SUTURE DEVICE
20200305860 ยท 2020-10-01
Assignee
Inventors
Cpc classification
A61B17/0401
HUMAN NECESSITIES
A61B2017/0427
HUMAN NECESSITIES
International classification
Abstract
The suture device comprises a suture element of elongated shape and intended to be inserted through the flaps of a surgical wound, in which the suture element is made of a shape memory material and has a first pointed extremity adapted to pierce the flaps to allow the passage of the suture element through the latter and their mutual approach to define a suture, and a second extremity opposite the first extremity, and by the fact that the suture element comprises an initial configuration wherein the extremities and the flaps are spaced apart from one another and a final configuration wherein the extremities and the flaps are mutually approached to define the suture.
Claims
1. A suture device comprising at least a suture element (2) of elongated shape and intended to be inserted through the flaps (3) of a surgical wound, characterized by the fact that said suture element (2) is made of a shape memory material and has a first pointed extremity (4) adapted to pierce said flaps (3) to allow the passage of said suture element (2) through the latter and their mutual approach to define a suture (5), and a second extremity (11) opposite to said first extremity (4), and by the fact that said suture element (2) comprises an initial configuration wherein said extremities (4, 11) and said flaps (3) are spaced apart from one another and a final configuration wherein said extremities (4, 11) and said flaps (3) are mutually approached to define said suture (5).
2. A suture device according to claim 1, characterized by the fact that said shape memory material comprises Nitinol.
3. A suture device according to claim 1, characterized by the fact that said suture element (2) has a length between 2 mm and 30 mm.
4. A suture device according to claim 1, characterized by the fact that said suture element (2) has a length between 4.5 mm and 17 mm.
5. A suture device according to claim 1, characterized by the fact that said suture element (2) comprises at least a curved portion (6) intended to be positioned astride of said flaps (3).
6. A suture device according to claim 1, characterized by the fact that said suture element (2) has a cross section greater than 100 m.
7. A suture device according to claim 1, characterized by the fact that said curved portion (6) has a radius of curvature (R) greater than 0.5 mm.
8. A suture device according to claim 1, characterized by the fact that said curved portion (6) has an angular extension (E.sub.1, E.sub.2, E.sub.3, E.sub.4) between 90 and 225.
9. A suture device according to claim 1, characterized by the fact that said second extremity (11) is provided with a locking portion (12) to lock said curved portion (6) astride of said flaps (13).
10. A suture device according to claim 1, characterized by the fact that said shape memory material is thermally deformable at a work temperature comprised between 10 C. and 40 C.
11. A suture device according to claim 1, characterized by the fact that: in said initial configuration, wherein said extremities (4, 11) are spaced apart from one another, said work temperature is below 20 C.; and in said final configuration, wherein said extremities (4, 11) are moved close together to reclose said curved portion (6), said flaps (13) are approached to each other to define said suture (5), said work temperature is higher than 30 C.
12. A suture device according to claim 1, characterized by the fact that in said initial configuration said work temperature is comprised between 16 C. and 20 C., and in said final configuration said work temperature is comprised between 36 C. and 40 C.
13. A suture device according to claim 1, characterized by the fact that said shape memory material in said initial configuration is in the martensitic phase, and in said final configuration is in the austenitic phase.
14. A suture device according to claim 1, characterized by the fact that said curved portion (6) comprises at least a flat-shaped section (19).
15. A suture device according to claim 1, characterized by the fact that said first extremity (4) and said second extremity (11) are formed on a first extension (14) and on a second extension (15) respectively, which in said final configuration are adapted to overlap to each other to define a reinforcing surface (16) of said suture element (2).
16. A suture device according to claim 1, characterized by the fact that said curved portion (6) comprises a first end (7) associated with said first extension (14) and a second end (9) associated with said second extension (15), said first extension (14) being inclined with respect to a vertical axis (18) passing through said first end (7) by an angle substantially equal to 30.
