GB2325165A

GB2325165A - Surgical knot pusher

Info

Publication number: GB2325165A
Application number: GB9709705A
Authority: GB
Inventors: Khaled Mostafa Kamel Ismail
Original assignee: Individual
Current assignee: Individual
Priority date: 1997-05-13
Filing date: 1997-05-13
Publication date: 1998-11-18
Anticipated expiration: 2017-05-13
Also published as: GB9709705D0; GB2325165B

Abstract

A surgical knot pusher 30 comprising an elongated plastic body 32 with a tapered end 34, an inlet 42 through the tapered end 34 and a slot 38 in the wall of the body 32 wherein the slot 38 is in communication with the inlet 42 through a passageway 40. The pusher may be used to form a succession of extra-corporeal knots and is particularly suitable for use in laparoscopic, minimal invasive surgery.

Description

KNOT PUSHER This invention relates to a knot pusher for use in the formation of knots in suture material used in surgery. It is particularly suitable for use as a knot pusher in laparoscopic, minimal invasive surgery.

One known form of knot pusher is an elongated plastics tube having a central longitudinally-extending passageway through which a suture can extend being attached towards one end of the device and emerging at the other, pusher end of the device attached to a surgical needle. The surgeon has to cut off the needle to form an extracorporeal knot and use the pusher to push the knot to the desired position. Thus this known device cannot be used to form a second or further knots and should be disposable after formation of one knot. Thus the procedure of using a pusher with its attached suture and needle must be repeated for each required knot.

Metal pushers are also known but if not disposed of after use on one patient, they must be sterilised, which may be difficult and expensive to achieve effectively. Moreover, metal pushers are not particularly convenient to use and are relatively difficult to manoeuvre.

Disposable plastic knot pushers which are known do not encircle the suture material at their pusher end causing the suture material to slip on many occasions.

It is an object of the present invention to provide an improved pusher which overcomes the above disadvantages.

Accordingly the invention provides a pusher in the form of an elongated plastics body, the body having a tapered end portion at one end, an inlet in the tapered end communicating through a passageway to a slot in a wall of the body, the slot extending along the tapered portion but stopping short of the tapered end.

Preferably the tapered portion is curvilinear whereby the slot and the passageway provide an arcuate passageway or tunnel through which a needle with attached suture may be passed.

The body is preferably made by injection moulding. The pusher may, therefore, be a disposable item that can be thrown away after use on a single patient but, because of its construction, it enables the surgeon to form a succession of extra corporeal knots from a single length of suture plus needle.

Thus after a stitch has been formed in the body of a patient, the needle with attached suture can be passed through the inlet at the tapered end of the pusher and out through the slot whereby an extra corporeal knot is formed.

The knot can be manoeuvred to the desired position using the pusher to lock the stitch in place. The suture may be cut adjacent the knot and sufficient length of suture remains to repeat the procedure and to form a second and further knots for the same patient.

One embodiment of the invention will now be described by way of example only with reference to the accompanying drawings in which: Figure 1 is an elevation in part section of a prior art known pusher; Figure 2 is an elevation of a knot pusher of the invention; and Figure 3 is a part-sectional view in the direction of arrow A of Figure 2.

In Figure 1 a known prior art knot pusher 10 has an elongated body 12 having an end portion 14 tapering to one end 16 and a longitudinally-extending central passageway 18 emerging at end 16. A suture 20 with a needle 22 attached at one end is secured at its other end in the body 12 adjacent the end of the body away from its tapered end.

The needle 22 has to be cut off to make an extra corporeal knot in suture 20, and the knot is pushed into the desired position by pusher 10. The suture is then cut between the knot and end 16 of the pusher, thereby the whole expensive system is used to take one stitch, requiring a freshly sutured pusher for each further stitch and extracorporeal knot.

In Figures 2 and 3, the pusher 30 of the invention has an elongated plastics body 32 having an end portion 34 tapering to one end 36. A slot 38 in the body leads via a passageway 40 to an inlet 42 in end 36.

In use, after a stitch has been put in place, a needle attached to a suture (neither shown) is passed into inlet 42 (in direction of arrow A), through passageway 40 and out through slot 38 (in direction of arrow B), whereby an extracorporeal knot may be readily formed using the free end of the suture material. The knot is pushed by the pusher to lock the stitch in place and the suture is cut adjacent the knot.

As there is enough length of unused suture attached to the needle, the needle and remaining length of suture may be re-used to form further knots.

Any suture material (e.g. those used in conventional surgery) can be used and so no additional expense is needed for laparoscopic stitching.

Thus the invention provides a pusher that is easy to use, can provide a succession of knots for one patient and then may be disposed of. Although not intended to be limited by dimensions, by way of example only in Figure 2 slot 38 may be about 2 mm in length. The pusher may be of overall length about 25 to 30 cms and of maximum diameter e.g. 5 mm.

Claims

1. A knot pusher for surgical knots, the pusher comprising an elongated plastics body, the body having a tapered end portion at one end, an inlet in the tapered end, the inlet communicating through a passageway to a slot in a wall of the body, the slot extending along the tapered potion but stopping short of the tapered end.

2. A knot pusher according to Claim 1, in which the tapered portion is curvilinear whereby the slot and the passageway provide an arcuate passageway or tunnel through which a needle with attached suture may be passed.

3. A knot pusher according to Claim 1 or 2, which is formed as an injection moulding.

4. A knot pusher according to Claim 1, 2 or 3, which is a disposable product.

5. A knot pusher according to any preceding Claim, which is of overall length about 25 to 30 cm and of maximum diameter 5 mm.

6. A knot pusher according to any preceding Claim, in which the slot is about 2 mm in length.

7. A knot pusher according to Claim 1, substantially as hereinbefore described with reference to and as shown in Figures 2 and 3 of the accompanying drawings.