CN-122028854-A - Systems and methods for robotic endoluminal suturing apparatus

Abstract

A suturing apparatus is provided. The suturing apparatus includes an elongate member comprising an articulatable curved segment and a shaft, and a needle end effector comprising a distal portion at a distal end of the curved segment, and a flexible configuration of the needle extending along an entire length of the curved segment.

Inventors

• Matthew Robert penny
• Neil Mark Walter

Assignees

• 诺亚医疗集团公司

Dates

Publication Date

20260512

Application Date

20240821

Priority Date

20230825

Claims (20)

1. 1. A suturing apparatus comprising: An elongated member comprising an articulatable curved segment and a shaft, and An end effector comprising a rigid distal portion at a distal end of the curved segment and a flexible shaft of a needle extending along an entire length of the curved segment.
2. 2. The suturing apparatus of claim 1, wherein the rigid distal portion comprises a collar retaining mechanism configured to peel a collar from the needle.
3. 3. The stapling instrument of claim 2, wherein said snare holding mechanism comprises a toggle to actuate the rod into a snare release position and into a snare holding position.
4. 4. The suturing apparatus of claim 3, wherein the collar retaining mechanism is independently controlled relative to the needle drive mechanism.
5. 5. The suturing apparatus of claim 1, wherein a needle drive mechanism is located approximately at a distal end of the shaft or at an interface between a proximal end of the articulatable curved segment and the distal end of the shaft.
6. 6. The suturing apparatus of claim 5, wherein the needle drive mechanism is coupled to the flexible shaft of the needle.
7. 7. The suturing apparatus of claim 6, wherein the flexible shaft of the needle is in an offset position relative to a neutral axis of the curved segment.
8. 8. The suturing apparatus of claim 7, wherein the flexible shaft of the needle accommodates path length variations as the curved segments articulate.
9. 9. The suturing apparatus of claim 8, wherein tension of a cable used to retract the needle is maintained by accommodating the path length variation.
10. 10. The stapling instrument of claim 1, further comprising a handle portion releasably attached to the instrument drive mechanism.
11. 11. The stapling instrument of claim 9, wherein said instrument drive mechanism is supported by a robotic arm.
12. 12. The stapling instrument of claim 10, wherein said robotic arm is configured to further support another instrument drive mechanism releasably attached to a handle portion of an endoscope.
13. 13. The suturing apparatus of claim 11, wherein the suturing apparatus is inserted through a working channel of an endoscope.
14. 14. A suturing apparatus comprising: a flexible elongate member comprising an articulatable curved segment connected to a distal end of the shaft, and An end effector comprising a rigid distal portion at a distal end of the curved section, and a needle drive mechanism for driving a needle, wherein the needle drive mechanism is located at the distal end of the shaft or at an interface between a proximal end of the articulatable curved section and the distal end of the shaft.
15. 15. The suturing apparatus of claim 13, wherein the rigid distal portion comprises a collar retaining mechanism configured to peel a collar from the needle.
16. 16. The stapling instrument of claim 14, wherein said snare holding mechanism comprises a toggle to actuate the rod into a snare release position and into a snare holding position.
17. 17. The suturing apparatus of claim 15, wherein the collar retaining mechanism is independently controlled relative to the needle drive mechanism.
18. 18. The suturing apparatus of claim 13, wherein the needle drive mechanism is coupled to a flexible shaft of the needle.
19. 19. The suturing apparatus of claim 17, wherein the flexible shaft of the needle extends along an entire length of the curved segment.
20. 20. The suturing apparatus of claim 19, wherein the flexible shaft of the needle is in an offset position relative to a neutral axis of the curved segment.

Description

Systems and methods for robotic endoluminal suturing apparatus Citation(s) The present application claims priority from U.S. provisional patent application No. 63/578,829, filed 8/25 at 2023, which is incorporated herein by reference in its entirety. Background Endoscopic procedures use endoscopy to examine the interior of a hollow organ or body cavity. Unlike many other medical imaging techniques, endoscopes are inserted directly into an organ via a port or other naturally occurring orifice. Flexible endoscopes that rely on intuitive manipulation and control can be delivered for diagnosis and treatment of diseases accessible through any natural orifice in the body. Depending on the clinical indication, endoscopes may be designated colonoscopes, gastroscopes, bronchoscopes, ureteroscopes, ENT scopes, and various other endoscopes. For example, a flexible colonoscope can be cannulated to the transverse colon for diagnostic and/or surgical treatment. The endoscopic device may have a working channel allowing tools such as a holder, cutter or stapling instrument to pass through. In another example, a suturing device may be coupled to the distal end of an endoscope, which enables suturing in a gastric canal of a patient. The flexible endoscope may have a curved section and a rigid tip or end effector attached to the curved section. For being steerable through a body lumen, the size (length) of the digital tip portion of the flexible endoscope is desirably as small as possible so that it can traverse a tortuous path. However, current suturing devices are designed for manual endoscopic devices (such as laparoscopes), which typically have a length or rigid structure that is larger than the desired size of the end effector. In laparoscopic surgery, suturing is one of the most difficult surgical tasks and several innovations have been made to make suturing easier for the clinician. In endoscopic surgery, surgical tasks including suturing are substantially more challenging due to limited space, tortuous anatomy, and compliance of the tool. It is therefore desirable to provide a suturing apparatus suitable for use with robotic endoscope platforms or lumens. Disclosure of Invention It is recognized herein that there is a need for a suturing apparatus adapted for robotic endoscopic platform or intracavity use that is reduced in size and improved in efficiency in the workflow. The present disclosure provides an improved suturing apparatus that may simplify the suturing workflow (e.g., closing a wound) of a body lumen (e.g., colon). The stapling instruments herein can have a compact design with a reduced diameter (e.g., no greater than 3 mm, 4 mm, 5 mm, 6 mm, 7 mm, etc.) and a reduced length of the end effector as compared to conventional stapling instruments. The length of the end effector may be reduced by providing a flexible construct in the suturing apparatus, allowing it to be placed through a flexible endoscope (e.g., a colonoscope) and robotically controlled in tortuous anatomy. Unlike conventional suturing apparatuses in which a needle driver is attached to a curved segment at a distal end that acts as an end effector, the flexible configuration of the suturing apparatus herein may advantageously allow for at least a portion of the needle driver to be placed within or co-located with the curved segment of the apparatus such that the effective length of the end effector is reduced. In some embodiments, the suturing apparatus or device may include a needle and a suture. Unlike conventional devices that typically have a free needle and needle driver that require separate introduction of the suture and needle, by including both the needle and suture in the suturing device, it advantageously simplifies the flow of robotic suturing operations. In addition, the needle may be maintained entirely within the suturing apparatus, thereby reducing the risk of damaging the needle, colonoscope, or tissue during needle introduction and removal from the surgical field. In one aspect of the present disclosure, a suturing apparatus is provided. The suturing apparatus includes an elongate member comprising an articulatable curved segment and a shaft, and an end effector comprising a rigid distal portion at a distal end of the curved segment, and a flexible shaft of a needle extending along an entire length of the curved segment. In some embodiments, the rigid distal portion includes a collar retaining mechanism (ferrule retention mechanism) configured to peel the collar from the needle. In some cases, the ferrule holding mechanism includes a toggle to actuate the lever into the ferrule release position and into the ferrule holding position. For example, the collar retaining mechanism is independently controlled relative to the needle drive mechanism. In some embodiments, the needle drive mechanism is located approximately at the distal end of the shaft or at the interface between the proximal end of the articulatable curved segment an