17. A suture device according to claim 1, characterized by the fact that said first extension (14) and said second extension (15) have a module of different rigidity with respect to said curved portion (6).
18. A suture device according to claim 1, characterized by the fact that said first extension (14) and said second extension (15) are manufactured in the austenitic phase and said curved portion (6) is manufactured in the martensitic phase.
19. A suture kit comprising: at least a suture device; and at least a support device (20) of said suture device (1) comprising: a main body (22, 23) provided with a gripping portion (22) graspable by an operator and with at least a fastening portion (23) of said suture device itself; heating means adapted to induce a change in temperature at said suture device (1).
20. A suture kit according to claim 19, characterized by the fact that said heating means comprise a duct (25) passing through said main body (22, 23).
21. A suture kit according to claim 19, characterized by the fact that said heating means comprise at least a heating element passing through said duct (25) and associable with power supply means, said heating means being of the electric type.
22. A suture kit according to claim 19, characterized by the fact that said heating means comprise a heating element of the type of a heating fluid passing through said duct (25), the latter being provided with an entry gap (27) made at said gripping portion (22) and associable with feeding means of the heating fluid, and with an exit gap (28) made at said fastening portion (23) and adapted to allow the dispensing of the heating fluid at said suture (5).
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0027] Other characteristics and advantages of the present invention will become more evident from the description of a preferred, but not exclusive, embodiment of a suture device, illustrated by way of an indicative, but non-limiting example, in the attached drawings in which:
[0028]
[0029]
[0030]
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[0032]
[0033]
[0034]
[0035]
[0036]
[0037]
EMBODIMENTS OF THE INVENTION
[0038] With particular reference to these figures, reference numeral 1 globally indicates a suture device.
[0039] The device 1 comprises a suture element 2 of elongated shape and intended to be inserted through the flaps 3 of a surgical wound.
[0040] According to the invention, the suture element 2 is made of a shape memory material and has a first pointed extremity 4 adapted to pierce the flaps 3 of the surgical wound to allow the passage of the suture element 2 through the latter and their mutual approach to define a suture 5, and a second extremity 11 opposite to the first extremity itself.
[0041] Specifically, the shape memory material comprises Nitinol.
[0042] In this respect, the presence of titanium oxide represents a protective cover which prevents the release of nickel ions.
[0043] Again, according to the invention, the suture element 2, being made of a shape memory material, is movable, by heating, between: [0044] an initial configuration, wherein the suture element itself is fitted through the flaps 3 following the piercing of the latter with the first extremity 4, and wherein the extremities 4, 11 and the flaps 3 are moved away from each other; and [0045] a final configuration, wherein the suture element 2 is fitted astride of the flaps 3, and has the extremities 4, 11 and the flaps reciprocally moved closer to define a suture 5.
[0046] The first extremity 4 can be shaped differently, e.g., it may present a pyramid, spatula or duckbill shape.
[0047] Preferably, the suture element 2 has a length between 2 mm and 30 mm.
[0048] Advantageously, the suture element 2 has a length between 4.5 mm and 17 mm.
[0049] Preferably, the suture element 2 has a cross section greater than 100 m.
[0050] Conveniently, the suture element 2 has a cross section between 200 m and 500 m.
[0051] Advantageously, the suture element 2 has a substantially circular cross section.
[0052] Furthermore, alternative embodiments cannot be ruled having the suture element 2 with cylindrical, triangular or cutting triangular cross section.
[0053] It is worth specifying that within the present treatise, the expression cross section is meant with reference to the diameter of the section of the suture element 2.
[0054] The suture element 2 comprises a curved portion 6 intended to be positioned astride of the flaps 3.
[0055] The curved portion 6 has a first end 7 associated with a first extension 14 and a second end 9 associated with a second extension 15 which, at the end of the suture, i.e., in the final configuration described in detail in the continuation of the present treatise, are adapted to overlap to each other to define a reinforcing surface 16 of the suture element 2.
