Source: https://patents.justia.com/patent/7179266
Timestamp: 2020-04-09 17:49:58
Document Index: 605546831

Matched Legal Cases: ['art 508', 'art 502', 'art 502', 'art 502', 'art 506', 'art 502', 'art 508', 'art 502', 'art 508', 'art 506', 'art 502', 'art 508', 'art 502', 'art 508', 'art 506', 'art 502', 'art 506', 'art 508', 'art 508', 'art 502', 'art 506', 'art 508', 'art 506', 'art 508', 'art 502', 'art 508', 'art 506', 'art 508', 'art 506', 'art 506', 'art 506', 'art 506', 'art 506', 'art 506', 'art 502', 'art 502', 'art 502', 'art 502', 'art 502', 'art 502', 'art 508', 'art 508', 'art 506', 'art 508', 'art 1508', 'art 1502', 'art 1502', 'art 1502', 'art 1506', 'art 1502', 'art 1508', 'art 1502', 'art 1508', 'art 1506', 'art 502', 'art 1508', 'art 1502', 'art 1508', 'art 1506', 'art 1502', 'art 1506', 'art 1508', 'art 1508', 'art 1502', 'art 1502', 'art 1502', 'art 1502', 'art 506', 'art 502', 'art 502', 'art 502', 'art 502', 'art 508', 'art 1502', 'art 1502', 'art 1502', 'art 502', 'art 1502', 'art 1508', 'art 508']

US Patent for Surgical device Patent (Patent # 7,179,266 issued February 20, 2007) - Justia Patents Search
Justia Patents Mechanical Suture Or Ligature ApplierUS Patent for Surgical device Patent (Patent # 7,179,266)
Apr 17, 2003 - X-Site, L.L.C.
FIG. 12 shows a partial cross-section perspective view of the device of FIG. 1 after removal from the blood vessel; FIGS. 13(a) and 13(b) show a suture device 1500 according to another embodiment of the present invention;
FIG. 1 shows a suture device 500 according to one embodiment of the present invention. The suture device 500 includes a tube 501 having a substantially circular cross-section. The suture device 500 includes a distal part 508 that defines a distal lumen 507 having a central axis 507a, a proximal part 502 that defines a needle insertion lumen 510 having a central axis 510a, and a housing 504 attached to a proximal end of the proximal part 502. A suture removal slot 513 extends along the surface of the proximal part 502 and communicates with the needle insertion lumen 510 so as to open an interior of the needle insertion lumen 510 to the outside of the device 500 along an entire length of the needle insertion lumen 510. As shown in FIG. 3, a width of the suture removal slot 513 is less than a diameter of a needle inserted through the needle insertion lumen 510 so that a needle received in the needle insertion lumen 510 can not escape from the needle insertion lumen 510 via the suture removal slot 513.
Referring back to FIG. 1, a central part 506 is coupled to a distal end of the proximal part 502 and to a proximal end of the distal part 508 so as to attach the proximal part 502 and the distal part 508 to each other. The central part 506 curves away from the proximal part 502 in the shape of an arc, and returns to connect to the distal part 508. A distal end of the proximal part 502 faces a proximal end of the distal part 508 across a tissue receiving gap 506a formed by the curvature of the central part 506. Advantageously, the proximal part 502, the central part 506 and the distal part 508 are configured such that the central axis 507a of the distal lumen of the distal part 508 is aligned with the central axis 510a of the needle insertion lumen 510 of the proximal part 502.
A cross-sectional area of the central part 506 may be substantially equal to that of the distal part 508 and the cross-sectional areas of both the central part 506 and the distal part 508 may remain substantially constant along their entire lengths while a cross-sectional area of the proximal part 502 may preferably be equal or slightly greater than that of the distal part 508 and the central part 506. More specifically, in a preferred embodiment, a maximum outer diameter of the distal part 508 is no larger than a maximum outer diameter of the central part 506. In this way, the opening in the blood vessel is not further stretched by the introduction of the distal part therethrough. FIG. 4 illustrates one embodiment of the invention wherein the arcuate portion of central part 506 has an oval cross section. The oval cross section allows the arcuate structure to be thinner in a first direction with respect to the tissue receiving gap 506a so that the tissue receiving gap 506a can be deeper, thereby enabling the needle to penetrate the blood vessel wall at a farther distance from the edge of the puncture to be sealed, as described in additional detail below. By enabling the needle to penetrate the blood vessel wall at a farther distance from the edge of the puncture to be sealed, a more stable and secure suture may be possible. The central part 506 of the suture device 500 may also include a ridge. FIG. 5 illustrates one embodiment, wherein the rigid arcuate member of central part 506 includes a raised ridge 517 serving as a catch, or stop, to assist in accurate placement of the suture device 500. Preferably, the raised ridge 517 is located on a proximal side of the central part 506 so that when the suture device 500 is inserted into a puncture in a blood vessel the edge of the puncture will catch on the ridge 517 when the suture device 500 has reached the appropriate depth, as described in additional detail below. The ridge 517 may be formed inside the concave portion of the central part 506, as depicted in FIG. 5 or may be formed around the entire circumference as shown in FIG. 5A.
