WO1995033408A1 - Instrument pour ligature a deux aiguilles - Google Patents

Instrument pour ligature a deux aiguilles Download PDF

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Publication number
WO1995033408A1
WO1995033408A1 PCT/US1995/006461 US9506461W WO9533408A1 WO 1995033408 A1 WO1995033408 A1 WO 1995033408A1 US 9506461 W US9506461 W US 9506461W WO 9533408 A1 WO9533408 A1 WO 9533408A1
Authority
WO
WIPO (PCT)
Prior art keywords
rod
needle
handle
assembly
loop
Prior art date
Application number
PCT/US1995/006461
Other languages
English (en)
Inventor
Jon A. Stevens
Original Assignee
Tahoe Surgical Instruments - Puerto Rico, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tahoe Surgical Instruments - Puerto Rico, Inc. filed Critical Tahoe Surgical Instruments - Puerto Rico, Inc.
Priority to AU26005/95A priority Critical patent/AU2600595A/en
Publication of WO1995033408A1 publication Critical patent/WO1995033408A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B17/06109—Big needles, either gripped by hand or connectable to a handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A61B17/12013—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0472—Multiple-needled, e.g. double-needled, instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/061—Needles, e.g. needle tip configurations hollow or tubular

Definitions

  • This invention relates to medical devices used to close surgical wounds, and in particular to a fixed double-needle ligature device particularly useful for creating circumferential ligatures as are needed in, for example, endoscopic surgery.
  • the surgeon often creates a trocar wound; a round hole in tissue that exposes the inside of a body cavity, such as the abdomen during laparoscopy. Once the surgery is completed, the trocar wound must be closed.
  • the difficulty lies in creating a loop suture to complete circumferential ligatures around such wounds. More precisely, it is difficult to loop a suture into a body cavity on one side of a wound and get the suture to exit the body cavity on the other side of the wound so the suture ends can be tied to close the trocar wound.
  • a prior art solution involves using a single needle device, such as the Grice Suture Needle, marketed by Ideas for Medicine, Inc.
  • the needle is first forced through the tissue while carrying the end of a suture into the body cavity.
  • the needle is then retracted (leaving the end of the suture in the body) and is inserted again on the other side of the wound.
  • a grasper is used to guide the end of the suture to the tip of the reinserted needle.
  • the needle includes a suture holding indentation near its tip in which the suture is secured as the needle is again withdrawn.
  • the suture is then tied to close the wound.
  • the single needle procedure includes sequential insertions of the needle into the body cavity, requiring significant surgical skill and manipulation.
  • the sequential process also takes significant time to complete. Further, loss of the suture end from the needle as it is withdrawn is a problem.
  • the present invention is directed to a device which includes two needles mounted substantially parallel and separated by a distance greater than the diameter of the wound to be closed.
  • the ligature device comprises two main parts : a needle assembly and a rod assembly.
  • the needle assembly is made up of a needle support means (usually a plastic, generally rectangularly shaped bar) for holding needles; first and second hollow needles, each of the needles having a shaft, a proximal end, a distal end, and a sharpened distal tip, and the needles are mounted on the needle support means at their proximal ends.
  • the needles extend substantially parallel to one another from the support means.
  • the needle assembly also includes a first suture support means for slidably supporting a suture, the support means comprising a transverse passage, e.g. a hole, across the shaft of the first needle.
