     In one embodiment, the axis of the needle securing channel extends between and is aligned with the proximal and distal needle recesses. 
     In one embodiment, the curved suture needle desirably includes the proximal end with a suture attachment barrel, the distal end with a sharpened tip, and a curved elongated body extending from the proximal end to the distal end of the curved suture needle. In one embodiment, the curved elongated body is disposed within the needle securing channel. 
     In one embodiment, the needle camera adaptor preferably has at least one suture retrieval slot formed in the outer wall of the tube-shaped body. The at least one suture retrieval slot preferably has an open end that is in communication with the lateral access opening and that faces toward the visualization device and a closed end that is distal to the open end. In one embodiment, the at least one suture retrieval slot narrows between the open end and the closed end thereof. In one embodiment, the needle camera adaptor preferably includes one or more suture retrieval slots. In one embodiment, the needle camera adaptor may include a pair of suture retrieval slots, wherein a first slot is located on a first lateral side of the outer wall and a second slot is located on a second lateral side of the outer wall. 
     In one embodiment, a needle camera adaptor may include a tube-shaped body having a proximal end, a distal end, a longitudinal axis that extends from the proximal end to the distal end, and a lumen that extends along the longitudinal axis of the tube-shaped body from the proximal end to the distal end thereof. 
     In one embodiment, a needle camera adaptor preferably includes a lateral access opening formed in an outer wall of the tube-shaped body that provides lateral access to the lumen of the tube-shaped body. In one embodiment, the lateral access opening is preferably located in a central region of the tube-shaped body that is between the proximal and distal ends of the tube-shaped body. 
     In one embodiment, a needle securing channel may be formed in the outer wall of the tube-shaped body. In one embodiment, the needle securing channel desirably extends between the lateral access opening and the distal end of the tube-shaped body. 
     In one embodiment, the needle camera adaptor preferably includes a proximal needle securing recess formed in an inner surface of the outer wall. In one embodiment, the proximal needle securing recess is located within the central region of the tube-shaped body and is off-set from the longitudinal axis. 
     In one embodiment, a needle camera adaptor preferably includes a distal needle securing recess formed in the inner surface of the outer wall, whereby the distal needle securing recess is located adjacent the distal end of the tube-shaped body and is in alignment with the longitudinal axis. 
     In one embodiment, the axis of the needle securing channel may extend between, intersect with, and/or be aligned with the proximal and distal needle securing recesses. 
     In one embodiment, a needle camera adaptor preferably includes at least one suture retrieval slot formed in the outer wall of the tube-shaped body. In one embodiment, the at least one suture retrieval slot preferably has an open end that is in communication with the lateral access opening and that faces toward the proximal end of the tube-shaped body and a closed end that is distal to the open end. 
     In one embodiment, the lateral access opening may be located between the visualization device and the distal end of the elongated body. 
     In one embodiment, the proximal needle securing recess may be located distal to the visualization device and opposite the lateral access opening. 
     In one embodiment, the proximal needle securing recess preferably accommodates the proximal end of a suture needle with a suture attached so as to not damage the suture. 
     In one embodiment, the proximal needle securing recess is desirably positioned off-set to a central axis that passes through the elongated member. 
     In one embodiment, the distal needle securing recess desirably provides optimum positioning of a curved suture needle to facilitate arming with a needle driver. 
     In one embodiment, the needle camera adaptor preferably maintains physical control of the suture needle during the passage of the suture needle and the visualization device (e.g., a camera) through a cannula (e.g., a trocar). 
     In one embodiment, the needle camera adaptor provides a visualization pathway. In one embodiment, the needle is visible during delivery under one focal length and the needle camera adaptor does not interfere with visualization under a longer focal length. 
     In one embodiment, the distal end of the needle camera adaptor preferably has a ramped or sloping distal end face, which provides for smoother entry of the distal end of the needle camera adaptor into a cannula. 
     In one embodiment, the needle camera adaptor preferably includes one or more suture engagement channels, which enable secure grasping of the suture to facilitate needle removal after use during a surgical procedure. 
     These and other preferred embodiments of the present patent application will be described in more detail below. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1A  is an exploded view of a system for delivering a suture needle through a cannula while simultaneously visualizing the suture needle during passage through the cannula including a needle camera adaptor, a surgical suture needle with a suture thread that is secured to the needle camera adaptor, and an endoscope/laparoscope that is adapted for being assembled with the needle camera adaptor, in accordance with one embodiment of the present patent application. 
         FIG. 1B  is a magnified view of the needle camera adaptor, the surgical suture needle, and the distal end of the endoscope shown in  FIG. 1A . 
         FIG. 2A  is a perspective view of a top side of the needle camera adaptor shown in  FIGS. 1A and 1B . 
         FIG. 2B  is a top plan view of the needle camera adaptor shown in  FIG. 2A . 
         FIG. 2C  is a cross-sectional view of the needle camera adaptor shown in  FIG. 2B . 
         FIG. 3  is a magnified view of the distal end of the needle camera adaptor shown in  FIG. 2B . 
         FIG. 4A  is a perspective view of a wall of the needle camera adaptor shown in  FIG. 3  including a needle securing channel and a pair of suture retrieval slots, in accordance with one embodiment of the present patent application. 
