Suture cinching device with cutter

Patent metadata

Field	Value
Publication number	US-11696753-B2
Application number	US-202017089641-A
Country	US
Kind code	B2
Filing date	Nov 4, 2020
Priority date	Nov 5, 2019
Publication date	Jul 11, 2023
Grant date	Jul 11, 2023

Abstract

Medical devices for cinch and cutting one or more suture, and methods for making and using such devices are disclosed. An example medical device may include a coupler, a sleeve releasably coupled to the coupler, a cutter slidably disposed within the sleeve, and a suture cinching member movable into and out of the sleeve. A wire may extend through and be longitudinally movable within the coupler to move the suture cinching member and cutter.

First claim

What is claimed is:

1. A medical device for cinching and cutting one or more sutures, the medical device comprising:
a coupler having a coupler lumen;
a sleeve releasably coupled to the coupler, the sleeve having a sidewall defining a sleeve lumen, the sidewall having a window into the sleeve lumen;
a cutter slidably disposed within the sleeve, the cutter having a cutting surface;
a suture cinching member moveable into and out of the sleeve lumen; and
a wire extending through and longitudinally movable within at least the coupler, the wire releasably connected to the cutter.

2. The medical device of claim 1 , wherein when the wire is in a distal position, the suture cinching member is in a first configuration for receiving one or more sutures, and proximal movement of the wire pulls the suture cinching member at least partially into the sleeve into a second configuration in which a portion of the one or more sutures is cinched within the sleeve and cut by the cutting surface of the cutter.

3. The medical device of claim 2 , wherein the cutter is configured such that when the suture cinching member is in the second configuration, further proximal movement of the wire causes the wire to be released from the cutter and the coupler to be released from the sleeve.

4. The medical device of claim 3 , wherein the cutter comprises a cutting member and a cutter actuator, the cutting member defining a cutter lumen with an opening extending into the cutter lumen, the opening defining the cutting surface, wherein the cutter actuator includes a distal rod connected to the suture cinching member.

5. The medical device of claim 4 , wherein the cutter actuator is connected to the suture cinching member and the wire, such that movement of the wire results in movement of the suture cinching member and the cutting member.

6. The medical device of claim 5 , wherein the suture cinching member includes a proximal portion configured to fit within the sleeve lumen, wherein when the suture cinching member is in the first configuration, the suture cinching member is positioned such that the proximal portion is spaced apart from an inner surface of the sleeve and the cutter is positioned with the opening aligned with the window in the sleeve.

7. The medical device of claim 6 , wherein when in the suture cinching member is moved to the second configuration, the suture cinching member and attached cutter are moved proximally until the proximal portion of the suture cinching member engages the inner surface of the sleeve and the opening in the cutter is proximal of the window in the sleeve.

8. The medical device of claim 3 , wherein the suture cinching member has a distal head with an outer diameter greater than a diameter of the sleeve lumen, wherein in the second configuration the distal head abuts a distal end of the sleeve.

9. The medical device of claim 3 , wherein the cutter is coupled to a yoke and the yoke is removably coupled to the wire, wherein the suture cinching member includes first and second opposing clamp arms fixed to the yoke.

10. The medical device of claim 9 , wherein the yoke is axially moveable within the sleeve lumen between a first position in which distal ends of the first and second opposing clamp arms are spaced apart, and a second position in which the distal ends are in contact with one another.

11. The medical device of claim 10 , wherein the first and second opposing clamp arms are biased in the first position such that when at least distal portions of the first and second opposing clamp arms are disposed distal of the sleeve, the first and second opposing clamp arms are in the first position, and moving the first and second opposing clamp arms proximally into the sleeve moves the first and second opposing clamp arms into the second position.

12. The medical device of claim 11 , wherein the cutter is disposed between the first and second opposing clamp arms.

13. The medical device of claim 12 , wherein the cutting surface is a linear cutting surface disposed transverse to a longitudinal axis of the sleeve.

14. The medical device of claim 13 , wherein a distal end of the first clamp arm has a rounded concave surface and a distal end of the second clamp arm has a rounded convex surface configured to engage the rounded concave surface on the first clamp arm.

15. The medical device of claim 14 , wherein when the first and second opposing clamp arms are in the second position, one or more sutures disposed between the first and second opposing clamp arms is clamped at a first location between the distal ends of the first and second opposing clamp arms and at a second location distal of the cutter.

16. The medical device of claim 15 , wherein the cutter is configured such that when the first and second opposing clamp arms are moved from the first position to the second position over one or more sutures, the first and second opposing clamp arms clamp the one or more sutures and the cutting surface cuts the one or more sutures.

17. The medical device of claim 2 , wherein the coupler has a projection extending into the coupler lumen, the cutter includes a proximal coupling member, and the wire includes a distal end removably coupled to the proximal coupling member of the cutter, wherein when the suture cinching member is in the second configuration, further proximal movement of the wire causes the proximal coupling member to engage the projection, stopping its proximal movement and releasing the distal end of the wire, and releasing the coupler from the sleeve.

18. The medical device of claim 2 , wherein the sleeve has an opening through the sidewall proximal of the window, and the cutter further comprises at least one deflectable wing configured to move into the opening when the suture cinching member moves into the second configuration.

19. A medical device for applying a cinch to one or more sutures, the medical device comprising:
an elongate shaft defining a shaft lumen;
a sleeve having a sleeve lumen and a window extending into the sleeve lumen;
first and second opposing clamp arms fixed to a yoke, wherein the yoke is axially moveable within the sleeve lumen between a first position in which distal ends of the first and second opposing clamp arms are spaced apart, and a second position in which the distal ends are in contact with one another;
a cutter coupled to the first and second opposing clamp arms, the cutter defining a cutting surface, the cutter configured such that when the first and second opposing clamp arms are moved from the first position to the second position over one or more sutures, the first and second opposing clamp arms clamp the one or more sutures and the cutting surface cuts the one or more sutures.

20. A method of cinching and cutting one or more sutures, the method comprising:
engaging one or more sutures with a suture cinching member, a distal portion of the suture cinching member disposed distal of a sleeve and a proximal portion of the suture cinching member disposed within a lumen of the sleeve, the suture cinching member connected to a cutter slidably disposed within the sleeve lumen; and
moving the suture cinching member and connected cutter proximally into the sleeve, thereby engaging a cutting surface on the cutter with the one or more sutures and cutting the one or more sutures.

Assignees

• Boston Scient Scimed Inc

Inventors

• Deuel Christopher R
• Wales Ryan V
• Fleury Sean P
• Gilbert Stan Robert

Classifications

• A61B17/0467 Primary

  Instruments for cutting sutures (surgical cutting instruments A61B17/32) · CPC title

• A61B2017/0496

  for tensioning sutures · CPC title

• A61B2017/00477

  Coupling (A61B2017/0046 takes precedence) · CPC title

• A61B17/1227 Primary

  Spring clips · CPC title

• A61B17/1285

  for minimally invasive surgery · CPC title