[0056] More in detail, the first extremity 4 and the second extremity 11 are made on the first extension 14 and on the second extension 15 respectively, which in the final configuration define precisely the reinforcing surface 16 of the suture element 2.
[0057] In the
[0058] The first length 8 joins the first end 7 to the first extension 14 and, parallel, the second length 10 joins the second end 9 to the second extension 15.
[0059] In order to facilitate the penetration of the suture element 2, the first extension 14, in this case the first extremity 4, is inclined with respect to a vertical axis 18 passing through the first end 7 by an angle substantially equal to 30.
[0060] Preferably, the vertical axis 18 is the orthogonal projection of the first end 7.
[0061] In detail, the first extremity 4 is oriented towards the inside of the curved portion 6 (
[0062] Alternative embodiments cannot furthermore be ruled out having the first extremity 4 oriented towards the outside of the curved portion 6 (
[0063] The second extremity 11 is provided with a locking portion 12 to lock the curved portion 6 astride of the flaps 3.
[0064] The locking portion 12 has a curved profile wound at least in part around itself and adapted to prevent the second length 10 from slipping out of the flaps 3.
[0065] As can be seen in the figures, the locking portion 12 is substantially hook shaped.
[0066] Moreover, the curved portion 6 comprises a flat-shaped section 19.
[0067] The flat-shaped section 19 is adapted to reduce the curvature in the external direction with respect to a central axis 13 passing through the curved portion 6.
[0068] At the same time, the aforementioned flat-shaped section 19 is adapted to facilitate the gripping of the device 1 by means of surgical instruments, such as, e.g., a support device 20 of the suture device according to the present invention.
[0069] With reference to the particular embodiment shown in the figures, the first extremity 4 and the second extremity 11 are formed on the first extension 14 and on the second extension 15, respectively.
[0070] Alternative embodiments cannot also be ruled out wherein the extensions 14, 15 are absent.
[0071] In this respect, it is pointed out that, with reference to the length of the suture element 2 is meant the extension presented by the suture element itself between the first end 7 and the second end 9, i.e., excluding the extensions 14, 15.
[0072] In fact, the first extension 14 and the second extension 15 have different extending measures according to the length of the suture element 2.
[0073] In the case in question, the extending measure of each extension 14, 15 is directly proportionate to the length of the suture element 2 by a factor substantially equal to 0.15.
[0074] To this must be added the fact that the first extension 14 and the second extension 15 have a module of different rigidity with respect to the curved portion 6.
[0075] More specifically, during manufacture, the extensions 14, 15 and the curved portion 6 are diversified from the viewpoint of thermal characterization.
[0076] In other words, the first extension 14 and the second extension 15 are manufactured in the austenitic phase and the curved portion 6 is manufactured in the martensitic phase.
[0077] Preferably, the curved portion 6 has a radius of curvature R greater than 0.5 mm.
[0078] It is specified that within this treatise, by the expression radius of curvature R is meant the radius of a circumference tangent to the curve defined by the curved portion 6, and which better approximates it.
[0079] Alternative embodiments cannot however be ruled out with the radius of curvature R greater than 2 mm.
[0080] Furthermore, alternative embodiments cannot be ruled out wherein the radius of curvature R has a gradual increase of 0.1 mm.
[0081] The curved portion 6 is adapted to contain the flaps 3 of the tissue to be sutured inside the relative radius of curvature R.
[0082] The aforementioned values are therefore variable according to the physiognomic characteristics of the tissue, such as, e.g., thickness, distance of introduction of the suture element 2 with respect to the flaps 3.
[0083] To this end, the curved portion 6 has a plurality of angular extensions E.sub.1, E.sub.2, E.sub.3, E.sub.4 different the one from the other according to the above-mentioned tissue characteristics.