  • the rod assembly of this embodiment includes rod support means for holding rods (again such as a rectangular plastic bar) , first and second rods, each of the rods having a shaft, a proximal end, and a distal end, the rods being mounted on the rod support means at their proximal ends. Like the needles, the rods extend substantially parallel to one another from the rod support means. At the distal end of the second rod is positioned a second suture support means for slidably supporting a suture.
  • this support means is a polymeric or wire filament in the form of a loop.
  • the rod assembly is slidably engaged with the needle assembly such that the first and second rods are positioned within the first and second needles and the rod assembly is movable with respect to the needle assembly from a rod extended position to a rod retracted position.
  • the rod assembly is in the rod extended position, the distal end of the first rod extends past the transverse passage in the first needle.
  • this configuration allows the second suture support means (i.e. the loop) to extend past the distal end of the second needle.
  • the invention is a ligature device which includes (1) a needle assembly comprising first and second hollow needles mounted on a first handle, each of the needles having a shaft, a proximal end, a distal end, the needles being mounted on the first handle at their proximal ends and extending substantially parallel to one another from the first handle; and (2) a rod assembly comprising a rod mounted on a second handle, the rod having a shaft, a proximal end, and a distal end, the rod being mounted on the second handle at its proximal end and extending substantially perpendicular to the handle, a loop filament extending from the distal end of the rod; wherein the rod assembly is slidably engagable with the needle assembly such that the rod can be positioned within the second needle and the rod assembly is movable with respect to the needle assembly from a rod extended position to a rod retracted position, and, when the rod assembly is in the rod extended position, the loop extends past the distal end of the second
  • the loop is formed of a shape memory alloy, and the loop, when in the rod extended position, deflects to a position under the distal end of the first needle.
  • the suture loop necessary for closing a trocar type wound can be quickly created by ensuring that the suture is carefully and firmly held within the needles of the device.
  • Fig. 1 is a side view of a first embodiment of the invention in its relaxed or rod retracted position while inserted into a body cavity;
  • Fig. 2 is a side view of the device of figure 1 in a compressed or rod extended position
  • Fig. 3 is a detailed side view showing the feed needle and feed rod
  • Figs. 4(a) and 4(b) show the end of the feed needle and feed rod, detailing the primed position of the suture
  • Fig. 5 shows the device of Fig. 1 during retraction of the suture through the outlet needle
  • Fig. 6 show an alternate embodiment of the invention showing a different, leaf spring-type biasing mechanism
  • Fig. 7(a) is a side view of an alternate embodiment of the invention in its relaxed or rod retracted position while inserted into a body cavity;
  • Fig. 7(b) is a side view of the device of Fig. 7(a) in a compressed or rod extended position;
  • Fig. 7(c) is a side view of the device of Figs. 7(a) and 7(b) during retraction of a suture;
  • Fig. 8 is a side cross-sectional view of another form of the embodiment shown in figures 7(a) through 7(c) , showing a different locking mechanism.
  • a first embodiment of the invention is shown in fig. 1, designated in its entirety by reference number 70.
  • Device 70 includes two hollow needles, suture feed needle 72 and suture retractor needle 74.
  • a needle separation bar (and handle) 76 holds needles 72 and 74 a distance apart and substantially parallel to each other.
  • Feed needle 72 includes aligned holes 80 and 82 near its tip 84. Needle tips 84 on each of needles 72 and 74 have angled cutting ends for easier insertion through tissue. While fig. 2 shows needle 74 being shorter than the feed needle 72, this is not necessary. However, to date it appears that the uneven length of the needles facilitates the ability to secure the fascia in a proper technical form.