Referring back to FIG. 1, and as previously mentioned, the suture device 500 includes a housing 504. A distal end of the housing 504 is attached to a proximal end of the proximal part 502. In addition, a proximal end of the housing 504 is attached to needle pusher housing 530. The needle pusher housing 530 defines a needle pusher channel 532 in which is disposed a needle pusher 534. The needle pusher 534 is axially slidable within the needle pusher channel 532 along a central axis 532a of the needle pusher channel 532. Advantageously, the proximal part 502, the housing 504 and the needle pusher housing 530 are configured such that the central axis 510a of the needle insertion lumen 510 of the proximal part 502 is aligned with the central axis 532a of the needle pusher channel 532 of the needle pusher channel 532.
The housing 504 houses a needle cartridge 540. The needle cartridge 540 includes a plurality of needle slots 544 in which needles 546 are disposed. The needles slots 544 are preferably arranged parallel to each other and extend from a distal end to a proximal end of the needle cartridge 540. In the embodiment shown in FIG. 1, the needle cartridge 540 has three needle slots 544. The needle cartridge 540 is moveable within the housing 504 between at least a first and a second position. In one embodiment, the housing 504 includes a spring element 542, such as a leaf spring or other suitable spring element, that contacts the needle cartridge 540 so as to move the needle cartridge 540 within the housing 504 between at least the first and second positions. In the embodiment shown in FIG. 1, the spring element 542 contacts the needle cartridge 540 so as to move the needle cartridge 540 within the housing 504 between three positions. In a first position, the needle cartridge 540 is positioned such that a first needle slot 544a is aligned with the central axis 532a of the needle pusher channel 532 and with the central axis 510a of the needle insertion lumen 510 of the proximal part 502. In a second position, as shown in FIG. 1, the needle cartridge 540 is positioned such that a second needle slot 544b is aligned with the central axis 532a of the needle pusher channel 532 and with the central axis 510a of the needle insertion lumen 510 of the proximal part 502. In a third position, the needle cartridge 540 is positioned such that a third needle slot 544c is aligned with the central axis 532a of the needle pusher channel 532 and with the central axis 510a of the needle insertion lumen 510 of the proximal part 502.
The suture device 500 is preferably substantially rigid from the proximal end of the needle pusher housing 530 to the needle entry opening 522 at the proximal end of the distal part 508, and, according to one embodiment, is integrally formed. In addition, the distal part 508 of the suture device 500 is preferably flexible, e.g., with a flexible tube connected to a distal end of the central part 506 and extending distally therefrom. This rigid structure ensures that the central axes 532a, 510a and 507a of the needle pusher channel 532, the needle insertion lumen 510 and the distal lumen 507, respectively, remain properly aligned with one another during operation of the suture device 500. The distal lumen 507 extends through the distal part 508 from the needle receiving opening 522 to a guide wire opening 538.
FIGS. 13(a) and 13(b) show a suture device 1500 according to another embodiment of the present invention. The suture device 1500 includes a tube 1501 having a substantially circular cross-section. The suture device 1500 includes a distal part 1508 that defines a distal lumen 1507 having a central axis 1507a, a proximal part 1502 that defines a needle insertion lumen 1510 having a central axis 1510a, and a housing 1504 attached to a proximal end of the proximal part 1502. A suture removal slot 1513 extends along the surface of the proximal part 1502 and communicates with the needle insertion lumen 1510 so as to open an interior of the needle insertion lumen 1510 to the outside of the device 1500 along an entire length of the needle insertion lumen 1510. As described more fully above in connection with the suture removal slot 513 of the suture device 500 shown in FIG. 1, a width of the suture removal slot 1513 is less than a diameter of a needle inserted through the needle insertion lumen 1510 so that a needle received in the needle insertion lumen 1510 can not escape from the needle insertion lumen 1510 via the suture removal slot 1513.
