Apparatus and method of extracorporeally applying and locking laparoscopic ...

[54] APPARATUS AND METHOD OF

EXTRACORPOREALLY APPLYING AND
LOCKING LAPAROSCOPIC SUTURE AND
LOOP LIGATURES

[76] Inventor: Theodor Lehrer, 936 Intracoastal Dr., Apt 21C, Ft. Lauderdale, Fla. 33304

[21] Appl. No.: 164,462
[22] Filed: Dec. 9,1993

[51] Int. CI.6 A61B 17/04

[52] U.S. CI 606/139; 606/144; 606/148;

289/1.5; 289/17

[58] Field of Search 606/139, 144,

606/147, 148; 289/1.2, 1.5, 2, 17

[56] References Cited

U.S. PATENT DOCUMENTS

3,344,790 10/1967 Dorner 128/340

3,871,379 3/1975 Clarke 128/326

4,493,323 1/1985 Albright et al 128/340

4,597,390 7/1986 Mulhollan et al 128/340

4,614,187 9/1986 Mulhollan et al 128/303 R

4,760,848 8/1988 Hasson 128/340

4,945,920 8/1990 Clossick 128/751

5,015,250 5/1991 Foster 606/147

5,037,433 8/1991 Wilketal 606/139

5,129,912 7/1992 Noda et al 606/139

5,147,373 9/1992 FerzU 606/144

OTHER PUBLICATIONS

Graumont & Hensel, Encyclopedia of Knots and Fancy
Ropework, New York 1945, preface & pp. 11, 56, 99-101.

Primary Examiner—Gary Jackson
Attorney, Agent, or Firm—John C. Smith

[57] ABSTRACT

A suture applier instrument for tying suture and loop ligatures in laparoscopic excisional procedures such as LAVH, tubal ligation, salpingectomy, cophorectomy and appendectomy; in the repair of the fallopian tubes, uterus and ovaries; and in retropubic colposuspension using locking slip knots; and an efficient extracorporeal method to effectively lock them. The slip knot is held at the tip of the suture applier instrument and is kept in position on the target tissues while its two suture strands are operated extracorporeally, tying the loop ligature with one of the strands and locking or tightening the knot itself with the other. Additional hitch knots may be introduced and tied after the slip knot has been applied, using the same instrument. New knots, spool for pretied knot sutures and knot tying techniques for use with the suture applier are presented.

10 Claims, 18 Drawing Sheets