  • a rod positioner bar 90 secures suture feed rod 92 to retractor rod 94.
  • Rods 92 and 94 are held parallel to each other and are spaced the same distance apart as the needles 72 and 74.
  • Rod 92 inserts into feed needle 72 and rod 94 inserts into loop needle 74.
  • a suture engaging loop 96 is attached to the end of rod 94.
  • the loop is formed from a filament of metal or plastic, such as polyethylene. Any material which will form the loop and which is inert with respect to tissue can be used, for example stainless steel .
  • the loop is formed from a filament of shape memory alloy (SMA) , such as Ni/Ti having the following composition (by weight) : 55.7% Ni, 43.9% Ti, 0.20% Cr, 0.033% C, 0.069% 0, 0.0019% H, and 0.0961% other elements, which alloy available from Shape Memory Applications, Inc. of Sunnyvale, California under the name NiTi Superelastic Wire
  • SMA shape memory alloy
  • pre-formed shape when the contorting force is removed.
  • “superelastic” SMA it is meant that the Ni/Ti alloy is in a form which does not require the application of heat or stress to cause the loop, in this case, to take the “memorized” shape.
  • SMA's are described in U.S. Pat. 5,067,957, which is incorporated herein by reference. However, the superelastic form (as opposed to forms which require heat or stress activation) has been found to be most useful in the present invention.
  • the degree of insertion of rods 92 and 94 into the needles 72 and 74 can advantageously be controlled by a biasing mechanism 100. Biasing mechanism 100 connects needle handle or bar 76 to bar 90 to provide a flexing motion.
  • biasing mechanism 100 is formed from plastic or metal tensioners to create a spring tension when forced out of its relaxed state. In its relaxed state, as shown in fig. 1, biasing mechanism 100 holds bars 76 and 90 apart by such a distance that the end of rod 92 will not pass holes 80 and 82 in needle 72, and loop 96 does not extend from the end of needle 74. Biasing mechanism 100 is closed by squeezing bars 76 and 90 together, as shown in fig. 2. When bars 76 and 90 meet, feed rod 92 is forced beyond holes 80 and 82 and loop 96 extends beyond the tip of loop needle 74. Biasing mechanism 100 flexes as bars 76 and 90 are squeezed together. Biasing mechanism 100 supplies a spring pressure when compressed such that when the bars 76 and 90 are released, the device will return to the relaxed state shown in fig. 1.
  • biasing mechanisms well known to those in the art may be substituted for the mechanism 100.
  • a simple leaf spring mechanism mounted between bars 76 and 90 could be used, as shown in fig. 6.
  • Typical dimensions for the elements of the device are as follows, using the embodiment shown in fig. 6 as an example.
  • the distance between the bars 76 and 90 when forced fully apart about 1.5 inches.
  • the needles 72 and 74 (formed from stainless steel hypodermic tubing .088 o.d. and .058 i.d.) are centered laterally on bar 76, approximately 0.8 inches apart. Bars 76 and 90 are approximately 3 inches wide.
  • Rod 92 is a .045 inch diameter solid stainless steel rod which measures about 5.6 inches in total length, measured from the top of bar 76, thus extending through needle 72 when fully extended, since needle 72 is approximately 4.75 inches long.
  • Needle 74 is approximately 4 inches long.
  • Rod 94 is about .056 inches in diameter and about 3.75 inches in length, extending a total of 5.6 inches when combined with loop 96.
  • springs 100 stainless steel strips about .2 inches wide and .025 inches thick can be used.
  • Latching mechanism 102 mounted or formed integrally with bar 76 allows bars 76 and 90 to be securely attached together, as shown in figure 2.
  • Latch 102 allows the surgeon to lock biasing mechanism 100 in its compressed position. The surgeon may want to let go of the device while it is inserted into the body cavity without the spring pressure of biasing mechanism 100 returning it to a relaxed position.