A central part 1506 is coupled to a distal end of the proximal part 1502 and to a proximal end of the distal part 1508 so as to attach the proximal part 1502 and the distal part 1508 to each other. The central part 1506 curves away from the proximal part 502 in the shape of an arc, and returns to connect to the distal part 1508. A distal end of the proximal part 1502 faces a proximal end of the distal part 1508 across a tissue receiving gap 1506a formed by the curvature of the central part 1506. Advantageously, the proximal part 1502, the central part 1506 and the distal part 1508 are configured such that the central axis 1507a of the distal lumen of the distal part 1508 is aligned with the central axis 1510a of the needle insertion lumen 1510 of the proximal part 1502.
The suture device 1500 includes a housing 1504. A distal end of the housing 1504 is attached to a proximal end of the proximal part 1502. In addition, a proximal end of the housing 1504 is attached to needle pusher housing 1530. The needle pusher housing 1530 defines a needle pusher channel 1532 in which is disposed a needle pusher 1534. The needle pusher 1534 is axially slidable within the needle pusher channel 1532 along a central axis 1532a of the needle pusher channel 1532. Advantageously, the proximal part 1502, the housing 1504 and the needle pusher housing 1530 are configured such that the central axis 1510a of the needle insertion lumen 1510 of the proximal part 1502 is aligned with the central axis 1532a of the needle pusher channel 1532 of the needle pusher channel 1532.
The housing 1504 houses a needle cartridge 1540. The needle cartridge 1540 includes a needle slot 1544 in which needles 1546 are disposed. FIG. 13(b) illustrates a cross-sectional view of the needle cartridge 1540. The needle slot 1544 extends from a distal end to a proximal end of the needle cartridge 1540. In the embodiment shown in FIGS. 13(a) and 13(b), the needle slot 1544 is arranged vertically. However, according to various other embodiments of the present invention, the needle slot 1544 is not arranged vertically. Furthermore, the needle slot 1544 is shown having fives needles, e.g., the needles 1546a to 1546e, disposed therewithin. However, the present invention contemplates that the needle slot 1544 may be configured to include any number of needles 1546. The needles 1546 are moveable within the needle slot 1544 such that the needles are successively positioned in alignment with the needle pusher channel 1532 and the needle insertion lumen 1510. In one embodiment, the housing 1504 includes a spring element 1542, such as a leaf spring or other suitable spring element, that contacts at least one of the needles 1546 so as to move the needles 1546 within the needle slot 1544. For instance, as shown in FIG. 13(b), in one embodiment of the present invention, the spring element 1542 contacts lower needle 1546e so as to bias all of the needles 1546 within the needle slot 1544 upwards, such that the uppermost needle 1546a is aligned with the needle pusher channel 1532 and the needle insertion lumen 1510. Once the uppermost needle 1546a is employed, e.g., pushed out of the needle slot 1544 during operation of the device, the spring element 1542 biases the remaining needles 1546 upwards so that the second uppermost needle, e.g., needle 1546b, is automatically aligned with the needle pusher channel 1532 and the needle insertion lumen 1510.
FIGS. 8 to 12 illustrate the operation of the suture device 500, according to the embodiment of the present invention shown in FIGS. 1 and 2. In operation, as shown in FIG. 8, when an invasive procedure has been performed on a patient and a catheter previously inserted into a blood vessel 402 (or other structure within the body) has been withdrawn, a guide wire 401 may be left in place extending through the skin 403, through the tissue tract 403a, through the puncture 404 and into the blood vessel. A suture device, such as the suture device 500, may then be used to seal the puncture 404.
In one embodiment, a proximal end 401a of the guide wire 401 is inserted through the distal lumen 507 so that the suture device 500 may be inserted into the puncture 404 and moved along the guide wire 401 through the puncture 404. FIG. 9 illustrates the distal end 508 of the suture device 500 inserted into the puncture 404. During the insertion and placement of the suture device 500 in the puncture 404, the valve 550 in the distal lumen 507 substantially prevents blood from flowing from the blood vessel 402, through the distal lumen 507, and into the patient's wound. The guide wire 401 may be withdrawn as the central part 506 enters through the skin 403.
