WO2010103467A1

WO2010103467A1 - A surgical needle used in laparoscopic surgery

Info

Publication number: WO2010103467A1
Application number: PCT/IB2010/051029
Authority: WO
Inventors: Ali Dogan Bozdag
Original assignee: Adnan Menderes Universitesi
Priority date: 2009-03-11
Filing date: 2010-03-10
Publication date: 2010-09-16
Also published as: AT510215A2

Abstract

This invention relates to a surgical needle (1) which is used in suturing fascia (A) openings formed during laparoscopic surgery and which comprises a hook-shaped front piece (2) with a sharp and closed tip (3) and an open end with a diameter that barely allows the suture thread (6) to pass through, an aperture (4) on the front piece (2) close to the tip (3), a back piece (5) attached to the open end of the front piece (2) which can be detached or reassembled during surgery, and a suture thread (6) embedded inside the front piece (2) and comes out upon passing through the back piece (5) that is attached to the front piece (2).

Description

A SURGICAL NEEDLE USED IN LAPAROSCOPIC SURGERY

FIELD OF THE INVENTION:

This invention relates to a surgical needle used in suturing fascial openings which are formed during laparoscopic surgery.

BACKGROUND OF THE INVENTION:

Lean and long instruments are used in laparoscopic surgery. These instruments reach the abdomen by passing through the inside of a hollow cylinder device called trocar. After the abdominal cavity is puffed up with CO2 gas in laparoscopic surgery, trocars are placed on the abdomen by penetrating through layers of abdominal wall and the fascia so that one end is within the abdomen and the other is outside the abdomen. Trocars possess a valve mechanism at one end which is closer to the abdominal wall. This mechanism prevents the gas inside the abdomen to leak out of the abdomen even in the case that laparoscopic instruments are placed inside the trocar. Abdominal fascia, which is located underneath the skin and subdermal structures, is the strongest layer of the abdomen. Trocars are taken out the latest following termination of a laparoscopic surgery and the abdominal fascial openings created by trocars are then sutured. Failure to close the fascial opening may cause hernia. Fascial openings may not efficiently be sewn shut by instruments and needles used in closing large abdominal wall lesions inasmuch as the fascial opening has a deep localization which likely becomes deeper in patients with large subdermal fat tissue.

The present state of the art involves surgical needles used in suturing up surgically-opened fascial openings and instruments used in suturing up fascial openings created during laparoscopic surgery. Surgical needles, although may be present in different shapes, are generally round-shaped and they resemble the letter "C". A suture thread is attached at the end of the needle so that the thread follows the needle during the process of suturing a lesion. Such needles are called atraumatic needles. These needles are subjects of the Russian patent documents numbered RU 2110 964 Cl and RU 2074 653 Cl. Another needle type which does not possess suture thread possesses an eye through which a suture thread can be slipped in order to follow the needle during the process of suturing a lesion.

It is difficult to close fascial openings caused by trocars by using either type of needle because it may not always be possible to penetrate into the lesion which resembles a deep well, to rotate these needles at such depth and to assemble the two lips of the fascial opening using these needles.

The type of needle possessing an eye at one end through which a suture thread can be slipped is the subject of the Japanese patent document numbered JP8243109 and the United Stated of America patent document numbered US 5158543.

The French patent document numbered FR2732209(Al), European patent document numbered EP 1955662, United Stated of America patent document numbered US5352219A, Korean patent document numbered KR20040075834 and International patent application numbered WO 9921489 Al disclose needles with eyes. These needles may create unnecessarily large openings on the fascia since their eye diameters are larger than the diameter of suture threads. In addition, such needles are relatively big instruments that need to be pushed forward manually. Therefore, in order to grab the suture thread, the surgeon either has to combine two lips of the fascia and pass the needle at once or pass it through either lips one by one.

Various instruments are available that are used to close fascial openings one of which is a mechanism with double long needles. The purpose of this mechanism is to pass the suture thread that follows one of the long and straight needles through the lips of the aperture by pulling it using the other needle. However, this mechanism is hardly practical since the distance between the needles is constant, while the diameter of the opening created in the fascia varies according to the entrance angles of trocars. Therefore it is not possible for the needles to pierce the lips of the fascial opening at an equal distance.

A complicated mechanism aiming at closing the fascial opening has been described in the United States of America patent document numbered US 2009/0018554 Al. The opening created by the tip of this device in the fascia has a larger diameter than that of suture thread rendering the use of this instrument unfavorable in several lesions.

Lean and long needles described in the United States of America patent documents numbered US 006066146A and US 2004/0087978 Al are directed downwards through the inside of the abdomen without visualization. These applications possess the risk of the tip of the needle injuring intraabdominal organs, such as the intestines.

BRIEF DESCRIPTION OF THE INVENTION:

The objective of the invention is to build a surgical needle, which has a back piece that can be assembled and detached during use, and which can close the fascial opening conveniently and reliably.