         FIG. 4B  is a magnified view of a suture retrieval slot shown in  FIG. 4A . 
         FIG. 5  is a perspective view of a curved surgical suture needle that is adapted to be secured to the needle camera adaptor shown in  FIGS. 2A-2C , in accordance with one embodiment of the present patent application. 
         FIG. 6A  is a perspective view of a top side of a needle camera adaptor and a curved surgical suture needle secured to the needle camera adaptor, in accordance with one embodiment of the present patent application. 
         FIG. 6B  is a top plan view of the needle camera adaptor and the curved surgical needle shown in  FIG. 6A . 
         FIG. 6C  is a side view of the needle camera adaptor and the curved surgical needle shown in  FIGS. 6A and 6B  with walls of the needle camera adaptor being partially transparent. 
         FIG. 7  is a magnified view of a needle securing channel of the needle camera adaptor shown in  FIGS. 6A-6C  with the curved surgical needle passing through the needle securing channel, in accordance with one embodiment of the present patent application. 
         FIG. 8A  is a perspective view of a distal end of the endoscope shown in  FIGS. 1A and 1B . 
         FIG. 8B  is another perspective view of the distal end of the endoscope shown in  FIGS. 1A, 1B, and 8A . 
         FIG. 9A  illustrates a stage of a method of assembling a needle camera adaptor with a distal end of an endoscope, wherein the needle camera adaptor and the endoscope are shown in cross-section, in accordance with one embodiment of the present patent application. 
         FIG. 9B  illustrates another stage of a method of assembling a needle camera adaptor with a distal end of an endoscope, wherein the needle camera adaptor and the endoscope are shown in cross-section, in accordance with one embodiment of the present patent application. 
         FIG. 10  is a perspective view of the system shown in  FIGS. 1A and 1B  after the needle camera adaptor has been assembled with the distal end of the endoscope. 
         FIG. 11  is a perspective view of a needle camera adaptor having a curved surgical needle secured to the needle camera adaptor and a camera assembled with a proximal end of the needle camera adaptor for visualizing the curved surgical needle as the needle camera adaptor and the curved surgical needle are advanced through a cannula for placement at a surgical site, in accordance with one embodiment of the present patent application. 
         FIG. 12A  is a perspective view of a trocar used for delivering the needle camera adaptor and the curved surgical needle of  FIG. 11  to a surgical site, in accordance with one embodiment of the present patent application. 
         FIG. 12B  illustrates a method of inserting the needle camera adaptor and the curved surgical needle secured to the needle camera adaptor into a proximal end of the trocar of  FIG. 12A , in accordance with one embodiment of the present patent application. 
         FIG. 13  illustrates a method of using a needle driver for removing the curved surgical needle shown in  FIG. 12B  from a needle securing channel of the needle camera adaptor, in accordance with one embodiment of the present patent application. 
         FIG. 14  illustrates a method of positioning a suture strand within suture retrieval slits of a needle camera adaptor, in accordance with one embodiment of the present patent application. 
         FIG. 15  illustrates a method of using the needle camera adaptor of  FIGS. 12B and 14  for removing a curved surgical needle and a suture strand from a surgical site and removing the curved surgical needle and the suture strand through a trocar, in accordance with one embodiment of the present patent application. 
         FIG. 16  is a perspective view of a needle camera adaptor having a proximal end with scalloped features, in accordance with one embodiment of the present patent application. 
     
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
     The systems, devices and methods disclosed herein teach instruments and methodologies for delivering a suture needle (e.g., a curved suture needle) and a suture (e.g., a suture strand) through a cannula and into an endoscopic surgical site while fully protecting the suture needle and simultaneously visualizing the suture needle during passage through the cannula. The systems, devices and methods disclosed herein are preferably designed to not interfere with the functionality of the surgical endoscope throughout the procedure. In addition, the systems, devices and methods preferably ensure that suture needles may be safely removed from the endoscopic workspace in a fully visualized and safe method. Unlike other systems and methods that lose sight of the suture needle during either the introduction or removal steps, the use of the needle camera adaptor disclosed herein ensures that the suture needle will always remain in sight of medical personnel so that the possibility of a dropped or lost suture needle is eliminated. 
     As used herein, the terms surgical needle and suture needle are used interchangeably. A surgical needle may have a suture attached thereto or may not have a suture attached thereto. A suture needle may have a suture attached thereto or may not have a suture attached thereto. Regardless of whether the terms surgical needle or suture needle are used herein, the terms may be used to describe both needles having sutures attached thereto and needles that do not have sutures attached thereto. 
     As used herein, the term cannula means a tube that is inserted into a body cavity to administer medicine, drain off fluid, and/or insert a surgical instrument. 
     As used herein, a trocar means a surgical instrument including a cannula, a seal at a proximal end of the cannula, and an obturator (e.g., a metal or plastic rod-like element with a sharpened or non-bladed tip) at a distal end of the cannula. During endoscopic surgery, trocars are inserted through the abdominal wall for the purpose of viewing and/or performing surgery in the abdominal or pelvic cavities. The trocar functions as a portal for the subsequent placement of other instruments, such as needle drivers, graspers, and staplers. In the present patent application, the terms trocar and cannula may be used interchangeably. 