FIG. 10 illustrates the suture device 500 in a first suture position within the puncture 404. In the first suture position, the suture device 500 is suitably positioned to insert a needle through a first side of a puncture 404. Advantageously, the needle cartridge 540 has several needles 546 disposed, e.g., pre-loaded, within its needle slots 544, such as first and second needle slots 544a and 544b. When the suture device 500 is positioned as shown in FIG. 10, the needle cartridge 540 is arranged in a first position within the housing 504. For instance, in this first position, the needle cartridge 540 may be positioned such that the first needle slot 544a is aligned with the central axis 532a of the needle pusher channel 532 and with the central axis 510a of the needle insertion lumen 510 of the proximal part 502. A first needle 546a, having a suture 528 attached at its proximal end, is disposed, e.g., pre-loaded, within the first needle slot 544a. The suture 528 may be formed of either “reabsorbable” or “non-reabsorbable” material, as is well known in the art. In order to actuate the device, the needle pusher 534 is moved distally within the needle pusher channel 532 so as to push the first needle 546a out of the first needle slot 544a and through the needle insertion lumen 510 of the proximal part 502. As shown in FIG. 10, as the pointed distal end of the first needle 546a exits the opening 514 of the needle insertion lumen 510, it penetrates the lining of the blood vessel on a first side 404a of the puncture 404, e.g., the side of the puncture 404 that is disposed within the tissue receiving gap 506a. The first needle 546a is then advanced through the needle receiving opening 522 until the entire first needle 546a is inserted within the distal lumen 507. The needle pusher 530 is then withdrawn back to its original, e.g., proximal-most, position in the needle pusher channel 532.
Thereafter, the suture device 500 is rotated into a second suture position. For example, as shown in FIG. 11, the suture device 500 may be rotated 180 degrees so that, in the second suture position, the suture device 500 is positioned to operate on a second side of the puncture 404, e.g., the side opposite from the side of the puncture 404 that was operated on by the suture device 500 in the first suture position. Again, when the suture device 500 is positioned in the second suture position, the position indication lumen 516 and the needle insertion lumen 510 may be observed so as to ensure that a portion of the blood vessel wall is received in the tissue receiving gap 506a between the opening 514 and the needle entry opening 522. Those skilled in the art will understand that any angular separation may be achieved depending, for example, on the number of sutures to be used in sealing the blood vessel.
When the suture device 500 is positioned as shown in FIG. 11, the needle cartridge 540 may be arranged in a second position within the housing 504, such as by an operator moving the needle cartridge 540 within the housing 504 or, for example, by the spring element 542 biasing the needle cartridge 540 towards the second position within the housing 504. In this second position, the needle cartridge 540 may be positioned such that the second needle slot 544b is aligned with the central axis 532a of the needle pusher channel 532 and with the central axis 510a of the needle insertion lumen 510 of the proximal part 502. A second needle 546b, having an opposite end of the suture 528 attached at its proximal end, is disposed, e.g., pre-loaded, within the second needle slot 544b. The needle pusher 534 is then moved distally within the needle pusher channel 532, e.g., from the proximal-most position to the distal-most position so as to move the second needle 546b out of the second needle slot 544b and through the needle insertion lumen 510 of the proximal part 502. As the pointed distal end of the second needle 546b exits the opening 514 of the needle insertion lumen 510, it penetrates the lining of the blood vessel on the opposite side 404b of the puncture 404, e.g., the portion of the blood vessel wall that is disposed within the tissue receiving gap 506a. The second needle 546b is then advanced through the needle receiving opening 522 until the entire second needle 546b is inserted within the distal lumen 507. The needle pusher 530 is then withdrawn back to its original, e.g., proximal-most, position in the needle pusher channel 532.
The suture device 500 is then withdrawn from the body, as illustrated in FIG. 12. As the suture device 500 is withdrawn from the body, the first and second needles 546a and 546b remain within the distal part 508 of the suture device 500. Once the suture device 500 is withdrawn, the suture 528 may then be disconnected, e.g., cut, from the first and second needles 546a and 546b. The two ends of the suture 528 may then be knotted and tightened so as to seal the puncture 404. In one embodiment, the two ends of the suture 528 are different so that a surgeon may differentiate between them during operation. For instance, one or both of the two ends of the suture 528 may be colored or marked so that a surgeon knows how to manipulate the suture ends, e.g., which end of the suture to pull, which end not to pull, etc. As shown in FIG. 12, the configuration of the sutures within the puncture 404 is such that, as the sutures are tightened, the opposite sides of the puncture 404 are drawn together to provide an improved sealing of the puncture 404.
