Hydrodynamic suture passer

Abstract

A hydrodynamic suturing instrument, comprises a elongated cannulated suturing needle having a distal end configured to carry a suture through tissue and a proximal end adapted to connect to a syringe barrel and a lumen extending from said proximal end to an opening at the distal end for having a size for the passage of a suture, and the opening at the distal end configured to receive a suture extending from the lumen along an outer surface of the needle wherein a sharp point extends forward of the suture. A companion instrument includes forceps having a distal end with jaws and a proximal end with a lumen extending from the proximal end to the distal end for passage of the needle, and the jaws having an opening enabling passage of the needle through tissue grasped in the jaws.

1 . A hydrodynamic suturing instrument, comprising in combination:
 a syringe having a barrel and plunger and a connector for detachably mounting a needle, the barrel having a capacity to receive a predetermined size and length of suture and sufficient fluid to draw the suture into the barrel and to expel the suture from the barrel, said syringe defining a hydraulic path and said plunger being mounted to act on the hydraulic path to draw the suture into the syringe;   an elongated cannulated suturing needle having a proximal end and a distal end, said needle comprising a lumen of a size to receive said predetermined size and length of suture extending from said proximal end to an opening at said distal end for the passage of a suture;   a connector at said proximal end adapted to connect to said syringe barrel connector and said distal end configured to pass with a suture through tissue; and   said distal end configured with a sharp point extending forward of said opening to said lumen, said opening further comprising a trailing edge, said opening configured to receive a suture extending from said lumen along an outer surface of said needle wherein said sharp point extends forward of said suture.   
     
     
         2 . A suturing instrument comprising:
 an elongated tubular member having a distal end and a proximal end and a passage extending from said proximal end to said distal end;   first and second jaws on said distal end disposed in opposed relation, one of said first and second jaws being movable relative to the other and having an opening therethrough, the other of said first and second jaws including an open end of said passage oriented toward said opening;   means at said proximal end for moving said movable jaw between open and closed positions;   a syringe having a needle, the needle of sufficient length to extend a forward end thereof through said passage past said open end and through said opening in said one of said jaws, the needle having a cannula with a lumen of sufficient size to receive a suture, a distal end of said needle configured with a sharp point extending forward of an opening to said lumen, said distal end further comprising a trailing edge; and   said syringe having sufficient capacity to draw a predetermined length of suture and liquid into said needle and expel said suture through said opening.   
     
     
         3 . A method for suturing comprising the steps of:
 providing an elongate needle having a distal end and a proximal end and a lumen extending from said proximal end to said distal end having sufficient size for passage of a predetermined size suture, said distal end having a tip configured with a sharp point extending forward of an opening of said lumen for passage with a suture through a tissue, said opening further comprising a trailing edge;   providing a syringe detachably connected to said needle proximal end;   selecting and introducing a length of suture into at least said needle from outside of said syringe and said needle;   filling said syringe with a quantity of liquid;   passing said distal end of said needle with said suture through a tissue to be sutured with the suture folded over the trailing edge; and   expelling said length of suture from said distal end of said needle by hydraulic force from a quantity of said liquid in said syringe.