Endoscopic fascial closure systems and methods for using same
Inventors
Assignees
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Publication Number
US-9055940-B2
Publication Date
2015-06-16
Expiration Date
Abstract
A system for closure of a fascial opening is disclosed. The system may include a first capture device for pulling one end of a suture through fascial tissue on one side of a fascial opening, and a second capture device for pulling an opposing end of the suture through the fascial tissue on an opposite side of the fascial opening. A trapping device for locating and engaging the first capture device can be used, prior to the capture device being pulled through the fascial tissue, so that the trapping device can subsequently pull the suture to facilitate closure of the fascial opening. Methods and apparatuses for closure of a fascial opening are also disclosed.
Core Innovation
The invention relates to an endoscopic fascial closure system and a method for closure of a fascial opening. A suture is positioned below a fascial opening, and first and second devices are used to access and grasp one end and an opposing end of the suture through fascial tissue on opposing sides of the fascial opening via first and second incisions in the body of a patient. The opposing end is pulled through the fascial tissue on a second of the opposing sides of the fascial opening with the second device and through the second incision.
A separate trapping mechanism is directed into the body through the second incision, advanced across the fascial opening and towards the first device, and the one end of the suture is pulled with the first device through the fascial tissue on a first of the opposing sides of the fascial opening and through a distal portion of the trapping mechanism. The trapping mechanism is retracted through the second incision and outside of the body of the patient for subsequent tying of the suture. This arrangement supports placing and relocating suture ends relative to the fascial opening using endoscopic access and a trapping mechanism that spans the opening.
The disclosure further includes system components and embodiments associated with the closure process. The system includes a suture delivery device, endoscopic capture devices for grasping and retaining suture ends through opposing tissue layers, and a tunneling trapping device with an entry gap and a one-way trap/clasp/slot for locating the capture device under the skin and facilitating pulling the suture across the defect. The system can also include a knot pusher for advancing a tied knot beneath the skin to tension and secure the closure.
Claims Coverage
The provided material includes one independent claim. The claim covers an endoscopic method for closing a fascial opening using opposing access through incisions, grasping opposing suture ends with first and second devices, and using a separate trapping mechanism advanced across the fascial opening to enable subsequent pulling and knotting.
Opposing incision access with first and second suture grasping devices
accessing, through fascial tissue on opposing sides of the fascial opening via first and second incisions in the body of a patient, one end of the suture with a first device for grasping the suture, and an opposing end of the suture with a second device for grasping the suture, respectively.
Endoscopic pulling of opposing suture end through fascial tissue and incision
pulling the opposing end of the suture through the fascial tissue on a second of the opposing sides of the fascial opening with the second device and through the second incision.
Separate trapping mechanism advanced across the fascial opening
directing a separate trapping mechanism into the body through the second incision, and advancing the trapping mechanism across the fascial opening and towards the first device.
Pulling the other suture end through fascial tissue and distal portion of the trapping mechanism
pulling the one end of the suture with the first device through the fascial tissue on a first of the opposing sides of the fascial opening and through a distal portion of the trapping mechanism.
Retracting the trapping mechanism for subsequent tying
retracting the trapping mechanism through the second incision and outside of the body of the patient for subsequent tying of the suture.
Across the independent claim, the core coverage is endoscopic positioning and grasping of opposing suture ends through incisions, combined with a separate trapping mechanism that is directed into the body and advanced across the fascial opening so that the suture end can be pulled through the fascial tissue and through the distal portion of the trapping mechanism, followed by retraction for subsequent tying.
Stated Advantages
Not explicitly described in patent.
Documented Applications
Not explicitly described in patent.
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