  • the mechanism can be design to lock the device in both the exnded or retracted positions, as shown in figure 8.
  • feed rod 92 is notched, as shown in fig. 3.
  • Notch 98 is in the same direction as the in- line holes 80 and 82 so as to prevent the suture passing through the holes from being cut by feed rod 92 passing holes 80 and 82.
  • a suture end 110 is first threaded through holes 80 and 82.
  • the suture is then "primed” by squeezing bars 76 and 90 together until rod 92 forces the suture slightly past holes 80 and 82. Bars 76 and 90 are then released whereby the suture is left in this "primed” position as shown in fig. 4(b) .
  • the suture is securely held such that upon insertion of device 70 into the body cavity, the suture will not slip back through holes 80 and 82.
  • Device 70 is then inserted through a cavity wall so that the ends of needles 72 and 74 penetrate the wall of the cavity, one on each side of the wound 10, as shown in fig. 1.
  • the amount of cavity wall used to close the trocar wound can be advantageously increased by inserting the longer feed needle 72 into the tissue first at approximately a 15° angle. The device is then rotated slightly to a position such that needles 72 and 74 are inserted perpendicular to the skin surface adjacent the wound. Upon insertion of device 70, suture end 110 will be free inside the body cavity. The surgeon then compresses bar 90 and bar 76 such that loop 96 extends beyond the tip of needle 74, as shown in fig. 2. Rod 92 passes holes 80 and 82 so as to hold a portion of the suture within feed needle 72 secure. A suture grasper (not shown) is then used to grasp suture end 110 and feed it through loop 96. Bars 90 and 76 are subsequently decompressed to withdraw loop 96 inside loop needle 74, as shown in fig. 5. Suture end 110 is securely held in place by loop 96.
  • Needles 72 and 74 are then removed from the body, thereby withdrawing the suture held by the loop 96.
  • the portion of the suture in needle 72 will be pulled taut before the tension is great enough to dislodge the end of the suture from loop 96.
  • the suture will slide freely through holes 80 and 82 to supply a sufficient length of suture to permit removal of the suture from the body.
  • the surgeon can remove the suture from loop 96, allowing suture ends 96 to be tied together.
  • FIG. 7 (a) -7(c) An alternate embodiment of the invention is shown in figs. 7 (a) -7(c) , designated in its entirety by reference number 111.
  • Device 111 includes two hollow needles, suture feed needle 112 and suture retractor needle 113.
  • a needle separation bar 114 holds needles 112 and 113 a distance apart and substantially parallel to each other. Needle separation bar 114 has in it an opening 130, leading to an opening in needle 112 at its proximal end 120. Proximal end 120 is positioned in needle separation bar opening 130. Needle tips 115 on each of needles 112 and 113 have angled cutting ends for easier insertion through tissue. While figs. 7 (a) -7(c) show retractor needle 113 being shorter than feed needle 112, this is not necessary. However, as discussed above, to date it appears that the uneven length of the needles facilitates the ability to secure the fascia in a proper technical form.
  • a suture engaging articulating loop 119 is attached to the end of rod 117.
  • the loop is formed from a filament of metal or plastic such as polyethylene. Any material which will form the loop and which is inert with respect to tissue can be used. As discussed above, in this embodiment, however, it is preferable to form the loop of a filament of superelastic SMA.
  • Retractor rod 117 is secured to handle 116. Rod 117 inserts into retractor needle 113. Biasing mechanism 118 connects handle 116 to needle separation bar 114 to provide flexing motion.
  • biasing mechanism 118 holds handle 116 and needle separation bar 114 apart by such a distance that loop
  • Biasing mechanism 118 is closed by squeezing handle 116 and bar 114 together, as shown in fig.