     As used herein, an endoscope means an illuminated flexible or rigid tubular instrument for visualizing inside a body cavity or the interior of a hollow organ or part (e.g., a bladder) for diagnostic or treatment purposes, including more specifically, laparoscopes. An endoscope may have one or more channels that enable surgical instruments to be passed through the endoscope for treating a patient. An endoscope may be inserted through a natural passageway (e.g., the esophagus) or through a small surgical opening formed in the skin or through a cannulated instrument, such as a trocar device. In one embodiment, an endoscope preferably includes a small camera with a light at the end of a cable for transmitting images to a video monitor. A surgeon may use special instruments that work through one of the channels of the endoscope alongside the cable used for transmitting images. 
     Referring to  FIGS. 1A and 1B , in one embodiment, a system  100  for delivering a suture needle through a cannula to a surgical site preferably includes a needle camera adaptor  102 , a suture needle  104 , and an endoscope  106 . The suture needle  104  may be an armed surgical needle including a suture thread secured to a proximal end of the surgical needle. In one embodiment, the suture needle may be a curved surgical needle that is used for suturing tissue. 
     Referring to  FIGS. 2A-2C , in one embodiment, the needle camera adaptor  102  preferably has a proximal end  108  and a distal end  110 . In one embodiment, the needle camera adaptor  102  preferably has an outer wall  112 , such as a tube-shaped outer wall, that extends along the length of the needle camera adaptor between the proximal and distal ends  108 ,  110  thereof. The outer wall  112  may have a generally cylindrical shape and may have a varying thickness. In one embodiment, the needle camera adaptor  102  preferably has a central lumen  114  that extends along a central or longitudinal axis A 1  thereof. The lumen  114  preferably extends from the proximal end  108  to the distal end  110  of the needle camera adaptor. The central lumen  114  may be utilized for securing a distal end of the endoscope  106  ( FIG. 1A ) to the proximal end  108  of the needle camera adaptor  102  and/or for providing visual access to the suture needle  104  as the combination of the needle camera adaptor and the suture needle are delivered through a cannula to a surgical site. The proximal end of the central lumen  114  may include a fully circular bore or may include flats, ribs or other non-circular geometries to facilitate proper alignment and/or a secure engagement between the distal end of the surgical endoscope  106  ( FIGS. 1A and 1B ) and the proximal end  108  of the needle camera adaptor  102 . 
     In one embodiment, the needle camera adaptor  102  preferably has a central region  116  that is open and that is defined by lateral edges  118 A,  118 B having a skived profile. In one embodiment, the central region  116  defines a lower lateral profile region of the needle camera adaptor, which enables a surgical instrument (e.g., a needle driver) to be inserted into the central region for removing a suture needle from its attachment with the needle camera adaptor. The opening in the central region may be referred to as a lateral access opening or an external access opening that enables a surgical tool to be inserted into the central region for releasing and/or removing a curved suture needle from its attachment to the needle camera adaptor. 
     In one embodiment, the needle camera adaptor  102  desirably includes a needle securing channel  120  formed in a topside of the tube-shaped outer wall  112  of the needle camera adaptor. In one embodiment, the needle securing channel  120  preferably extends between the distal end of the central region  116  and the distal end  110  of the needle camera adaptor. In one embodiment, the needle securing channel  120  is adapted to receive and hold a suture needle such as an armed suture needle. In one embodiment, the needle camera adaptor  102  preferably includes opposing resilient elements  122 A,  122 B (e.g., scalloped features) that are located on opposite sides of the needle securing channel  120 , which may apply compressive forces on lateral sides of the suture needle for holding the suture needle within the needle securing channel  120 . In one embodiment, a gap between the opposing resilient elements  122 A,  122 B is preferably slightly smaller than the width of the needle securing channel  120 . In one embodiment, the suture needle is releasably secured within the needle securing channel  120 . 
     In one embodiment, the needle camera adaptor  102  preferably has a floor  124  or inner surface that extends through the central region  116  and toward the distal end  110  of the needle camera adaptor. In one embodiment, the needle camera adaptor  102  desirably includes a suture relief pocket  126 , also known as a proximal needle securing recess, which is formed in the floor  124  within the central region  116  of the needle camera adaptor. As will be described in more detail herein, the suture relief pocket  126  (a/k/a proximal needle securing recess) is adapted to seat a proximal end of a suture needle and a portion of a suture strand that is secured to the proximal end of the suture needle. 
     In one embodiment, the suture relief pocket  126  is offset from the longitudinal or central axis A 1  of the needle camera adaptor  102  and provides a locating feature for the proximal end of a suture needle having an attached suture thread. 
     In one embodiment, the needle camera adaptor  102  desirably includes a needle point recess  128 , also known as a distal needle securing recess, which is formed in the floor  124  or inner surface of the tube-shaped body and that is located adjacent the distal end  110  of the needle camera adaptor  102 . The needle point recess  128  (a/k/a the distal needle securing recess) is adapted to receive and seat the sharpened pointed tip of a suture needle (e.g., a curved surgical needle) to prevent the sharpened pointed tip from scratching the inner surface of a cannula and/or contacting a patient&#39;s tissue as the suture needle is passed through a cannula for being positioned at a surgical site. 
