Laparomed Corporation

Advanced Surgical, Inc.

Urohealth Systems, Inc.

Terry Buelna

Wayne Arthur Noda

Paul Lubock

Stuart J Gourlay

Alfred Cushieri

An improved device and method for suturing penetrations and incisions through tissue into a body cavity. The device should find particular use in laparoscopic and other types of minimally invasive surgical procedures. A device according to the invention includes a shaft and an inverted needle joined to the shaft. Two ends of a length of suture material are attached at or near a sharpened proximal tip on the needle. The device may include a movable shield that is slidable to alternately cover and expose the sharpened tip of the needle. This shield may include a blunt distal end and an inclined proximal surface to assist the surgeon in guiding the hook into and out of the body cavity. The device may be provided with a visual and tactile indicator on one side of the device to assist the user in threading and removing the suture material into and out of a selected side of the hook.

Surgical suturing device

A self-introducing infusion catheter comprises a substantially rigid, elongate shaft having a longitudinal passage therethrough and an infusion port at its distal end. An electrode is further mounted at the distal end. The electrode is electrically coupled to a connector at the proximal end of the shaft which may be connected to an electrosurgical power supply. The connector is further in communication with the passage in the shaft and provides fluid connection with an infusion fluid delivery device. In the method of the invention, the catheter is connected to an electrosurgical power supply and ablative energy is applied to abdominal tissue through the electrode. This facilitates penetration of the tissue to position the device in the abdominal cavity through the abdominal wall. The distal end of the catheter is positioned through an incision in a body structure, such as the cystic duct, and the proximal end is connected to an infusion fluid delivery device. The distal end is clamped in position in the duct, and an infusion fluid such as contrast medium is infused into the duct.

Self-introducing infusion catheter

A suture applying device comprises an elongate shaft having a length of suture therein. A pre-tied loop suture is held at the distal end of the shaft with a free end of the suture being attached within a handle secured to the proximal end of the shaft. In a first embodiment, a pulley and puller assembly is provided for closing the pre-tied suture loop, where the pulley permits a greater length of suture to be taken in than is traveled by the puller. In a second embodiment, a pair of opposed jaws are slidably mounted within the handle for selectively engaging and gripping the free end of the suture. In this way, an arbitrarily large length of suture may be taken in by pulling on the free end of the suture in successive strokes. The device further includes a sheath slidably disposed on the shaft for protecting the suture during introduction. The sheath automatically retracts when the device is introduced through a trocar sleeve or cannula, thereby exposing the suture loop.

Device and method for applying large-diameter ligating loop

The invention provides a tissue manipulation system including a tethered clamp, a clamp applicator for positioning the clamp through a trocar sleeve and applying the clamp to a tissue location in the abdominal cavity, and a rigid positioning shaft for engaging the clamp and/or tether to manipulate the clamp. In a further embodiment, the tissue manipulation system includes an introducer through which the tether can be withdrawn from the abdominal cavity and a retainer attached to the proximal end of the introducer for clamping the tether in position. The tissue manipulation system further includes an obturator for inserting the introducer into the abdomen, and a tether snare for retrieving the tether and withdrawing it through the introducer.

Tethered clamp retractor

A trocar system comprises an obturator and a trocar cannula. The obturator includes an elongate shaft having a tapered distal end and a proximal end. At least one port is provided near the distal tip of the tapered distal end and open to an axial lumen within the obturator. A mechanism for producing an audible signal in response to superatmospheric pressure at the port, typically a whistle structure, is provided near the proximal end of the trocar. In this way, when the trocar system is introduced to an insufflated region during laparoscopic surgery, an audible whistle will be provided to alert the treating surgeon.

Trocar system having penetration indicator

The invention provides a tissue manipulation system including a tethered clamp and a clamp applicator for positioning the clamp through a trocar sleeve and applying the clamp to a tissue location in the abdominal cavity. In a further embodiment, the tissue manipulation system includes a introducer through which the tether can be withdrawn from the abdominal cavity and a clamp attached to the proximal end of the introducer for clamping the tether in position. The tissue manipulation system further includes an obturator for inserting the introducer into the abdomen, and a tether snare for retrieving the tether and withdrawing it through the introducer.

A suture applying device comprises an elongate shaft having a slidably mounted cutting member. A pre-tied suture loop is held at the distal end of the shaft with a free end of the suture being attached to a body member which is slidably received over the shaft. The cutting member is secured to the shaft by a link which collapses under a predetermined compressive force, causing the cutting member to move distally forward relative to the shaft to sever the free end of the suture. In this way, the suture loop can be initially tightened and subsequently severed by simply retracting the body member relative to the shaft in a single motion.

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Long Beach, CA, United States of America

Terry Buelna