  • loop 119 extends beyond the tip of loop needle 113 and past the distal end of needle 112.
  • the coil springs of biasing mechanism 118 compress as handle 116 and bar 114 are squeezed together.
  • Biasing mechanism 118 supplies a spring pressure such that when the handle 116 and bar 114 are released, the device will return to the relaxed state shown in fig. 7(c) .
  • biasing mechanisms As discussed above other types of biasing mechanisms are well known to those in the art and these other biasing mechanisms (leaf springs, other material such as flexible polymeric materials, etc.) may be substituted for the coil springs shown.
  • a latching mechanism (not shown in figure 7, see
  • the surgeon may want to release the device while it is inserted into the body cavity without the spring force the biasing mechanism 118 returning it to a relaxed position.
  • device 111 is inserted through a cavity wall so that the ends of needles 112 and 113 penetrate the wall of the cavity 50 one needle on each side of the wound.
  • the amount of cavity wall used to close the trocar wound can be advantageously increased by inserting the longer feed needle 112 into the tissue first at approximately a 15° angle. The device is then rotated slightly to a position such that needles 112 and 113 are inserted perpendicular to the skin surface adjacent to the wound.
  • articulating loop 119 Upon insertion of device 111, the surgeon compresses handle 116 and bar 114 causing articulating loop 119 to extend beyond the tip of needle 112 and deflect (using the superelastic SMA) completely under the distal end of needle 112 as shown in fig. 7(b) . Then, an end 121' of a suture 121 is fed through opening 130 in needle separation bar 114 and then through opening 120 in needle 112 and through loop 119 inside the body cavity. Handle 116 and bar 114 are decompressed to withdraw loop 119 inside loop needle 113 as shown in fig. 7(c) . Suture end 121' is firmly held in place by loop 119.
  • Needles 112 and 113 are then removed from the body, thereby withdrawing suture 121 held by loop 119.
  • the portion of the suture in needle 112 will be pulled taut before the tension is great enough to dislodge the end of the suture from loop 119. Thereafter, the suture will slide freely through needle 112 to supply a sufficient length of suture to permit completion of removal of device 111 from the body.
  • FIG 8 another view having the same basic structure as the device shown in figures 7(a) through 7(c) is shown, though the device of figure 8 provides an altered configuration which is easier for the physician to hold in use.
  • the elements of figure 8 are numbered consistently with those used in figures 7.
  • rod 117 of figures 7 which rod would be positioned in opening 206 and pass through passage 208 of figure 8.
  • bar 114 of the previous embodiment has been reconfigured in the embodiment of figure 8, indicating that any number of configurations might be adopted which nevertheless incorporate the key elements of the invention. In this embodiment, the reconfiguration permits opening 130 to be positioned as shown.
  • Figure 8 also shows a different locking mechanism for the device, which, like the lock mechanism of figure 6 is labelled 202.
  • the lock utilizes a horizontally disposed cross bar, biased using spring 204 and latch 205.
  • Latch 205 is forced into depressions 212 formed in support columns 210 for handle 116.
  • the lock is released by pressing button 202.
  • figure 8 includes the handle 116 shown both in the retracted and the extended positions. While the invention has been described with reference to the closure of trocar wounds arising from endoscopic surgery, those skilled in the art will recognize that the invention will be useful for any procedure requiring ligature of a major vessel or organ. Such procedures would include, for example, a bladder suspension, a uterine neck ligation for a laparoscopic assisted vaginal hysterectomy (LAVH) , an appendectomy or a laparoscopic bowel resection.
  • LAVH laparoscopic assisted vaginal hysterectomy