     In one embodiment, the needle camera adaptor  102  preferably has a distal end wall  138  or distal stop that extends laterally across the distal end  110  of the needle camera adaptor and along a lower end of the needle camera adaptor  102 . The distal end wall  138  preferably projects slightly above the floor  124  or inner surface of the needle camera adaptor  102  and desirably functions as a stop to prevent the sharpened tip of a curved surgical needle from extending beyond the distal end  110  of the needle camera adaptor  102 , which prevents the point from being damaged and/or from scratching the cannula during passage through the cannula. 
     In one embodiment, the distal end  110  of the needle camera adaptor  102  preferably includes a sloping distal end face  140  that defines an oblique angle at the distal end  110  of the needle camera adaptor  102 . The oblique angle of the sloping distal end face  140  preferably facilitates passing the needle camera adaptor  102  through a cannula, or through a seal at a proximal end of a trocar. 
     In one embodiment, the needle camera adaptor  102  preferably includes a pair of suture retrieval slots  142 A,  142 B that are formed in the outer wall  112  of the needle camera adaptor  102 . In one embodiment, the pair of suture retrieval slots  142 A,  142 B are adapted to seat a suture strand for removing the suture needle and the suture strand from a surgical site. At the end of a surgical procedure, when it is desired to remove the suture needle and the suture thread from a patient, the suture is preferably inserted and/or pressed into the suture retrieval slots  142 A,  142 B. 
     Referring to  FIG. 2B , in one embodiment, the needle securing channel  120  is formed with two opposing resilient elements  122 A,  122 B, which may include two semi-circular features on the channel  120 . In this configuration, the opposing resilient elements  122 A,  122 B result in a portion of the needle securing channel  120 , located near the central region of the needle securing channel  120 , that is greater in width than the abutting regions and is suited to receive the elongated body portion of the suture needle  104  ( FIG. 1A ). 
     Referring to  FIG. 2B , in one embodiment, the needle camera adaptor  102  preferably has a length that extends along a central or longitudinal axis A 1  thereof between the proximal end  108  and the distal end  110 . In one embodiment, the needle securing channel  120  is adapted to engage the sides of a suture needle when the suture needle is secured to the needle camera adaptor  102 . In one embodiment, the needle securing channel  120  preferably extends along a second axis A 2  that defines an oblique angle relative to the longitudinal axis A 1 . Thus, a suture needle may be mounted to the needle camera adaptor  102  at a slightly skewed orientation relative to the longitudinal axis A 1  of the needle camera adaptor. The skewed orientation of the suture needle desirably enables the suture needle, and particularly the side of the suture needle, to be continuously viewed on a video monitor as the suture needle is passed through a cannula and delivered to a surgical site. 
     The continuous visualization feature is important because the endoscopic lens and associated views may not be movable relative to the curved suture needle. The ability to visualize the side of the curved suture needle, due to the slightly skewed orientation along the second axis A 2 , preferably facilitates grasping the curved suture needle with a surgical instrument, such as a needle driver. In one embodiment, when grasping the curved suture needle with a surgical instrument, the focal point of an endoscope may be adjusted to near field positioning to enable the visualization during grasping of the suture needle by the needle driver. Once the curved surgical needle is removed from the needle camera adaptor  102 , the focal point of the endoscope may be adjusted to a far field setting so that the features of the needle camera adaptor (e.g., outer wall  112 ) are out of the width of the field of view and do not obstruct the endoscope views. 
     Referring to  FIGS. 2B and 2C , in one embodiment, the suture retrieval slots  142 A,  142 B of the needle camera adaptor  102  preferably have respective open ends  144 A,  144 B that face toward the proximal end  108  of the needle camera adaptor, and respective closed ends  146 A,  146 B that are narrower than the respective open ends. As such, the respective suture retrieval slots  142 A,  142 B are wider at the open ends  144 A,  144 B and narrower at the closed ends  146 A,  146 B thereof. 
     Referring to  FIG. 2C , in one embodiment, the tube-shaped outer wall  112  of the needle camera adaptor  102  preferably has a top side (designated “TOP” in  FIG. 2C ), a bottom side (designated “BOTTOM” in  FIG. 2C ), and a mid-section that is located between the top side and the bottom side. In one embodiment, the suture retrieval slots  142 A,  142 B are preferably located between the mid-section and the top side of the tube-shaped outer wall  112 , and more preferably adjacent the top side of the tube-shaped outer wall  112 . Positioning the suture retrieval slots  142 A,  142 B adjacent the top side of the tube-shaped outer wall  112 , as well as proper shaping of the suture retrieval slots, desirably minimizes the likelihood that the suture retrieval slots will snag and/or get hung up on the seal flaps of the cannula during removal of the needle camera adaptor  102  and the suture needle from the cannula. 
     Referring to  FIG. 3 , in one embodiment, the needle camera adaptor  102  preferably includes the needle securing channel  120  that extends along a second axis A 2  that is skewed relative to the longitudinal axis A 1  of the needle camera adaptor. In one embodiment, the needle securing channel  120  preferably extends from a distal end of the central region  116  of the needle camera adaptor  102  to the sloping distal end face  140  that is adjacent the distal end  110  of the needle camera adaptor  102 . 
