Tissue fixation devices and methods of fixing tissue

• US 20040133238A1
• Filed: 10/02/2003
• Published: 07/08/2004
• Est. Priority Date: 06/22/1999
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Cerier, Jeffrey C.
• Granted Patent: US 7,846,180 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0474 Knot pushers
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/061 : hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185
• CPC Class Codes: A61B 2017/2905 : flexible
• CPC Class Codes: A61B 2017/2915 : arcuate shaped guiding means
• CPC Class Codes: A61B 2017/2916 : pins in guiding slots
• CPC Class Codes: A61B 2017/2917 : with flexible part
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires

Abstract

A tissue fixation device may include a suture, a first securing element connected to a first portion of the suture, and a second securing element connected to a second portion of the suture. The first and second securing elements are each rotatable from a first position during deployment of the tissue fixation device that is suitable for each securing element to pass through a respective hole formed in tissue to a second position when the tissue fixation device is deployed that inhibits each securing element from passing through the respective hole formed in the tissue. An exemplary method of fixing tissue may include creating two holes in the tissue and deploying a tissue fixation device having a suture connecting two securing elements by advancing each securing element through a respective hole in the tissue and causing each securing element to rotate to a position that inhibits the securing element from passing through the respective hole.

Claims

1. A method of fixing tissue comprising:

creating two holes in the tissue; and

deploying a tissue fixation device having a suture connecting two securing elements by advancing each securing element through a respective hole in the tissue, and

causing each securing element to rotate to a position that inhibits the securing element from passing through the respective hole.

2. The method of claim 1, wherein causing each securing element to rotate comprises rotating each securing element from a position at least substantially parallel to the respective holes in the tissue to a position at least substantially perpendicular to the respective holes in the tissue.

3. The method of claim 1, wherein each securing element is advanced through a respective hole as the respective hole is created.

4. A method of fixing tissue with a tissue fixation device having a suture connected to a securing element, the method comprising:

creating a hole in the tissue by advancing the securing element through the tissue using a deployment instrument; and

deploying the tissue fixation device by

separating the securing element from the deployment instrument, and

configuring the securing element to inhibit the securing element from passing through the hole.

5. The method of claim 4, wherein configuring the securing element comprises rotating the securing element into a position that inhibits the securing element from passing through the hole.

6. The method of claim 4, further comprising creating a hole in one or more pledgets by advancing the securing element through the one or more pledgets using the deployment instrument.

7. A tissue fixation device comprising:

a suture;

a first pledget having at least one through hole formed therein, a first portion of the suture passing through the at least one through hole in the first pledget and a second portion of the suture configured to inhibit the second portion from passing through the at least one through hole in the first pledget;

a second pledget having at least one through hole formed therein, the first pledget being spaced apart from the second pledget to receive tissue therebetween when the tissue fixation device is deployed;

a first securing element connected to a portion of the suture, the first securing element being rotatable from

a first orientation in which the securing element is oriented at least substantially parallel to the at least one through hole formed in the first pledget and the second pledget, to

a second orientation in which the securing element is oriented at least substantially perpendicular to the at least one through hole in the second pledget.

8. The tissue fixation device of claim 7, further comprising a second suture and a second securing element connected to a portion of the second suture.

9. The tissue fixation device of claim 8, wherein a first portion of the second suture passes through a second through hole in the first pledget and a second portion of the suture is configured to inhibit the second portion of the suture from passing through the second through hole in the first pledget.

10. The tissue fixation device of claim 9, wherein the second securing element is rotatable from

a first position in which the second securing element is oriented at least substantially parallel to the second through hole in the first pledget and a second through hole in the second pledget to

a second position in which the securing element is oriented at least substantially perpendicular to the second through hole in the second pledget.

11. A tissue fixation device comprising:

a suture;

a first securing element connected to a first portion of the suture; and

a second securing element connected to a second portion of the suture, each said first and second securing elements being rotatable from a first position during deployment of the tissue fixation device that is suitable for each securing element to pass through a respective hole formed in tissue to a second position when the tissue fixation device is deployed that inhibits each securing element from passing through the respective hole formed in the tissue.

12. The tissue fixation device of claim 11, wherein the first and second securing elements are spaced apart from a third portion of the suture when the tissue fixation device is deployed, the tissue being fixed between the securing elements and the third portion during deployment.

13. The tissue fixation device of claim 12, wherein a portion of the suture is coupled to another portion of the suture.

14. The tissue fixation device of claim 13, wherein the portions are coupled by knotting.

15. The tissue fixation device of claim 13, wherein the portions are coupled by welding.

16. The tissue fixation device of claim 13, wherein the first portion of the suture passes through openings in the first securing element.

