WO2017008820A2 - A 2-part system for endoluminal suturing: "a flexible needle holder and a flexible conduit" - Google Patents

A 2-part system for endoluminal suturing: "a flexible needle holder and a flexible conduit" Download PDF

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Publication number
WO2017008820A2
WO2017008820A2 PCT/EG2015/000032 EG2015000032W WO2017008820A2 WO 2017008820 A2 WO2017008820 A2 WO 2017008820A2 EG 2015000032 W EG2015000032 W EG 2015000032W WO 2017008820 A2 WO2017008820 A2 WO 2017008820A2
Authority
WO
WIPO (PCT)
Prior art keywords
flexible
needle holder
needle
conduit
endoscopic
Prior art date
Application number
PCT/EG2015/000032
Other languages
French (fr)
Other versions
WO2017008820A3 (en
Inventor
Mohamed Youssef SELEEM
Original Assignee
Seleem Mohamed Youssef
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 Seleem Mohamed Youssef filed Critical Seleem Mohamed Youssef
Priority to PCT/EG2015/000032 priority Critical patent/WO2017008820A2/en
Publication of WO2017008820A2 publication Critical patent/WO2017008820A2/en
Publication of WO2017008820A3 publication Critical patent/WO2017008820A3/en

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
    • A61B17/04—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
    • A61B17/062—Needle manipulators
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2905—Details of shaft flexible

Definitions

  • a 2-part System for Endoluminal Suturing " A flexible Needle Holder and A flexible Conduit"
  • endoscopic suturing and ensuring safe tissue apposition is increasing for various indications in modem surgical practice.
  • the potential applications for endoscopic suturing are feasible in the esophagus, the stomach, the rectum and the colon.
  • These indications include, but not limited to, closing defects, fistulae repair, repair of leaks and penetrating ulcers or acute bowel perforations and fixing endoscopic stents
  • the handle may be axial (ethicon ⁇ type) or pistol or storz ⁇ or ring handle or ergo handle or axial ergo
  • the shaft usually will range 2 to 5 mm in diameter according to the needed grasping force
  • the jaw is 2 - 4 mm long enabling the jaw to hold the needle and to make self adjustment safely- and automatically in the proper postion of suturing- so that a suture can be applied easily -the jaw may be straight or curved and may be directed to the right or to the left
  • the instrument may be fixed or detachable (modular) and rotating allowing a wider range of movement
  • a shaft "insertion tube” which is flexible.
  • Its distal part has a tip which is controllable and flexible allowing up to 20- or more if possible- degree of anterior and posterior angulation of the proximal end B- How it works
  • the gastroscope will be. introduced to the stomach and insuflation of air is done -An overtube (50 cm-length and 19 mm external diameter) will be introduced -The needle holder is passed through the proximal opening and advanced forward till the jaws come out at the distal end
  • the conduit will pass through an Over tube -16 mm internal diameter- beside the flexible gastroscope .
  • a pediatric gastroscope may be used instead of the adult scope

Abstract

The system is consisted of 2 parts: 1- A flexible endoscopic needle holder of different diameters the jaws of this needle holder can adjust the position of the needle 2- A fexible endoscopic conduit - which looks like a flexible endoscope without camera, air insuflation or working channels. It is of various diameter which enable the flexible needle holder to pass through it and to move freely in and out. The distal end of the "conduit" has a bending capability allowing the needle holder to be directed to the area that needs to be sutured. He also applied a new concept for endoluminal suturing using the same principle as SILS (single inscion laparoscopy) using commercial needles.