     In one embodiment, the needle camera adaptor  102  preferably includes opposing resilient elements  122 A,  122 B (e.g., scalloped features) that project into opposing sides of the needle securing channel  120  for providing resilient and/or flexible holding elements that are adapted to engage the sides of a suture needle for releasably securing the suture needle within the needle securing channel. In one embodiment, when a suture needle is secured within the channel  120 , the opposing resilient elements  122 A,  122 B preferably apply a light compressive force into the lateral sides of a curved surgical needle for securing the needle to the needle camera adaptor. A surgical instrument may be used for overcoming the compressive forces applied by the opposing resilient elements  122 A,  122 B so that the suture needle may be removed from the needle camera adaptor for being used during a surgical procedure. 
     In one embodiment, the needle securing channel  120  is formed at the upper end of the outer wall  112  of the needle camera adaptor  102  and extends between the central region  116  and the sloping distal face  140  of the needle camera adaptor. The wall thickness adjacent the needle securing channel may be thinner to provide a more flexible region of the tube-shaped outer wall. 
     In one embodiment, the distal end of the surgical needle channel  120  preferably includes opposing guide surfaces  148 A,  148 B that assist in guiding the elongated body of the curved suture needle into the needle securing channel  120  for releasably securing the suture needle to the needle camera adaptor. 
     In one embodiment, the distal end of the needle securing channel  120  preferably includes opposing tapered guide surfaces  148 A,  148 B (adjacent the sloping distal surface  140 ) that may be used for guiding the curved elongated body of the suture needle into the needle securing channel  120 . 
     In one embodiment, a needle camera adaptor may have one or more suture retrieval slots (e.g., two suture retrieval slots) that are adapted to engage a suture strand. 
     Referring to  FIGS. 4A and 4B , in one embodiment, the needle camera adaptor  102  preferably includes the pair of suture retrieval slots  142 A,  142 B that are formed in the outer wall  112  thereof. The first suture retrieval slot  142 A desirably has an open end  144 A and a closed end  146 A. The open end  144 A is preferably wider than the closed end  146 A so that the suture retrieval slot  142 A becomes narrower between the open end  144 A and the closed end  146 A. 
     In one embodiment, the second suture retrieval slot  142 B has an open end  144 B and a closed end  146 B. The second suture retrieval slot  142 B preferably becomes narrower between the open end  142 B and the closed end  146 B thereof. 
     Referring to  FIG. 4B , in one embodiment, a suture strand may be inserted into the open end  144 B of the second suture retrieval slot  142 B and advanced in the distal direction designated DIR 1  until the opposing top and bottom surfaces  150 ,  152  of the second suture retrieval slot  142 B engage the outer surface of the suture strand for forming a friction fit between the suture strand and the second suture retrieval slot  142 B. After the suture strand has been captured within the second suture retrieval slot  142 B, the needle camera adaptor may be retracted in the direction designated DIR 2  for retracting the suture strand (and the attached suture needle) through a cannula (e.g., a trocar). A similar friction fit may be formed between the suture strand and the first suture retrieval slot  142 A ( FIG. 4A ). 
     Referring to  FIG. 5 , in one embodiment, a suture needle  104 , such as a curved surgical needle, may be releasably secured to the needle camera adaptor  102  ( FIG. 1A ) disclosed herein. In one embodiment, the suture needle  104  may be made of metal such as stainless steel. In one embodiment, the suture needle  104  may be a CT-1 needle sold by Ethicon, Inc. of Somerville, N.J. In one embodiment, the suture needle  104  preferably includes a curved elongated body  154  having a proximal end  156  and a distal end  158 . In one embodiment, the curved suture needle  104  preferably includes a suture attachment barrel  160  located at the proximal end  156  of the needle, which is adapted to be secured to a distal end of a suture strand. In one embodiment, the curved suture needle  104  preferably includes a sharpened tip  162  that is adapted to pierce tissue and/or facilitate passage of the curved suture needle  104  through tissue. In one embodiment, the curved suture needle  104  may include a series of elongated grooves  164 , knurling, or roughening formed in the outer surface of the elongated body  154  for enabling the curved suture needle  104  to be grabbed or gripped by a surgical instrument, such as the jaws of a needle driver. In one embodiment, the elongated grooves  164  preferably extend along the longitudinal axis of the curved elongated body  154  of the suture needle  104 . 
     Referring to  FIG. 6A-6C , in one embodiment, the suture needle  104  may be releasably secured to the needle camera adaptor  102 . In one embodiment, the elongated body  154  of the suture needle  104  may be pressed into the needle securing channel  120  of the needle camera adaptor  102  so that the suture attachment barrel  160  of the suture needle  104  (and a segment of a suture strand) is disposed within the proximal needle securing recess  126  and the sharpened distal tip  162  of the suture needle  104  is disposed within the distal needle securing recess  128  of the needle camera adaptor  102 . In one embodiment, a portion of the needle body  154  preferably passes through the opposing resilient elements  122 A,  122 B ( FIG. 3 ), which desirably generates a slight compression force on the lateral sides of the needle body to hold the suture needle in place and prevent the accidental release of the suture needle from the needle camera adaptor. 