It should be recognized that, while the operation described above illustrates the operation of the suture device 500 shown in FIGS. 1 and 2, a similar operation may be performed when the suture device 1500 shown in FIGS. 13(a) and 13(b) is employed. For instance, when the suture device 1500 shown in FIGS. 13(a) and 13(b) is employed, the suture device 1500 is placed in a first suture position within a puncture, e.g., positioned to insert a needle through a first side of a puncture. Advantageously, the needle slot 1544 of the needle cartridge 1540 has two or more needles 1546 disposed, e.g., pre-loaded, within the needle slot 1544. In the first position, the uppermost needle 1546 in the needle slot 1544, e.g., needle 1546a, is aligned with the central axis 1532a of the needle pusher channel 1532 and with the central axis 1510a of the needle insertion lumen 1510 of the proximal part 1502. A first needle 1546a has a suture 1528 attached at its proximal end. The needle pusher 1534 is moved distally within the needle pusher channel 1532 so as to push the first needle 1546a out of the needle slot 1544 and through the needle insertion lumen 1510 of the proximal part 1502. The pointed distal end of the first needle 1546a exits the needle insertion lumen 1510 and penetrates the lining of the blood vessel on a first side of the puncture. The first needle 1546a is then advanced through the needle receiving opening 1522 until the entire first needle 1546a is inserted within the distal lumen 1507. The needle pusher 1530 is then withdrawn back to its original, e.g., proximal-most, position in the needle pusher channel 1532.
Thereafter, the suture device 1500 is rotated into a second suture position so as to operate on a second side of the puncture. Advantageously, in the second position, the next uppermost needle, e.g., needle 1546b, in the needle slot 1544 is aligned with the central axis 1532a of the needle pusher channel 1532 and with the central axis 1510a of the needle insertion lumen 1510 of the proximal part 1502. Specifically, after the needle pusher 1530 has pushed the first needle 1546a out of the needle slot 1544 and after the needle pusher 1530 is withdrawn towards its original, e.g., proximal-most, position in the needle pusher channel 1532, the spring element 1542 biases the needles 1546 within the needle slot 1544 so as to move the second needle 1546b into alignment with the central axis 532a of the needle pusher channel 532 and with the central axis 510a of the needle insertion lumen 510 of the proximal part 502. The second needle 1546b has an opposite end of the suture attached at its proximal end. The needle pusher 1534 is then moved distally within the needle pusher channel 1532, e.g., from the proximal-most position to the distal-most position so as to move the second needle 1546b out of the needle slot 1544 and through the needle insertion lumen 1510 of the proximal part 1502. As the pointed distal end of the second needle 1546b exits the needle insertion lumen 1510, it penetrates the lining of the blood vessel on the opposite side of the puncture and is advanced until the entire second needle 1546b is inserted within the distal lumen 1507. The needle pusher 1530 is then withdrawn back to its original, e.g., proximal-most, position in the needle pusher channel 1532.
The suture device 1500 is then withdrawn from the body, such that, as the suture device 500 is withdrawn from the body, the first and second needles 1546a and 1546b remain within the distal part 1508 of the suture device 1500. Once the suture device 1500 is withdrawn, the suture may then be disconnected, e.g., cut, from the first and second needles 1546a and 1546b. The two ends of the suture may then be knotted and tightened so as to seal the puncture.