17. The tissue fixation device of claim 16, wherein the second portion of the suture passes through openings in the second securing element.

18. The tissue fixation device of claim 11, further comprising a first pledget having a plurality of through holes formed therein, the suture passing through the through holes in the first pledget.

19. The tissue fixation device of claim 18, further comprising a second pledget having a plurality of through holes formed therein, the suture passing through the through holes in the second pledget, the second pledget being spaced apart from the first pledget when the tissue fixation device is deployed.

20. The tissue fixation device of claim 18, wherein the suture passes through the through holes as to enable the pledget to be positioned between the first and second securing elements and the tissue when the tissue fixation device is deployed.

21. The tissue fixation device of claim 18, wherein the suture has two ends, and both ends are disposed on the same side of the first pledget.

22. The tissue fixation device of claim 11, wherein the first securing element and the second securing element are oriented at least substantially parallel to the holes in the tissue in the first position.

23. The tissue fixation device of claim 11, wherein the first securing element and the second securing element are oriented at least substantially perpendicular to the holes in the tissue in the second position.

24. The tissue fixation device of claim 11, wherein the first securing element and the second securing element are each generally cylindrical in shape.

25. The tissue fixation device of claim 11, wherein each said first securing element and second securing element includes a sharp tip.

26. The tissue fixation device of claim 11, wherein each said first securing element and second securing element have an elongated shape such that the long axis of the securing element is larger than the diameter of the respective hole.

27. The tissue fixation device of claim 11, wherein the suture is endless.

28. The tissue fixation device of claim 11, wherein the suture forms a closed loop.

29. A tissue fixation device comprising:

a suture; and

a first securing element having a proximal end and a distal end, the first securing element being coupled to a first portion of the suture, the distal end of the first securing element having a sharp tip, the proximal end of the first securing element being configured for removable attachment to a deployment instrument, the first securing element being configured to secure the tissue fixation device to a distal side of tissue,

the suture having a proximal portion configured to so secure the tissue fixation device at a proximal side of the tissue during deployment as to fix the tissue between the first securing element and the proximal portion of the suture.

30. The tissue fixation device of claim 29, further comprising a second securing element having a proximal end and distal end, the second securing element being coupled to a second portion of the suture, the distal end of the of the second securing element having a sharp tip.

31. The tissue fixation device of claim 30, wherein the first securing element and the second securing element are each rotatable from a first position that is suitable for each securing element to pass through a respective hole formed in the tissue to a second position that inhibits each securing element from passing through the respective hole formed in the tissue.

32. The tissue fixation device of claim 30, wherein the suture is arranged in a loop such that a portion of the suture is coupled to another portion of the suture.

33. The tissue fixation device of claim 32, wherein the portions are coupled by knotting.

34. The tissue fixation device of claim 32, wherein the portions are coupled by welding.

35. The tissue fixation device of claim 32, wherein the first portion of the suture passes through openings in the first securing element to connect the suture to the first securing element.

36. The tissue fixation device of claim 35, wherein the second portion of the suture passes through openings in the second securing element to connect the suture to the second securing element.

37. The tissue fixation device of claim 30, further comprising a first pledget having a plurality of through holes formed therein, the suture passing through the through holes in the first pledget.

38. The tissue fixation device of claim 37, further comprising a second pledget having a plurality of through holes formed therein, the suture passing through the through holes in the second pledget, the second pledget being spaced apart from the first pledget when the tissue fixation device is deployed to receive tissue therebetween.

39. The tissue fixation device of claim 30, wherein the first securing element and the second securing element are each integrally coupled to the deployment instrument and configured to separate from the instrument during deployment.

40. The tissue fixation device of claim 30, wherein each securing element is generally cylindrical in shape and the proximal end of each securing element includes a reduced diameter portion for removable attachment to deployment instrument.

41. A tissue fixation device comprising:

a suture;

a first pledget having a plurality of through holes formed therein, the suture passing through the through holes in the first pledget;

a second pledget having a plurality of through holes formed therein, the first pledget being spaced apart from the second pledget to receive tissue therebetween when the tissue fixation device is deployed;

a first securing element having a sharp tip and a proximal end configured for removable attachment to an instrument, the first securing element being coupled to the suture; and

a second securing element having a sharp tip and a proximal end configured for removable attachment to an instrument, the second securing element being coupled to the suture.