     Referring to  FIG. 7 , in one embodiment, the suture needle  104  is preferably releasably secured to the needle camera adaptor  102  by pressing the elongated body  154  of the suture needle  104  into the needle securing channel  120  that extends between the central region  116  and the sloping distal face  140  of the needle camera adaptor  102 . The needle securing channel  120  preferably includes the afore-mentioned opposing resilient elements  122 A,  122 B ( FIG. 3 ) that apply a compressive force to the respective lateral sides of the elongated body  154  of the suture needle  104  for releasably securing the suture needle  104  within the needle securing channel  120 . The holding force provided by the opposing resilient elements  122 A,  122 B may be desirably overcome by using a surgical instrument, such as a needle driver, for removing the suture needle  104  from the needle securing channel  120 . 
     Referring to  FIGS. 8A and 8B , in one embodiment, the endoscope  106  may include a cannula that desirably has an elongated conduit  166  that extends along the length thereof from a proximal end to a distal end  168  of the endoscope. In one embodiment, the distal end  168  of the endoscope  106  preferably includes a first light element  172  that is located at an upper end of the distal end  168  of the endoscope  106 , and a second light element  174  that is located at an underside or lower end of the distal end  168  of the endoscope  106 . In one embodiment, each of the first and second light elements  172 ,  174  may includes one or more fiber optic lights (e.g., bundles of optical fibers) that transmit light for providing visible light at a surgical site. In one embodiment, the first light element  172  may include a first bundle of optical fibers that are designed to provide light at the distal end  168  of the endoscope for illuminating a surgical site. In one embodiment, the second light element  174  may include a second bundle of optical fibers that are also designed to provide light at the distal end  168  of the endoscope for illuminating the surgical site. In one embodiment, the first and second light elements  172 ,  174  may include light emitting diodes (LEDs). 
     In one embodiment the opening at the distal end  168  of the endoscope  106  is preferably covered by an optical lens  181  that closes the distal end of the endoscope. The optical lens  181  preferably covers the first and second light elements  172 ,  174 . In one embodiment, the light transmitted from the first and second light elements  172 ,  174  preferably passes through the optical lens  181  for illuminating a surgical site. 
     In one embodiment, the distal end  168  of the endoscope  106  preferably includes a stop  176  that extends laterally across the distal end of the endoscope  106 , at the lower end or underside of the endoscope, for aligning and orienting the distal end  168  of the endoscope  106  relative to the needle camera adaptor  102  ( FIGS. 6A-6C ). 
     In one embodiment, the endoscope  106  may include a camera that is adapted to record moving or still pictures at the distal end  168  of the endoscope  106 . In one embodiment, the camera may include its own light source for providing visible light at the distal end  168  of the endoscope  106  and/or at a surgical site. 
     The endoscope  106  shown and described above merely discloses one design for an endoscope, telescope and/or visualization device that may be assembled with a needle camera adaptor, and is not intended to limit the scope of various types of devices that may be utilized. For example, in one embodiment, an endoscope that may be assembled with one of the needle camera adaptors disclosed herein may include one or more of the telescopes or visualization devices sold under the trademark HOPKINS® by Karl Storz SE &amp; Co. KG of Tuttlingen, Germany, having the web address www.karlstorz.com (hereinafter referred to as Karl Storz). In one embodiment, an endoscope configured for being assembled with one of the needle camera adaptors disclosed herein may be Model #26003 AA (10 mm diameter), sold under the trademark HOPKINS® Straight Forward Telescope 0° by Karl Storz. In one embodiment, an endoscope configured for being assembled with one of the needle camera adaptors disclosed herein may be Model #26003 BA (10 mm diameter), sold under the trademark HOPKINS® Forward-Oblique Telescope 30° by Karl Storz. 
     Referring to  FIG. 9A , in one embodiment, the needle camera adaptor  102  has the proximal end  108  and the central lumen  114  that extends along the longitudinal axis A 1  of the needle camera adaptor  102 . In one embodiment, the needle camera adaptor  102  preferably includes a stop surface  178  (e.g., a sloping surface) that extends laterally across the width of the needle camera adaptor and that faces toward the proximal end  108  of the needle camera adaptor. 
     Referring to  FIGS. 9A and 9B , in one embodiment, the needle camera adaptor  102  may be assembled with the endoscope  106  by directing the sloping distal face  170  at the distal end  168  of the endoscope  102  into the proximal opening at the proximal end  108  of the needle camera adaptor. The distal end  168  of the endoscope  106  is preferably advanced in the distal direction DIR 1  until the sloping surface of the stop  176  at the distal end of the endoscope abuts against the stop  178  of the needle camera adaptor  102 . The sloping surfaces of the opposing stops  176 ,  178  are preferably mirror images of one another and preferably have a similar slope. The opposing sloping stops  176 ,  178  preferably align and orient the needle camera adaptor  102  relative to the distal end  168  of the endoscope  106 . The endoscope  106  preferably captures still and/or moving images of the suture needle secured to the needle camera adaptor  102 , thereby providing continuous visualization of the suture needle as the needle camera adaptor  102  and the suture needle are delivered through a cannula for being deployed at a surgical site. 
     In one embodiment, an endoscope and a needle camera adaptor may not have orienting features such as the opposing stops  176 ,  178  shown and described above in  FIGS. 9A and 9B . 
       FIG. 10  shows the system  100  of  FIGS. 1A-9B  after the needle camera adaptor  102  has been assembled with the distal end  168  of the endoscope  106 . The curved suture needle  104  is releasably secured to the needle camera adaptor  102  so that the curved suture needle may be advanced through a cannula for being positioned at a surgical site. As the curved suture needle  104  is advanced through a cannula to a surgical site, visualization of the curved surgical needle  104  may be maintained at all times via the visualization device, or camera, that is assembled to the proximal end of the endoscope  106 . 
