Methods for hyoid suspension

• US 10,182,810 B2
• Filed: 07/01/2016
• Issued: 01/22/2019
• Est. Priority Date: 03/31/2010
• Status: Active Grant

• Current Assignee: Siesta Medical, Inc.
• Original Assignee: Siesta Medical, Inc.
• Inventors: van der Burg, Erik, Martin, Peter, Feezor, Chris, Hirotsuka, Mark, Jackson, Jasper, Cheng, Christopher T., Kolber, Michael, Liston, Adam H.
• Primary Examiner(s): Woo, Julian W
• Application Number:
  US15/201,234
• Publication Number:
  US 20170000477A1
• Time in Patent Office: 935 Days
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 2017/00814 Surgery of the tongue, e.g. glossoplasty
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0461 with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/248 Operations for treatment of snoring, e.g. uvulopalatoplasty
• CPC Class Codes: A61B 2090/309 using white LEDs
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

Suture passer systems for tissue suspension and tissue compression, and more particularly for tongue suspension, are described. The system can include at least a first elongate tubular body or shaft, a needle having a lateral bias carried by the elongate body, and a retrieval element operably connected to the elongate tubular body. The needle can have a substantially straight configuration when located within the elongate tubular body, and be configured to exit an opening at or near a distal end of the elongate tubular body and assume a laterally biased or curved shape to form a path through tissue. The needle is configured to carry a suture. The retrieval element can be configured to retrieve the suture carried by the needle after the needle has formed a curved or otherwise angled path through tissue. The system can also include one or more bone anchors to secure the suture loops. Methods of placing one or more suture loops into tissue, such as the base of the tongue, are also described.

Claims

1. A method of attaching a tension element with respect to a hyoid bone, comprising:

creating a first pathway proximate the hyoid bone;

passing the tension element through the first pathway proximate the hyoid bone and around the hyoid bone;

attaching a bone anchor comprising a locking mechanism to a mandible;

passing the tension element through the locking mechanism after passing the tension element around the hyoid bone;

tensioning the tension element by passing the tension element through at least a portion of the bone anchor, wherein tensioning the tension element thereby moves the hyoid bone; and

activating the locking mechanism, thereby reversibly locking the tension element with respect to the hyoid bone and the mandible.

2. The method of claim 1, further comprising:

deactivating the locking mechanism; and

adjusting the tension of the tension element with respect to the hyoid bone after deactivating the locking mechanism; and

reactivating the locking mechanism.

3. The method of claim 1, wherein passing the tension element through the first pathway comprises looping the tension element around the hyoid bone.

4. The method of claim 1, wherein the method does not comprise tying any knots.

5. The method of claim 1, further comprising providing the tension element comprising a doubled-over length of a suture.

6. The method of claim 1, wherein the tension element comprises a suture.

7. The method of claim 1, wherein the tension element is flexible.

8. The method of claim 1, wherein the tension element comprises a flattened cross-section.

9. The method of claim 1, wherein activating the locking mechanism comprises closing a cam lock.

10. The method of claim 1, wherein passing the tension element through the locking mechanism comprises passing the tension element through an eyelet of the locking mechanism.

11. The method of claim 10, wherein activating the locking mechanism comprises turning a locking screw with respect to an internally threaded surface, thereby reducing the size of the eyelet.

12. A method of attaching a suture with respect to a hyoid bone to treat a condition of an airway, comprising:

passing a suture loop comprising the suture around the hyoid bone;

attaching a bone anchor to a mandible;

after passing the suture loop around the hyoid bone, suspending the hyoid bone by releasably attaching the suture to the bone anchor, wherein the suture can be released from, tensioned, and/or reattached to the bone anchor thereby moving the hyoid bone in a general superior and anterior direction and locking the suture with respect to the hyoid bone and the mandible without tying any knots.

13. The method of claim 12, further comprising detaching the suture from the bone anchor.

14. The method of claim 12, wherein suspending the hyoid bone comprises passing the suture through a locking mechanism connected to the bone anchor, and tensioning the suture.