[0084] In particular, within this treatise, by the expression angular extension E.sub.1, E.sub.2, E.sub.3, E.sub.4 is meant the length expressed in sexagesimal degrees around the central axis 13 of the curved portion 6 and defined by the angular distance between the first end 7 and the second end 9 respectively.
[0085] The curved portion 6 has an angular extension E.sub.1, E.sub.2, E.sub.3, E.sub.4 between 90 and 225.
[0086] With reference to the
[0087] In a first embodiment of the device 1, the curved portion 6 has an angular extension E.sub.1 substantially equal to 90 (
[0088] In a second embodiment of the device 1, the curved portion 6 has an angular extension E.sub.2 substantially equal to 135 (
[0089] In a third embodiment of the device 1, the curved portion 6 has an angular extension E.sub.3 substantially equal to 180 (
[0090] In a fourth embodiment of the device 1, the curved portion 6 has an angular extension E.sub.4 substantially equal to 225 (
[0091] As is known to the expert in the sector, shape memory material is super-elastic: this permits the transition of such material between two different crystalline shapes, the transition of which from one phase to another is due to various work temperature values.
[0092] As said above, the shape memory material is thermally deformable at a work temperature comprised between 10 C. and 40 C.
[0093] In the case in question, the suture element 2 is movable by heating between: [0094] the initial configuration (
[0096] In particular, in the initial configuration the work temperature is comprised between 16 C. and 20 C., and in the final configuration the work temperature is comprised between 36 C. and 40 C.
[0097] Preferably, in the initial configuration, the work temperature is substantially equal to 18 C.
[0098] Advantageously, in the final configuration the work temperature is substantially equal to 38 C.
[0099] With reference to the particular embodiment shown in the figures, heating occurs by means of the irrigation of a fluid 17 on the flaps 3. Preferably, such fluid 17 is water.
[0100] Alternative embodiments cannot however be ruled out having other types of heating, e.g. of the electric type.
[0101] It is worth specifying that the shape memory material in the initial configuration is in the martensitic phase, and in the final configuration is in the austenitic phase.
[0102] More in detail, the martensitic phase is stable at low temperatures and, on the contrary, the austenitic phase is stable at high temperatures.
[0103] The maintenance of the suture element 2 in the final configuration is ensured by the physiological temperature of the human body.
[0104] In fact, in case of the removal of the suture element 2, the latter is irrigated with a fluid 17 at a work temperature substantially equal to 15 C. aimed at returning the suture element 2 to the initial configuration.
[0105] Before the detailed explanation of the operation of the present invention, it is useful to underline that the device 1 is compatible with Nuclear Magnetic Resonance (NMR) examinations.
[0106] Furthermore, the presence of a shape memory material permits graduating the transition phases from the initial configuration to the final configuration, by providing intermediate work temperatures.
[0107] In other words, it is possible to intervene on the closure of the suture element, graduating the work temperatures and obtaining a millimeter closure gradient.
[0108] The operation of the present invention is the following.
[0109] In the face of a surgical wound, the flaps 3 are spaced apart from one another (
[0110] In the case in question, in the initial configuration the ends 7, 9 are spaced apart from one another and the curved portion 6 encircles the tissue to be sutured inside it.
[0111] The positioning in initial configuration is ensured by the presence of the locking portion 12 which prevents the second extension 15 from overrunning the tissue.
[0112] The radius of curvature R and the angular extension E.sub.1, E.sub.2, E.sub.3, E.sub.4 are selected by the operator in the field according to the characteristics of the tissue to be sutured, e.g., according to its thickness or hardness.
[0113] After the curved portion 6 has been positioned, the suture element 2 is heated by means of the irrigation of water 17 at a work temperature substantially equal to 38 C.; this determines the transition of the shape memory material from the martensitic phase to the austenitic phase.
[0114] In the transition from the initial configuration to the final configuration (
[0115] The two extensions 14, 15, in exceeding the junction points of the ends 7, 9 considerably increase the strength of the suture element 2 in the final configuration.