     Referring to  FIG. 11 , in one embodiment, the needle camera adaptor  102  is secured to the distal end of the endoscope  106 , whereupon the system may capture video and/or images of the curved suture needle  104  that is positioned within the central region  116  of the needle camera adaptor  102 . The first and second light elements  172 ,  174  desirably provide light for the visualization device  180  so that video images of the suture needle  104  may be captured by the system. The optical lens  181  of the endoscope  106  is desirably exposed and the focal width is located within the inner lumen of the needle camera adaptor  102 . In one embodiment, the visualization device  180  (e.g., a camera), the optical lens  181 , and the first and second light elements  172 ,  174  are all integrated together into the endoscope  106  and function together as a unified component that is assembled with the needle camera adaptor  102 . 
     In one embodiment, the elongated body  154  of the curved suture needle  104  is releasably secured within the needle securing channel  120  of the needle camera adaptor  102 . The sharpened tip  162  of the curved suture needle  104  is preferably secured within the distal needle securing recess  128  (e.g., a needle point recess) and the suture attachment barrel  160  is preferably secured within the proximal needle securing recess  126  (e.g., suture relief pocket) formed in the floor  124  or inner surface of a tube-shaped wall of the needle camera adaptor  102 . A distal end of a suture thread  182 , which is secured to the needle attachment barrel  160 , desirably extends from the proximal needle securing recess, through the skived portion, and extends proximally along the external surface of the needle camera adaptor  102 . 
     In one embodiment, the suture needle  104  is mounted in a slightly skewed orientation (i.e., along axis A 2  shown in  FIG. 2B ) relative to the central or longitudinal axis A 1  ( FIG. 3 ) of the needle camera adaptor  102 . This skewed orientation enables the visualization of the side of the curved suture needle. This feature is important as the endoscope lens  181  and associated view is not movable relative to the suture needle  104 . The ability to visualize the side of the suture needle  104  facilitates grasping the suture needle with a surgical instrument, such as a needle driver. In one embodiment, to grasp the suture needle  104 , the focal point of the visualization device  180  may be adjusted to near field positioning to enable the visualization during the arming of the needle driver. Once the suture needle  104  is removed by the needle driver from the needle camera adaptor  102 , the focal point of the visualization device  180  may be adjusted to a far field setting so that the structural features of the needle camera adaptor  102  are out of the width of the field of view and do not obstruct the views of the visualization device  180 . 
     Referring to  FIG. 12A , in one embodiment, a cannula  184 , such as a trocar, may be utilized for advancing the needle camera adaptor  102 , the curved suture needle  104  secured thereto ( FIG. 11 ), and the suture strand  182  to a surgical site. The cannula  184  desirably provides percutaneous access to inner regions within the human body. In one embodiment, the cannula  184  desirably has an elongated tube  186  with a proximal end  188  including a seal  190  and a distal end  192 . The elongated tube  186  preferably has a conduit that extends between the trocar seal  190  and the distal end  192  thereof. 
     The elongated tube  186  may be made from metallic and/or polymeric materials. In one embodiment, the elongated tube  186  may be produced with frictional engagement features  195 , such as raised rings or ribs. In embodiments in which the elongated tube  186  is made of polymeric materials, the tube may comprise transparent materials to enable the visualization of items disposed inside the tube. 
     In one embodiment, when the cannula  184  is inserted into a patient for abdominal surgery, the distal end  192  of the elongated tube  186  is exposed to the visceral compartment and the seal  190  is near the patient&#39;s skin. The inner lumen of the surgical cannula assembly  184  is accessed through the proximal seal  190  and provides direct access to the visceral compartment for endoscopic instrumentation. 
     Referring to  FIG. 12B , in one embodiment, the distal end  110  of the needle camera adaptor  102  may be inserted into the proximal end  188  of the cannula  184  by advancing the sloping distal face  140  of the needle camera adaptor through the seal  190  of the cannula  184 . In one embodiment, the needle camera adaptor  102 , the suture needle  104  and the suture thread  182  may be advanced through the opening at the distal end  192  of the elongated tube  186  of the cannula  184  ( FIG. 12A ). As the needle camera adaptor  102  is advanced to the distal end of the elongated tube  186  of the cannula  184 , the visualization device  180  may be used for simultaneously visualizing the suture needle  104  during passage through the cannula and subsequent placement within an endoscopic surgical site. 
     In  FIG. 12B , the assembly of the needle camera adaptor  102  and the endoscope  106  is shown prior to insertion through the proximal seal ring  188 . As can be seen, the suture needle  104  is ideally positioned for insertion through the cannula assembly  184  with the needle tip  162  protected from potential damage while the expansible sealing valve  190  at the proximal end  188  of the cannula  184  is protected from damage during insertion of the suture needle  104 . As the needle camera adaptor  102 , the suture needle  104 , the suture strand  182 , and the endoscope  106  are inserted into the cannula  184 , the surgical suture strand  182  extends along the side of the needle camera adaptor  102  and the endoscope and out of the expansible sealing valve  190  until it is pulled into the visceral compartment. 