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Reproductive Health (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un instrument pour ligature à deux aiguilles (10) permettant de former efficacement la boucle d'une suture destinée à fermer une blessure telle que celle provoquée par un trocart. Dans une réalisation préférée, l'instrument comporte un ensemble à deux aiguilles (72, 74) garantissant que la suture (110) est effectivement maintenue en place pendant le retrait de l'aiguille.
PCT/US1995/006461 1994-06-08 1995-05-15 Instrument pour ligature a deux aiguilles WO1995033408A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU26005/95A AU2600595A (en) 1994-06-08 1995-05-15 Double needle ligature device

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US25536394A 1994-06-08 1994-06-08
US08/255,363 1994-06-08

Publications (1)

Publication Number Publication Date
WO1995033408A1 true WO1995033408A1 (fr) 1995-12-14

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ID=22967980

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1995/006461 WO1995033408A1 (fr) 1994-06-08 1995-05-15 Instrument pour ligature a deux aiguilles

Country Status (2)

Country Link
AU (1) AU2600595A (fr)
WO (1) WO1995033408A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1032314A1 (fr) * 1997-11-19 2000-09-06 Applied Medical Resources Corporation Appareil de suture ameliore et procede associe
WO2009069119A1 (fr) * 2007-11-30 2009-06-04 Easylap Ltd. Ensemble et procédé de suture
WO2013070841A1 (fr) * 2011-11-09 2013-05-16 Easylap Ltd. Ensemble de suture comprenant un espaceur
WO2016154488A2 (fr) 2015-03-24 2016-09-29 Sentreheart, Inc. Dispositifs de ligature de tissu et procédés associés
US10716571B2 (en) 2015-03-24 2020-07-21 Sentreheart Llc Devices and methods for left atrial appendage closure
US10799241B2 (en) 2009-04-01 2020-10-13 Sentreheart Llc Tissue ligation devices and controls therefor
US10966725B2 (en) 2007-03-30 2021-04-06 Sentreheart Llc Devices and systems for closing the left atrial appendage

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4655906A (en) * 1986-05-02 1987-04-07 Phillips Petroleum Company Hydrotreating process employing a novel catalytic composition
JPH04226643A (ja) * 1990-12-29 1992-08-17 Masataka Funada 医療用器具

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4655906A (en) * 1986-05-02 1987-04-07 Phillips Petroleum Company Hydrotreating process employing a novel catalytic composition
JPH04226643A (ja) * 1990-12-29 1992-08-17 Masataka Funada 医療用器具

Cited By (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1032314A1 (fr) * 1997-11-19 2000-09-06 Applied Medical Resources Corporation Appareil de suture ameliore et procede associe
EP1032314A4 (fr) * 1997-11-19 2004-07-21 Applied Med Resources Appareil de suture ameliore et procede associe
US11826050B2 (en) 2007-03-30 2023-11-28 Atricure, Inc. Devices, systems, and methods for closing the left atrial appendage
US11020122B2 (en) 2007-03-30 2021-06-01 Sentreheart Llc Methods for closing the left atrial appendage
US10966725B2 (en) 2007-03-30 2021-04-06 Sentreheart Llc Devices and systems for closing the left atrial appendage
AU2008331095B2 (en) * 2007-11-30 2014-05-15 Easylap Ltd. Suturing assembly and method
WO2009069119A1 (fr) * 2007-11-30 2009-06-04 Easylap Ltd. Ensemble et procédé de suture
US8603112B2 (en) 2007-11-30 2013-12-10 Easylap Ltd. Suturing assembly and method
US10799241B2 (en) 2009-04-01 2020-10-13 Sentreheart Llc Tissue ligation devices and controls therefor
US11950784B2 (en) 2009-04-01 2024-04-09 Atricure, Inc. Tissue ligation devices and controls therefor
CN104023650B (zh) * 2011-11-09 2017-02-15 伊兹拉普有限公司 具有间隔件的缝合组件
US10143467B2 (en) 2011-11-09 2018-12-04 Thd Lap Ltd. Suturing assembly with spacer
CN104023650A (zh) * 2011-11-09 2014-09-03 伊兹拉普有限公司 具有间隔件的缝合组件
WO2013070841A1 (fr) * 2011-11-09 2013-05-16 Easylap Ltd. Ensemble de suture comprenant un espaceur
JP2015500678A (ja) * 2011-11-09 2015-01-08 イージーラップ エル・ティー・ディー スペーサを有する縫合アセンブリ
EP3273870A4 (fr) * 2015-03-24 2018-12-19 Sentreheart, Inc. Dispositifs de ligature de tissu et procédés associés
US10716571B2 (en) 2015-03-24 2020-07-21 Sentreheart Llc Devices and methods for left atrial appendage closure
US10959734B2 (en) 2015-03-24 2021-03-30 Sentreheart Llc Tissue ligation devices and methods therefor
WO2016154488A2 (fr) 2015-03-24 2016-09-29 Sentreheart, Inc. Dispositifs de ligature de tissu et procédés associés
EP4285843A3 (fr) * 2015-03-24 2024-05-22 AtriCure, Inc. Dispositifs de ligature de tissu

Also Published As

Publication number Publication date
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