Description

A 2-part System for Endoluminal Suturing: " A flexible Needle Holder and A flexible Conduit"
Technical Field
Medicine: flexible endoscopy and endoscopic suturing
Background Art
The need for endoscopic suturing and ensuring safe tissue apposition is increasing for various indications in modem surgical practice. The potential applications for endoscopic suturing are feasible in the esophagus, the stomach, the rectum and the colon. These indications include, but not limited to, closing defects, fistulae repair, repair of leaks and penetrating ulcers or acute bowel perforations and fixing endoscopic stents
- Also recently it has many indications in the field of obesity (bariatric) surgery management such as:
1- Endoscopic Closure of leaks after sleeve gatrectomy
2- Reduction of stoma after gastric bypass surgery
3- Reduction of gastric pouch after sleeve failure or placation failure
4- Primary endoscopic sleeve gastroplasty
-This invention allows utilizing regular routine laparoscopic surgical suturing techniques with the usages of commercial needles to be applied through the flexible endoscope There are many available commercial options for endoscopic suturing and tissue apposition, yet all of them are expensive, and necessitate specially designed endoscopes and special disposable consumables. Therefore, there is an obvious need for a more cost effective set up utilizing regular medical supplies like suture materials.
Disclosure Of Invention A- Description
1- The needle holder
Which is flexible can be made of different lengths (30 to 90) cm according to the site where it will be used (colon & rectum or esophagus & stomach)
It consists of a handle, a shaft and jaws
The handle may be axial (ethicon © type) or pistol or storz© or ring handle or ergo handle or axial ergo
The shaft usually will range 2 to 5 mm in diameter according to the needed grasping force
The jaw is 2 - 4 mm long enabling the jaw to hold the needle and to make self adjustment safely- and automatically in the proper postion of suturing- so that a suture can be applied easily -the jaw may be straight or curved and may be directed to the right or to the left
The instrument may be fixed or detachable (modular) and rotating allowing a wider range of movement
2- The conduit
It is a flexible system (a flexible endoscope with no camera. No working channels) it may be of different lengths (25:80 cm) according to the site used in i.e colon & rectum or esophagus & stomach. It has 4 parts
A Proximal opening for the introduction of the needle holder
A body containing the knobs which control movements and bending
A shaft "insertion tube" which is flexible.
Its distal part has a tip which is controllable and flexible allowing up to 20- or more if possible- degree of anterior and posterior angulation of the proximal end B- How it works
- The gastroscope will be. introduced to the stomach and insuflation of air is done -An overtube (50 cm-length and 19 mm external diameter) will be introduced -The needle holder is passed through the proximal opening and advanced forward till the jaws come out at the distal end
- A 3 - 5 cm length of the needle holder will protrude out of the distal end of the conduit allowing the jaws of the needle holder to grasp the needle with the self adjustment mechanism
- The conduit will pass through an Over tube -16 mm internal diameter- beside the flexible gastroscope . A pediatric gastroscope may be used instead of the adult scope
- The needle and suture will be held by the needle holder and thrown blindly through the stomach or advanced first then the scope will follow to work under vision
- An instrument (grasper or spiral ) will pass through The working channel of the gastroscope holding tissue then the needle will be passed through the tissues
- Interrupted sutures can be done and an endoscissor will be passed through the gastroscope to cut the sutures Brief Description of Drawings
The pictures of the needle holder and flexible conduit are given:
-2 pictures of the flexible conduit ( FIG.1,2)
-3 pictures of the needle holder showing the tip,shaft,handle and whole length (FIG. 3,4,5)

Claims

Claims
1- A flexible endoscopic needle holder of different diameters the jaws of this
needle holder can make self adjustment of the position of the needle automatically
2- A flexible endoscopic conduit - which looks like a flexible endoscope without camera , air insuflation or working channels. It is of various diameter which enable the flexible needle holder or any other flexible instrument to pass through it and to move freely in and out. The distal end of the "conduit" has a bending capability allowing the needle holder to be directed to the area that needs to be sutured
3 - Moreover, I am claiming the application of the same technique of suturing in Single Inscion laparoscopic Surgery (SILS) through the flexible endoscopy i.e. using the needle holder and commercial surgical needles such as the ski needle to take endoluminal sutures
PCT/EG2015/000032 2015-07-15 2015-07-15 A 2-part system for endoluminal suturing: "a flexible needle holder and a flexible conduit" WO2017008820A2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/EG2015/000032 WO2017008820A2 (en) 2015-07-15 2015-07-15 A 2-part system for endoluminal suturing: "a flexible needle holder and a flexible conduit"

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EG2015/000032 WO2017008820A2 (en) 2015-07-15 2015-07-15 A 2-part system for endoluminal suturing: "a flexible needle holder and a flexible conduit"

Publications (2)

Publication Number Publication Date
WO2017008820A2 true WO2017008820A2 (en) 2017-01-19
WO2017008820A3 WO2017008820A3 (en) 2017-05-11

Family

ID=57756752

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EG2015/000032 WO2017008820A2 (en) 2015-07-15 2015-07-15 A 2-part system for endoluminal suturing: "a flexible needle holder and a flexible conduit"

Country Status (1)

Country Link
WO (1) WO2017008820A2 (en)

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7637905B2 (en) * 2003-01-15 2009-12-29 Usgi Medical, Inc. Endoluminal tool deployment system
US20050209612A1 (en) * 2004-03-02 2005-09-22 Nakao Naomi L Endoscopic suturing assembly and associated methodology using a temperature biased suture needle
EP2120728B1 (en) * 2007-03-15 2020-04-15 Boss Instruments, Ltd., Inc. Replaceable tip suturing device and system for use with differing needles
US20090112063A1 (en) * 2007-10-31 2009-04-30 Bakos Gregory J Endoscopic overtubes
DE102010053410A1 (en) * 2010-12-06 2012-06-06 Karl Storz Gmbh & Co. Kg Endoscopic instrument system
DE102011107614A1 (en) * 2011-06-30 2013-01-03 Siegfried Riek Instrument system for minimum-invasive surgery, has guiding tube pre-tensioned in distal final longitudinal section at bend, where longitudinal section slides out from distal end of channel, and instrument passed through guide tube

Also Published As

Publication number Publication date
WO2017008820A3 (en) 2017-05-11

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