     Referring to  FIG. 13 , after the needle camera adaptor  102  and the curved suture needle  104  have been passed through the cannula  184  ( FIGS. 12A and 12B ) for being positioned at a surgical site, the curved suture needle  104  is preferably uncoupled and/or removed from its attachment to the needle camera adaptor. In one embodiment, a needle driver  194  having opposing jaws  196 A,  196 B may be used for grasping the elongated body  154  of the curved suture needle  104  and removing the curved suture needle from the needle securing channel  120  ( FIG. 11 ) of the needle camera adaptor  102 . The visualization device  180  ( FIG. 11 ) may be used for visualizing the suture needle  104  and the needle driver  194  as the needle driver is used for removing the suture needle  104  from the needle camera adaptor  102 . 
     Referring to  FIG. 14 , in one embodiment, at the conclusion of a surgical procedure, the suture needle  104  and the suture  182  secured thereto are preferably retracted from the surgical site for being removed from a patient. In one embodiment, the suture  182  extends from the needle attachment barrel  160  of the curved suture needle  104 . The suture  182  preferably has a free or cut end  185 . In one embodiment, the needle driver  194  is utilized to grasp an end of the suture  182  that is adjacent the needle attachment barrel  160  of the curved suture needle  104 , and a grasping tool  198  having opposing jaws  200 A,  200 B is preferably utilized for grasping the suture  182  near the free or cut end  185  of the suture. Tension may be applied to a section of the suture  182  that is located between the needle driver  194  and the grasping tool  198 , whereupon the tensioned section of the suture  182  that is located between the instruments  194 ,  198  may be pushed into the open ends  144 A,  144 B of the respective suture retrieval slots  142 A,  142 B. In the position shown in  FIG. 14 , the suture  182  is secured within the suture retrieval slots  142 A,  142 B of the needle camera adaptor  102  in preparation for being removed from the surgical site via the cannula  184  ( FIGS. 12A and 12B ). In one embodiment, the sharpened tip  162  of the curved suture needle  104  is desirably located away from the suture retrieval slots  142 A,  142 B of the needle camera adaptor  102 . 
     Referring to  FIG. 15 , in one embodiment, the curved suture needle  104  and the suture strand  182  may be retracted through the conduit  215  of the elongated tube  186  of the cannula  184  ( FIGS. 12A and 12B ). The captured suture strand  182  preferably forms a friction fit with the suture retrieval slots  142 A,  142 B of the needle camera adaptor  102 . The captured suture stand  182 , the curved suture needle  104 , and the needle camera adaptor  102  are preferably retracted through the conduit  215  in the direction designated DIR 2 , whereby the sharpened tip  162  trails away from the pulling direction DIR 2 . In this orientation, the curved suture needle  104  does not present a risk of damaging the expansible seal  190  located at the proximal end  188  of the cannula  184  ( FIG. 12B ). 
     Referring to  FIG. 16 , in one embodiment, a needle camera adaptor  202  preferably has a proximal end  208  and a distal end  210 . In one embodiment, the needle camera adaptor  202  preferably has an outer wall  212 , such as a tube-shaped outer wall, that extends along the length of the needle camera adaptor between the proximal and distal ends  208 ,  210  thereof. The outer wall  212  may have a generally cylindrical shape and may have a varying thickness. In one embodiment, the needle camera adaptor  202  preferably has a central lumen  214  that extends along a central or longitudinal axis A 2  thereof. The lumen  214  preferably extends from the proximal end  208  to the distal end  210  of the needle camera adaptor. The central lumen  214  may be utilized for securing a distal end of an endoscope  106  ( FIG. 1A ) to the proximal end  208  of the needle camera adaptor  202  and/or for providing visual access to a suture needle as the combination of the needle camera adaptor and the suture needle are delivered through a cannula to a surgical site. 
     In one embodiment, adjacent the proximal end  208  of the needle camera adaptor  202 , the tube-shaped outer wall  212  preferably includes an inner surface having castellated or scalloped features  225  for enabling the needle camera adaptor  202  to be secured to a distal end of an endoscope  106  ( FIG. 1A ) and/or for properly orienting the needle camera adaptor that is secured to the distal end of the endoscope. In one embodiment, the castellated or scalloped features  225  may be used to fine tune the amount of hoop stress and/or frictional forces that are needed to allow for easy attachment and removal of the needle camera adaptor  202  from the endoscope while still providing sufficient clamping force to enable the needle camera adaptor to remain attached to the endoscope as the needle camera adaptor is withdrawn from a surgical site through a trocar, cannula, or surgical tool. 
     In one embodiment, the proximal end of a needle camera adaptor (e.g., the tube-shaped outer wall adjacent the proximal end) may include a compressive material that grips onto the distal end of the cannula of the endoscope for forming a secure fit between the needle camera adaptor and the endoscope and/or for properly orienting the needle camera adaptor that is secured to the distal end of the endoscope. 
     While the foregoing is directed to embodiments of the present invention, other and further embodiments of the invention may be devised without departing from the basic scope thereof, which is only limited by the scope of the claims that follow. For example, the present invention contemplates that any of the features shown in any of the embodiments described herein, or incorporated by reference herein, may be incorporated with any of the features shown in any of the other embodiments described herein, or incorporated by reference herein, and still fall within the scope of the present invention.