FIGS. 14 to 16 illustrate another process for sealing a puncture in accordance with the present invention, which may be employed with either the suture device 500 shown in FIGS. 1 and 2 or the suture device 1500 shown in FIGS. 13(a) and 13(b). For the purposes of illustration only, the process will be described in connection with the operation of the suture device 500 shown in FIGS. 1 and 2. As shown in FIG. 14, the suture device 500 is placed in a first suture position within a puncture, and the needle pusher 534 is moved distally within the needle pusher channel 532 so as to push the first needle 546a such that the pointed distal end of the first needle 546a penetrates the lining of the blood vessel on a first side of the puncture. The first needle 546a is then advanced until the first needle 546a is inserted within the distal lumen 507, and the needle pusher 530 is withdrawn back to its original, e.g., proximal-most, position in the needle pusher channel 1532. The first needle 546a has a suture 528 attached at its proximal end. In this embodiment, the suture 528 has attached thereto a patch 560 of hemostatic agent. In one embodiment of the present invention, the hemostatic agent includes collagen and may have a sponge or compressed sponge form—however, the present invention contemplates that any type of hemostatic agent in any shape or form may be employed. In the embodiment shown, the hemostatic agent patch 560 has a first hole 560a and a second hole 560b through which the suture 528 is inserted, thereby attaching the hemostatic agent patch 560 to the suture 528. Various other attachment methods may alternatively be employed.
Thereafter, and as shown in FIG. 15, the suture device 500 is rotated into a second suture position. The needle pusher 534 pushes the second needle 546b such that the pointed distal end of the second needle 546b penetrates the lining of the blood vessel on a second side of the puncture. The second needle 546b is then advanced until the second needle 546b is inserted within the distal lumen 507. The second needle 1546b has an opposite end of the suture 528 attached at its proximal. The needle pusher 1530 is then withdrawn back to its original, e.g., proximal-most, position in the needle pusher channel 1532.
The suture device 500 is then withdrawn from the body. As the suture device 500 is withdrawn from the body, the first and second needles 546a and 546b remain within the distal part 508 of the suture device 500. Once the suture device 500 is withdrawn, the suture may then be disconnected, e.g., cut, from the first and second needles 546a and 546b. Either before or after the suture are disconnected from the first and second needles 546a and 546b, the ends of the suture are moved such that the hemostatic agent 560 is positioned against the puncture, thereby helping to seal the puncture. Once the ends of the suture have been moved sufficiently to position the hemostatic plug 560 against the puncture, the suture ends may be knotted and tightened so as to retain the hemostatic agent plug 560 against the blood vessel lining, thereby sealing the puncture.
FIG. 17 illustrates one embodiment of a knot pushing device 200 in which a knot pushing rod 212 has a curved hole 210 disposed therethrough. Specifically, the curved hole 210 is coaxial with the knot pushing rod 212 at one end of the knot pushing rod 212 but curves so as to exit the side of the knot pushing rod 212. In the embodiment shown in FIG. 17, one end 228a of a suture 228 is threaded through a hole of the hemostatic plug 202 and through the curved hole 210 of the knot pushing rod 212. In this manner, the hemostatic plug 202 is advanced along one end 228a of suture 228 until it reaches the puncture 204.
FIG. 18 illustrates another embodiment of a knot pushing device 1200 in which a knot pushing rod 1212 has a curved hole 1210 disposed therethrough. Again, the curved hole 1210 is coaxial with the knot pushing rod 1212 at one end of the knot pushing rod 1212 but curves so as to exit the side of the knot pushing rod 1212. FIG. 18 also illustrates a sheath 1216 having a sheath hub 1214 that is arranged to fit coaxially over the knot pushing rod 1212 and the hemostatic plug 1202. In the embodiment shown in FIG. 18, two ends 1228a and 1228b of a loading snare 1228 are threaded through a hole of the hemostatic plug 1202 and through the curved hole 1210 of the knot pushing rod 1212. The loading snare 1228 is employed to grasp one end of a suture, and is tightened on the end of the suture by the knot pushing rod 1212 being moved distally relative to the sheath 1216. Continued advancement of the knot pushing rod 1212 relative to the sheath 1216 causes the hemostatic plug 1202 to be advanced also. In this manner, the hemostatic plug 1202 is advanced along the loading snare 1228 and along one end of a snared suture until it reaches a puncture.
4008303 February 15, 1977 Glick et al.
4518384 May 21, 1985 Tarello et al.
5728114 March 17, 1998 Evans et al.
6010514 January 4, 2000 Burney et al.
6436109 August 20, 2002 Kontos
6451031 September 17, 2002 Kontos
Patent Publication Number: 20040210251
Inventor: Stavros Kontos (Montvale, NJ)
Primary Examiner: Anh Tuan Nguyen
Assistant Examiner: Tuan Van Nguyen
Application Number: 10/418,572
Current U.S. Class: Mechanical Suture Or Ligature Applier (606/144); Suturing Or Ligating Aid Or Guide (606/148)