[0116] Given the need to remove the suture element 2, the latter is irrigated by means of water at a work temperature substantially equal to 15 C.; this causes the return of the suture element 2 to the initial configuration, i.e., in the martensitic phase.
[0117] The extremities 4, 11, by moving away from each other, interrupt the reinforcing surface 16, making it possible to remove the suture element 2 from the flaps 3.
[0118] Furthermore, the present invention also relates to a suture kit 1, 20.
[0119] The kit 1, 20 comprises the suture device 1 described previously and to the detailed description of which full reference is made.
[0120] Furthermore, the kit 1, 20 comprises a support device 20 of the device 1.
[0121] Specifically, the support device 20 comprises a main body 22, 23 having a gripping portion 22 graspable by an operator and a fastening portion 23 of the suture device itself.
[0122] The gripping portion 22 comprises a first arm 22a and a second arm 22b associated with each other by interposition of connection means 22c of the type of a screw or a spring.
[0123] In other words, the support device 20 is based on a double lever of first class, like scissors in common use, wherein the connection means 22c act as a fulcrum.
[0124] In the same way, the fastening portion 23 comprises a beak element 24 movable between an opening configuration wherein the first arm 22a and the second arm 22b are spaced apart from each other, and a closing configuration wherein the first arm 22a and the second arm 22b are approached to one another.
[0125] In other words, the operator, by gripping the support device 20, grasps the suture device 1 determining the transition from the opening configuration, wherein the beak element 24 is also open, to the closing configuration, wherein the beak element 24 is closed and retains the suture device itself.
[0126] Furthermore, the support device 20 comprises heating means adapted to induce a change in temperature at the suture device 1.
[0127] More in detail, the heating means comprise a duct 25 passing through the main body 22, 23.
[0128] With reference to a particular embodiment, the heating means comprise a heating element passing through the duct 25 and associable with power supply means.
[0129] In this specific case, the heating means are of the electric type.
[0130] According to an alternative embodiment, the heating means comprise a heating element of the type of a fluid passing through the duct 25.
[0131] Preferably, the through duct is provided with an entry gap 27 made at the gripping portion 22, in this case either on the first arm 22a or on the second arm 22b, and associable with fluid feeding means, and with an exit gap 28 made at the fastening portion 23 and adapted to allow the dispensing of the fluid at the suture 5.
[0132] As shown in
[0133] The heating means are operatively connected to activation means of the type of a pedal which can be pressed as required by the operator.
[0134] The operation of the kit 1, 20 is as follows.
[0135] The operator grips the support device 20, grasping the suture device 1 with it.
[0136] In detail, the operator grips the support device 20 in the opening configuration, i.e., with the first arm 22a and the second arm 22b spaced apart from each other, and grasps the suture device 1 by means of the reciprocal approaching of the first and of the second arm 22a, 22b which causes the closure of the beak element 24.
[0137] At this point, the suture device 1 is made to pass through the flaps 3 and, after having been positioned, it is heated by means of the activation of the heating means.
[0138] In other words, the transition from the martensitic phase to the austenitic phase of the suture element 2 takes place by means of diffused heating at the suture 5.
[0139] This means that after the suture element 2 has been positioned, the operator, by pressing on the activation means, diffuses heat, by means of the dispensing of the heating fluid or electricity.
[0140] It has in practice been ascertained that the described invention achieves the intended objects.
[0141] The fact is underlined that the particular solution of providing a suture element having a pointed extremity adapted to pierce the flaps of the surgical wound, and made of Nitinol, permits making a suture completely without knots, while at the same time eliminating the use of needles and considerably reducing the risk of infections and inflammations.
[0142] To this the fact must be added that the presence of a shape memory material permits making a completely operator-independent and needle-independent suture, wherein the closure of the suture element is determined only by the applied work temperature, ensuring the formation of a suture the strength of which is uniform over the entire extension surface of same.