Medical instrument to place a pursestring suture, open a hole and pass a guidewire

Abstract

A therapeutic instrument for the ergonomic, effective and safe opening and closing of targeted remote tissue sites; includes a pistol grip style handle with a hand activated lever for needle deployment and, optionally, with features to control tissue cutting and guide wire installation; also incorporates a specialized elongated rigid or flexible instrument shaft, which enables vacuum assisted holding of tissue at a uniquely contoured distal tip, where placement of a suture in a purse string configures occurs along with, if desired, tissue cutting and guide wire passage.

1 . A cutter for a surgical instrument comprising:
 an elongated hollow shaft having a proximal end and a distal end configured for receiving a guide wire in the shaft;   a cutting blade on the distal end of the shaft; and   a turning horn on the distal end of the shaft configured for turning a guide wire away from an axis of the shaft as the guide wire exits the shaft.   
   
   
       2 . The cutter of  claim 1  in which the cutting blade comprises a cutting edge on a proximal surface of the blade. 
   
   
       3 . The cutter of  claim 2  in which the cutting blade comprises a sharpened tip. 
   
   
       4 . A needle and sleeve combination for selectively attaching the sleeve to the needle, the needle comprising;
 a shaft characterized by a first diameter;   a distal end characterized by a second diameter smaller than the first diameter;   an enlarged region proximate to the distal end having a dimension in one direction larger than the second diameter and a dimension in another direction smaller than the second diameter; and   the sleeve comprising a resilient cylindrical body having a proximal end configured for receiving the distal end of the needle and a circumferential rib within the sleeve, the rib configured to pass over the enlarged region of the needle to releasably lock the sleeve and the needle together.   
   
   
       5 . The combination of  claim 4  in which the enlarged region comprises a rounded surface in the one direction, and a flat surface in the another direction. 
   
   
       6 . The combination of  claim 4  comprising a suture having one end attached to the sleeve. 
   
   
       7 . The combination of  claim 4  in which the sleeve comprises a connecting region distal of the enlarged region connected to the suture.