DETAILED DESCRIPTION OF THE INVENTION:

The surgical needle built to achieve the objective of this invention has been shown in attached figures, where:

FIGURE-I is a perspective view of the inventive surgical needle;

FIGURE -2 is a view of the inventive surgical needle showing all pieces separately; FIGURE -3 is a view of the inventive surgical needle at the instance of piercing the first fascia wall;

FIGURE -4 is a view of the inventive surgical needle after piercing the first fascia wall;

FIGURE -5 is a view of an embodiment of the inventive surgical needle at the instance of piercing the opposite fascia wall;

FIGURE -6 is a view of the embodiment of the inventive surgical needle given in

Figure 5, after piercing the opposite fascia wall;

FIGURE -7 is a view of another embodiment of the inventive surgical needle;

FIGURE -8 is a view of the embodiment of the inventive surgical needle given in

Figure 7 at the instance of the needle and the thread passing through the opposite fascia wall;

FIGURE -9 is a view of the embodiment of the inventive surgical needle given in

Figure 7 after the needle and the thread pass through the opposite fascia wall;

Each piece in figures has been numbered as follows:

1. Needle

2. Front piece

3. Tip

4. Aperture

5. Back piece

6. Suture thread A. Fascia

The inventive surgical needle (1) comprises a front piece (2) with a sharp tip (3), an aperture (4) on the front piece (2) close to the tip (3), a removable back piece (5) that is attached to back of the front piece (2), and a suture thread (6) that is embedded into the front piece (2) and passes through the inside of the back piece (5). The front piece (2) is a hook-shaped tube with one end open and the other closed and its inner diameter barely allows the suture thread (6) to pass through. The closed tip (3) is sharpened in order for a smooth penetration to the fascia (A). The suture thread (6) is embedded inside the front piece (2), starting right behind the aperture (4) at the tip (3). The tip (3) of the front piece (2) is not engaged up to the point that the suture thread (6) is embedded. The back piece (5) is attached at the other end of the front piece (2). The back piece (5) is a hollow cylinder which is slightly larger than the front piece (2) with two open ends.

The open end of the front piece (2) which serves as an exit for the suture thread (6) is attached to the back piece (5). The suture thread (6) passes through the inside of the front piece (2) as well as the back piece (5) and lies outside the needle (1). The back piece (5) is removable allowing separation and assembly of the front and the back pieces (2, 5) whenever desired during surgery.

The back piece (5) is attached to the front piece (2) at initial use of the needle (1). The needle (1) is passed through one lip of fascia (A) opening (Figure 3) by the help of a needle holder (not shown in figures). Front piece (2) of the needle (1) is passed through one lip of the fascia (A) by pushing forward using a needle holder, while the back piece (5) is not pushed forward, but taken out by being pulled back using another needle holder (Figure 4).

The back piece (5) of the needle (1) allows the needle (1) to be more conveniently grabbed by the help of a needle holder and helps the front piece (2) to pass through the fascia (A). The front piece (2), after passing through the fascia (A), is pushed forward while the back piece (5) is pulled back thus eliminating the difficulty of pushing forward the back piece (5) of the needle (1) towards the core of a deep lesion. The back piece (5) may then be attached to the front piece (2) depending on the varying surgical strategy. In the case that there is no need for attachment of the back piece (5), suturing process may be continued by holding the front piece (2) of the needle (1) by a needle holder. In one embodiment of the invention, after the front piece (2) is passed through one lip of the fascia (A), it is passed from the downside towards the upside of the opposite lip of the fascia (A) thereby ensuring the suturing (Figure 5).

In the case the fascia (A) is located underneath a deep and narrow lesion, it might be impossible to pass the needle (1) through the downside of the opposite lip of the fascia (A). In another embodiment of the invention, the suture thread (6) behind the front piece (2) is cut after the front piece (2) passes through one lip of the fascia (A). The front piece (2) and the back piece (5) of the needle (1) are assembled and the front piece (2) is passed towards the downside of the opposite fascia (A) by being pushed downwards on the opposite fascia wall. The suture thread (6) is passed through the aperture (4) at the tip (3) of the front piece (2) and attached to the needle (1) after the front piece (2) is passed beneath the opposite fascia (A) wall (Figure 6). The needle (1) then is pulled back over the fascia (A) in order to pull out the suture thread (6). Therefore the suture thread (6) is passed through both lips of the fascia (A) opening (Figure 7).

Fascia opening is closed conveniently and reliably by the needle (1) of the invention.

Various applications of the inventive needle (1) can be developed. The invention is principally reflected by the claims and may not be limited by the examples described herein.

Claims

1. A surgical needle (1) comprising a front piece (2) with a sharp, closed tip (3) and an aperture (4) on the front piece (2) close to the tip (3); characterized in that it comprises a hook-shaped front piece (2) which has a diameter which barely allows the suture thread (6) to pass through and whose other end is open; a back piece (5) attached to the open end of the front piece (2) which can be detached or reassembled during surgery; a suture thread (6) which is embedded inside the front piece (2) and comes out upon passing through the back piece (5) that is attached to the front piece (2).

2. A surgical needle (1) as claimed in Claim 1 characterized by a front piece (2) which is passed through one lip of the fascia (A) by pushing forward manually and a back piece (5) which is detached by being pulled back out instead of being pushed forward.

3. A surgical needle (1) as claimed in Claim 2 characterized by a front piece (2) which, after being passed through one lip of the fascia (A), is pulled out by being passed from the lower part towards the upper part of the opposite fascia (A).

4. A surgical needle (1) as claimed in Claim 2 characterized in that, after the front piece (2) is passed through one lip of the fascia (A), the suture thread (6) at the back of the front piece (2) is cut, and that upon assembling the front piece (2) and the back piece (5) and by holding the back piece (5), the front piece (2) is pushed downwards on the wall of the opposite fascia to pass underneath the fascia (A).

5. A surgical needle (1) as claimed in Claim 4 characterized in that, as the front piece (2) passes underneath the opposite fascia (A) wall, the suture thread (6) is assembled to the needle (1) by being passed through the aperture (4) at the tip (3) of the front piece (2) and that it allows the suture thread (6) to be pulled out by being pulled back upwards from the lower part of the fascia (A).